Trandolapril and Eprosartan: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Eprosartan
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 adverse events (ie, hypotension, syncope, hyperkalemia, changes in renal function, acute renal failure)
Interaction Deep Dive
Dual blockade of the renin-angiotensin-aldosterone system with concomitant use of an ACE inhibitor and an angiotensin receptor blocker (ARB) was associated with an increased incidence of side effects. In patients with established atherosclerotic disease, heart failure, or diabetes with end organ damage, coadministration of an ACE inhibitor and an ARB resulted in an increased incidence of hypotension, syncope, hyperkalemia, and changes in renal function (including acute renal failure) as compared with either agent alone4. Concomitant use should generally be avoided; however, should coadministration be necessary, closely monitor blood pressure, renal function, and electrolytes 3. In a meta-analysis in patients with left ventricular dysfunction, the addition of an ACE inhibitor to ARB therapy was associated with an increased overall risk of adverse events leading to discontinuation of therapy compared with ACE inhibitor therapy alone 1.
Why it happens (mechanism)
Dual blockade of the renin-angiotensin-aldosterone system
Literature reports
1 report — tap to read
a) A systematic review and meta-analysis of 18,160 patients with heart failure or left ventricular dysfunction from 9 randomized trials revealed the addition of angiotensin receptor blocker (ARB) to ACE inhibitor therapy was associated with an increased risk of adverse events leading to discontinuation of therapy compared with ACE inhibitor therapy alone. All patients had a NYHA functional class II to IV heart failure, an ejection fraction of 45% or below, or had left ventricular dysfunction acutely postmyocardial infarction. Losartan, candesartan, valsartan, irbesartan, and telmisartan were involved. The follow-up duration varied from 4 weeks to 41 months. Analysis revealed combination therapy increased the risk of developing any adverse effect by 2.3%. The risk of hypotension increased 1.1%, risk of worsening renal function increased 1%, and risk of hyperkalemia increased 0.6%. However, the risk of angioedema or cough did not significantly differ between treatment arms. If combination strategy is warranted, patients should be monitored closely for potential adverse effects 1.
Common questions
Can I take Trandolapril and Eprosartan together?
Increased risk of adverse events (ie, hypotension, syncope, hyperkalemia, changes in renal function, acute renal failure) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Trandolapril and Eprosartan interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Trandolapril or Eprosartan 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 a safer alternative to one of these medications for me?
References (4)
- Lakhdar R, Al-Mallah MH, & Lanfear DE: Safety and tolerability of angiotensin-converting enzyme inhibitor versus the combination of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker in patients with left ventricular dysfunction. J Card Fail 2008; 14(3):181-188.
- Product Information: Lotensin(R) oral tablets, benazepril HCl oral tablets. Validus Pharmaceuticals LLC (per FDA), Parsippany, NJ, 2014. DailyMed
- Product Information: EXFORGE oral tablets, amlodipine valsartan oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2019. DailyMed
- Product Information: COZAAR(R) oral tablets, losartan potassium oral tablets. Merck Sharp & Dohme Corp. (per FDA), Whitehouse Station, NJ, 2011. DailyMed
Keep reading about Eprosartan
Keep reading about Trandolapril
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