Trandolapril and Capsaicin Topical: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Capsaicin Topical
Trandolapril
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of cough
Interaction Deep Dive
One case of cough associated with the use of capsaicin cream during ACE inhibitor therapy has been reported1. Substance P is partially metabolized by ACE inhibitors; accumulation of its metabolites is thought to lead to local irritation of the respiratory tract causing cough 23. This, in addition to accumulation of bradykinin as a result of ACE inhibitor therapy, may increase the risk of cough.
Why it happens (mechanism)
Respiratory tract irritation by substance P metabolites
Literature reports
1 report — tap to read
a) A 53-year-old Caucasian female maintained on an ACE inhibitor for several years experienced cough upon topical administration of capsaicin 0.075% cream to her lower extremities. She had not previously experience cough associated with ACE inhibitor therapy. Cough recurred with each topical application of capsaicin and was of sufficient severity to limit the use of the cream 1.
Common questions
Can I take Trandolapril and Capsaicin Topical together?
Increased risk of cough Always confirm with your pharmacist or prescriber before making any change.
How serious is the Trandolapril and Capsaicin Topical interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Trandolapril or Capsaicin Topical need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (3)
- Hakas JF: Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990; 65:322.
- O'Hollaren MT & Porter GA: Topical capsaicin induces cough in patient receiving ACE inhibitor (response). Ann Allergy 1990; 65:322-23.
- Fuller RW, Maxwell DL, & Dixon CMS: Effects of substance P on cardiovascular and respiratory function in human subjects. J Appl Physiol 1987; 62:1473-79.
Keep reading about Capsaicin Topical
Keep reading about Trandolapril
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