Warnings and Precautions With Trandolapril (Cont.)

• There are a number of medicines that trandolapril can potentially interact with (see Drug Interactions With Trandolapril).
   
• ACE inhibitors are more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people on trandolapril during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings.

Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.

• ACE inhibitors may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans. Seek emergency medical care immediately if you notice swelling in the head or neck area, or if you experience wheezing or difficulty breathing or swallowing.
   
• In addition to head and neck angioedema, ACE inhibitors have also been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, stomach pain with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
   
• Trandolapril may cause extremely low blood pressure in some people. Extremely low blood pressure is more likely to happen in people who are on dialysis or taking a diuretic, who have diarrhea or vomiting, or who sweat a lot. This is why it is important to drink fluids regularly while taking trandolapril. If you have any possible symptoms of extremely low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider and stop taking the medicine.

Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how trandolapril affects you.

• People on trandolapril can be at increased risk of infections. Talk with your healthcare provider if you develop any infections, such as a sore throat or fever.
   
• Trandolapril is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that trandolapril has health risks to your unborn child. Prior to taking trandolapril, let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking trandolapril, contact your healthcare provider immediately (see Mavik and Pregnancy for more information).
   
• ACE inhibitors, including trandolapril, are known to cause a cough. If a cough becomes bothersome, talk to your healthcare provider about alternate options for your condition (see Mavik Cough).
   
• While taking trandolapril, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. This is because potassium in the blood can increase to dangerous levels in some people taking trandolapril.
   
• ACE inhibitors, including trandolapril, have been known to cause a decrease in kidney function, especially in certain groups, such as those with severe congestive heart failure. Let your healthcare provider know if you have symptoms such as a decrease in urine output, drowsiness, headache, or back pain. Your healthcare provider will also regularly check your kidney function with a blood test.
   
• If you have kidney disease or kidney failure, your body may metabolize the trandolapril differently than intended. Therefore, your healthcare provider will monitor your situation more closely.
   
• In clinical studies, ACE inhibitors, including trandolapril, have rarely been known to cause liver failure. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
   
• It is not known whether or not trandolapril passes through breast milk. Therefore, if you are nursing and taking trandolapril, talk with your healthcare provider about whether you should discontinue trandolapril or stop breastfeeding.