Drug General Information (ID: DDIGL1Z6UD)
Drug Name			Trandolapril		Drug Info		Tacrolimus		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Immunosuppressive Agents
Structure

Mechanism of Trandolapril-Tacrolimus Interaction (Severity Level: Moderate)
Increased risk of hyperkalemia Click to Show/Hide Mechanism Graph
Drug Name		Trandolapril				Tacrolimus
Mechanism		Hyperkalemia				Hyperkalemia
Key Mechanism Factor 1
		Factor Name		Hyperkalemia
		Factor Description		Hyperkalemia is a condition in which the level of potassium in the blood is higher than normal. While mild cases may not produce symptoms, severe hyperkalemia can lead to fatal arrhythmias if left untreated.
Mechanism Description		Increased risk of hyperkalemia by the combination of Trandolapril and Tacrolimus

Recommended Action
Management		Serum potassium levels and renal function should be monitored regularly when tacrolimus is used in combination with ACE inhibitors or angiotensin II receptor antagonists. Particular caution is warranted in patients with renal impairment, diabetes, old age, severe or worsening heart failure, or dehydration. Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as nausea, vomiting, weakness, listlessness, tingling of the extremities, paralysis, confusion, weak pulse, and a slow or irregular heartbeat.

References
1	Perazella MA "Drug-induced hyperkalemia: old culprits and new offenders." Am J Med 109 (2000): 307-14. [PMID: 10996582]
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".