General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hypotensive effects magnified by natriuretic agents or sodium depletion. May cause hyperkalemia, metabolic acidosis. Acute renal dysfunction with bilateral or transplant renal artery stenosis, low renal perfusion pressure. Dry cough in 5-10% of patients.
Half-Life (Normalesrd) Hours
6-10/No data
Plasma Protein Binding %
65-94
Volume Of Distribution L/Kg
0.26
Dose For Normal Renal Function
1-2 mg q24h
Second Dose
Second Dose: 1-4 mg q24h
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
50-100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None, [D]
Supplement For Dialysis [Recommendation Level]: Pd
PD: None, [D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 100% dose, doses do not need adjustment until GFR <30, [D]
References
Bevan EG, McInnes GT, Aldigier JC, Conte JJ, Grunfeld JP, Harper SJ, et al. Effect of renal function on the pharmacokinetics and pharmacodynamics of trandolapril. Br J Clin Pharmacol. 1993; 35: 128-35. [PMID: 8443030] / Danielson B, Querin S, LaRochelle P, Sultan E, Mouren M, Bryce T, et al. Phar-macokinetics and pharmacodynamics of trandolapril after repeated administration of 2 mg to patients with chronic renal failure and healthy control subjects. J Cardiovasc Pharmacol. 1994; 23 Suppl 4: S50-9. [PMID: 7527102]
Toxicity Notes
Titrate based on blood pressure response.