An ACE inhibitor for blood pressure and the heart
Trandolapril
A once-daily ACE inhibitor that lowers blood pressure and protects the heart, with a dry cough, dizziness on the first doses and the need for kidney and potassium checks the main considerations.
What is Trandolapril?
Trandolapril is an ACE inhibitor used to treat high blood pressure and to protect the heart after a heart attack. It is taken once a day and works by relaxing the blood vessels, with a persistent dry cough, dizziness when first starting and the need for kidney and potassium blood tests being the main things to be aware of. It must not be used in pregnancy.
Education and reference only. This is a plain-language guide to Trandolapril — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Trandolapril is an angiotensin-converting enzyme (ACE) inhibitor. It is used to lower high blood pressure and to support the heart in people who have had a heart attack with reduced heart function. In the UK it is sold as Gopten and as a generic medicine.
How it works
Trandolapril blocks the enzyme that makes angiotensin II, a hormone that narrows blood vessels and makes the body hold on to salt and water. By reducing angiotensin II, it relaxes and widens the blood vessels, lowers blood pressure and eases the workload on the heart.
Company & origin
Originated / developed by: Marketed in the UK as Gopten and as generic trandolapril..
Trandolapril is an ACE inhibitor introduced in the 1990s and used in the UK to treat high blood pressure and protect the heart after a heart attack.
What it treats
Conditions Trandolapril is used for
Practical use
How to take Trandolapril
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it once a day, at about the same time each day.
- It can be taken with or without food.
- Consider taking the first dose at bedtime, as it may cause dizziness when you start.
- Stand up slowly from sitting or lying down, especially in the first days of treatment.
- If you miss a dose, take it when you remember unless it is nearly time for the next one; do not double up.
- Do not stop taking it suddenly without speaking to your doctor, even if you feel well.
Weighing it up
Advantages & disadvantages of Trandolapril
Advantages
- Once-daily dosing for steady blood-pressure control.
- Protects the heart and kidneys, particularly useful in people with diabetes or after a heart attack.
- Well established and available cheaply as a generic medicine.
- Does not usually cause weight gain or affect cholesterol.
Disadvantages
- Commonly causes a persistent dry, tickly cough that can be troublesome.
- Can cause dizziness or fainting, especially with the first dose.
- Needs blood tests to monitor kidney function and potassium levels.
- Must be stopped and avoided in pregnancy.
- Rarely causes angioedema, a serious swelling of the face, lips or throat.
Practical use
Good to know
Trandolapril is taken once a day and is usually a long-term medicine. The first dose can make you feel dizzy, so many people take it at bedtime to start with, and you will have blood tests to check your kidneys and potassium soon after starting.
Who should not take it / use with caution
- Women who are pregnant, planning pregnancy or breastfeeding.
- Anyone who has had angioedema (severe swelling) with an ACE inhibitor before.
- People with narrowing of the arteries to both kidneys.
- People with significant kidney problems or high potassium levels, who need careful supervision.
- Those taking certain potassium-raising medicines or salt substitutes containing potassium.
Monitoring
- Blood pressure to check it is well controlled.
- Kidney function and potassium before starting and shortly after starting or changing the dose.
- Watch for a troublesome cough or any swelling of the face or throat.
- Review during illness with vomiting or diarrhoea, when it may need to be paused.
Side effects
- A persistent dry cough.
- Dizziness or light-headedness, especially when standing up or after the first dose.
- Headache, tiredness or a raised potassium level.
- Changes in kidney function shown on blood tests.
- Rare but serious: angioedema (swelling of the face, lips, tongue or throat) needing emergency help, or a severe allergic reaction.
Key interactions
- Other blood-pressure medicines, which add to the lowering effect.
- Potassium supplements, potassium-sparing diuretics such as spironolactone, and potassium-containing salt substitutes, which raise potassium.
- NSAIDs such as ibuprofen, which can reduce its effect and harm the kidneys.
- Lithium, whose levels can rise.
- Other medicines acting on the same system (ARBs or aliskiren), which are generally not combined with it.
Available as: Capsules.
Answers
Trandolapril: frequently asked questions
Why does trandolapril cause a cough?
ACE inhibitors can lead to a build-up of substances in the airways that trigger a dry, tickly cough. If it becomes troublesome, your doctor may switch you to a similar medicine called an ARB.
Why might I feel dizzy when I start trandolapril?
The first dose can lower your blood pressure noticeably, which may cause dizziness. Taking it at bedtime to start with and standing up slowly can help.
Can I take trandolapril in pregnancy?
No. ACE inhibitors can harm an unborn baby and must not be used in pregnancy. Tell your doctor straight away if you are pregnant or planning to be.
Do I need blood tests with trandolapril?
Yes. You will have blood tests to check your kidney function and potassium level before and after starting, and from time to time afterwards.
Can I take ibuprofen with trandolapril?
It is best avoided where possible, as anti-inflammatory painkillers can reduce the medicine's effect and increase the risk of kidney problems. Ask your pharmacist for advice on painkillers.
The wider class
About ACE inhibitors
Trandolapril belongs to the ace inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.