Trandolapril-Verapamil

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Drug Information

Common brand names:

Tarka

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Zinc

    In a study of 34 people with hypertension, six months of captopril or enalapril (ACE inhibitors related to trandolapril) treatment led to decreased zinc levels in certain white blood cells, raising concerns about possible ACE inhibitor–induced zinc depletion.

    While zinc depletion has not been reported with ramipril, until more is known, it makes sense for people taking trandolapril long term to consider, as a precaution, taking a zinc supplement or a multimineral tablet containing zinc. (Such multiminerals usually contain no more than 99 mg of potassium, probably not enough to trigger the above-mentioned interaction.) Supplements containing zinc should also contain copper, to protect against a zinc-induced copper deficiency.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • Fiber

    Constipation is a common side effect of verapamil treatment. Increasing fluid and fiber intake can ease constipation.

  • Iron

    In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous sulfate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • Potassium

    An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels. This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), or large amounts of high-potassium foods (such as bananas and other fruit) at the same time as taking ACE inhibitors could cause life-threatening problems. Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

  • Vitamin D

    Vitamin D may interfere with the effectiveness of verapamil. People taking verapamil should ask their doctor before using vitamin D-containing supplements.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • Grapefruit

    Grapefruit juice may increase verapamil blood levels. The importance of this interaction regarding verapamil effectiveness and side effects is unknown. Until more is known, it makes sense for people taking this drug to either avoid drinking grapefruit juice entirely or drink grapefruit juice only under the careful monitoring and supervision of the prescribing doctor. In theory, this last possibility might allow for a decrease in drug dose, but it could be dangerous in the absence of diligent monitoring. The same effects might be seen from eating grapefruit as from drinking its juice.

  • Pleurisy Root

    As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as calcium channel blockers.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Pomegranate

    Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice. The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with verapamil in the same way that grapefruit juice does.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.