Drug Interaction Report

Trandolapril and Everolimus: Interaction Details

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

Everolimus

Afinitor Afinitor Disperz® Afinitor® Torpenz Zortress Zortress®
+

Trandolapril

Mavik®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close 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, 16 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
delayed
Evidence
established
Severity
Major

What happens

Increased risk of angioedema

Interaction Deep Dive

Use caution with the concomitant use of an ACE inhibitor and a mammalian target of rapamycin (mTOR) inhibitor, as this may increase the risk of angioedema. The incidence of angioedema with this combination in a study was 6.6%. Consider avoiding this combination by using an angiotensin receptor blocker (ARB) instead of an ACE inhibitor; patients receiving and ARB plus either everolimus or sirolimus had a reported angioedema incidence of 0.8%1.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) A retrospective study found the incidence of angioedema in patients taking both an ACE inhibitor and a mammalian target of rapamycin (mTOR) inhibitor to be 6.6%. Mean time to onset was 123 days, and most cases were mild to moderate and resolved with steroids and/or drug discontinuation. The incidence of angioedema in patients receiving mTOR inhibitors without an ACE inhibitor was 1.9%, and in 2 previous studies the reported incidence of ACE inhibitor-induced angioedema ranged from 0.3% to 0.68%. The incidence in patients receiving an angiotensin receptor blocker plus an mTOR inhibitor was 0.8% 1.

Common questions

Can I take Trandolapril and Everolimus together?

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

How serious is the Trandolapril and Everolimus interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

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 Everolimus 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 (1)

  1. Duerr M, Glander P, Diekmann F, et al: Increased incidence of angioedema with ACE inhibitors in combination with mTOR inhibitors in kidney transplant recipients. Clin J Am Soc Nephrol 2010; 5(4):703-708. PubMed
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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:

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.