When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to verapamil, trandolapril or another ACE inhibitor, or you are pregnant.

How to Use This Medicine:
Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• It is best to take this medicine with food or milk.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with aliskiren if you have diabetes.
• Some foods and medicines can affect how trandolapril/verapamil works. Tell your doctor if you are using any of the following:
  
  • Almotriptan, buspirone, carbamazepine, clarithromycin, colchicine, cyclosporine, digoxin, doxorubicin, erythromycin, everolimus, imipramine, ivabradine, lithium, midazolam, phenobarbital, rifampin, ritonavir, sirolimus, St John's wort, sulfinpyrazone, tacrolimus, telithromycin, temsirolimus, theophylline
  • Another blood pressure medicine, including an angiotensin receptor blocker (ARB) or a beta-blocker
  • Diuretic (water pill, including amiloride, spironolactone, triamterene)
  • Insulin or diabetes medicine (including glyburide)
  • Medicine for heart rhythm problems (including disopyramide, flecainide, quinidine)
  • Medicine to lower cholesterol (including atorvastatin, lovastatin, simvastatin)
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
• Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney problems, liver disease, diabetes, heart failure, heart disease, heart rhythm problems (such as PR interval prolongation), or an autoimmune disorder.
• This medicine may cause the following problems:
  
  • Angioedema (severe swelling)
  • Serious liver problems
  • Kidney problems
• This medicine could lower your blood pressure too much, especially when you first use it or if you are dehydrated. Stand or sit up slowly if you are dizzy or lightheaded.
• Do not stop using this medicine without asking your doctor, even if you feel well. This medicine will not cure your high blood pressure, but it will help keep it in the normal range. You may have to take blood pressure medicine for the rest of your life.
• Tell any doctor or dentist who treats you that you are using this medicine.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Chest pain that may spread, trouble breathing, unusual sweating, fainting
• Confusion, weakness, uneven heartbeat, numbness or tingling in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fever, chills, sore throat, and body aches
• Lightheadedness, dizziness, or fainting

If you notice these less serious side effects, talk with your doctor:

• Dry cough
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088