Drug Interaction Report

Trandolapril and Capsaicin Transdermal Patch: Interaction Details

A pharmacist-reviewed analysis of the Trandolapril and Capsaicin Transdermal Patch interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Capsaicin Transdermal Patch

Aspercreme Warming® Patch Coralite ® Medicated Heat Patch Medirelief Hot® Patch Qutenza Qutenza® Patch Salonpas Pain Relieving Hot® Patch Satogesic Hot Satogesic Hot® Patch
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Trandolapril

Mavik®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 62 documented Trandolapril interactions, 45 are rated moderate — including this one.
Onset
rapid
Evidence
probable
Severity
Moderate

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 Transdermal Patch together?

Increased risk of cough Always confirm with your pharmacist or prescriber before making any change.

How serious is the Trandolapril and Capsaicin Transdermal Patch 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 Transdermal Patch 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)

  1. Hakas JF: Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990; 65:322.
  2. O'Hollaren MT & Porter GA: Topical capsaicin induces cough in patient receiving ACE inhibitor (response). Ann Allergy 1990; 65:322-23.
  3. 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.
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Capsaicin Transdermal Patch

Keep reading about Capsaicin Transdermal Patch

All Capsaicin Transdermal Patch interactions (79) Capsaicin Transdermal Patch drug information
Trandolapril

Keep reading about Trandolapril

All Trandolapril interactions (62) Trandolapril drug information
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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Trandolapril + Activated Charcoal American Hellebore American Mistletoe Asarabacca Siberian Cocklebur Tyramine Adrafinil Agmatine + 141 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.