Drug General Information (ID: DDI5R4PQ68)
Drug Name			Trandolapril		Drug Info		Fluorescein		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Diagnostic Agents
Structure

Mechanism of Trandolapril-Fluorescein Interaction (Severity Level: Moderate)
Increased risk of angioedema/anaphylactoid reactions Click to Show/Hide Mechanism Graph
Drug Name		Trandolapril				Fluorescein
Mechanism		Anaphylactoid reactions				Anaphylactoid reactions
Key Mechanism Factor 1
		Factor Name		Angioedema/anaphylactoid reactions
		Factor Description		Anaphylactoid reaction is a condition in which symptoms similar to an allergic reaction occur, but no immune sensitization is detected. Most commonly, the syndrome begins with skin involvement, usually pruritus, flushing, urticaria, or angioedema. Angioedema is a reaction to a trigger that causes swelling of the tissue below the inner layer of the skin, called the dermis or submucosa, and the swelling can occur on the face, throat, or around the genitals.
Mechanism Description		Increased risk of angioedema by the combination of Trandolapril and Fluorescein

Recommended Action
Management		Patients should be closely monitored for signs of severe, acute hypersensitivity reactions during fluorescein injection, and facilities and equipment for resuscitation, cardiovascular support, and airway management should be immediately available. Clinicians should be aware that larger doses of epinephrine or other adrenergic agents may be required.

References
1	Ray K, Dorman S, Watson R "Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction." J Hum Hypertens 13 (1999): 717-20. [PMID: 10516744]
2	Product Information. Vasotec (enalapril). Merck &amp Co, Inc, West Point, PA.
3	Product Information. AK-Fluor (fluorescein). Akorn Inc, Buffalo Grove, IL.