Active Ingredient: Trandolapril

Indication for Trandolapril

Population group: only adults (18 years old or older)
Therapeutic intent: Curative procedure

All grades of essential hypertension. Trandolapril may be used alone or in combination with other antihypertensive agents.

For this indication, competent medicine agencies globally authorize below treatments:

0.5 mg once daily and thereafter 0.5-4 mg once daily


Dosage regimens

Oral, 0.5 milligrams trandolapril, once daily. Afterwards, oral, between 0.5 milligrams trandolapril and 4 milligrams trandolapril, once daily. The maximum allowed total dose is 4 milligrams trandolapril daily.

Detailed description

For adults not taking diuretics, without congestive heart failure and without renal or hepatic insufficiency, the recommended initial dosage is 0.5 mg as a single daily dose. A 0.5 mg dose will only achieve a therapeutic response in a minority of patients. Dosage should be doubled incrementally at intervals of 2 to 4 weeks, based on patient response, up to a maximum of 4 mg as a single daily dose.

The recommended maintenance dose range is 1 to 2 mg as a single daily dose. If the patient response is still unsatisfactory at a dose of 4 mg trandolapril, combination therapy should be considered with diuretics and calcium channels blockers.


Normally no dose reduction is needed. Pharmacokinetic studies of hypertensive patients over 65 who have normal kidney function for their age indicate that dose adjustment is not necessary. As some elderly patients may, however, be especially sensitive to ACE inhibitors, it is recommended initially to use low doses and to monitor the blood pressure response and the kidney function.

Caution must be exercised in older patients with concurrent diuretic treatment, congestive heart failure or renal or hepatic insufficiency. The dose should be adjusted according to the blood pressure response.

Dosage considerations

Trandolapril may be taken before, during or after a meal.

Active ingredient


Trandolapril is a prodrug, which is rapidly, non-specifically hydrolysed to its potent, long-acting active metabolite, trandolaprilat (other metabolites are inactive) and acts as an orally-active angiotensin converting enzyme inhibitor (ACE inhibitor) without a sulphydryl group. In addition to inhibition of plasma ACE, trandolapril has been experimentally shown to inhibit tissue ACE (particularly vascular, cardial and adrenal). The clinical relevance of tissue ACE inhibition has not been established in humans.

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