II. Indications

III. Mechanism

  1. See ACE Inhibitor
  2. Non-sulfhydryl Angiotensin Converting Enzyme (ACE) inhibitor
  3. Trandolapril is a prodrug, converted to its active form Trandolaprilat in the liver via de-esterification

IV. Dosing: Adults

  1. Adequate 24 hour Blood Pressure control may require twice daily dosing
  2. Hypertension
    1. Start 1 mg orally daily or divided twice daily
      1. Start 0.5 mg/day in renal dysfunction or comorbid Diuretic use
    2. Target 2 to 4 mg orally daily
  3. Congestive Heart Failure (CHF) or post-Myocardial Infarction
    1. Start 0.5 to 1 mg orally daily
    2. Titrate to target 4 mg orally daily
  4. Maximum: 8 mg/day (but no benefit above 4 mg/day)

V. Supplied

  1. Available as generic scored tablet (1 mg) and unscored tablet (2 and 4 mg)

VI. Metabolism

  1. Excretion 66% hepatic and 33% renal

VII. Adverse Effects

VIII. Safety

  1. See ACE Inhibitor
  2. Pregnancy Category X
  3. Avoid in Lactation

X. References

  1. (2016) Presc Lett, Resource #321151, ACE Inhibitor Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 68-9
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

trandolapril (on 4/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TRANDOLAPRIL 1 MG TABLET Generic $0.21 each
TRANDOLAPRIL 2 MG TABLET Generic $0.17 each
TRANDOLAPRIL 4 MG TABLET Generic $0.24 each

Ontology: trandolapril (C0076891)

Definition (NCI) A non-sulfhydryl angiotensin-converting enzyme (ACE) inhibitor with antihypertensive activity. As a prodrug, trandolapril is converted by de-esterification in the liver into its active form trandolaprilat. Trandolaprilat competitively binds to and inhibits ACE, thereby blocking the conversion of angiotensin I to angiotensin II. This prevents the potent vasoconstrictive actions of angiotensin II and results in vasodilation. Trandolaprilat also decreases angiotensin II-induced aldosterone secretion by the adrenal cortex, which leads to an increase in sodium excretion and subsequently increases water outflow.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C052035
SnomedCT 108562001, 386871006
English 1-(2-((1-(ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)octahydro-1H-indol-2-carboxylic acid, trandolapril, trandolapril (medication), trolandapril, TRANDOLAPRIL, trandolapril [Chemical/Ingredient], Trandolapril, Trandolapril (product), Trandolapril (substance)
Spanish trandolaprilo, trandolapril (producto), trandolapril (sustancia), trandolapril

Ontology: Mavik (C0721596)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C052035
English Mavik, mavik, Gopten, Knoll brand of trandolapril, Abbott brand of trandolapril