Drug General Information (ID: DDIYDU9RFE)
Drug Name			Trandolapril		Drug Info		Irbesartan		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antihypertensive Agents
Structure

Mechanism of Trandolapril-Irbesartan Interaction (Severity Level: Major)
Increased risk of hyperkalemia Click to Show/Hide Mechanism Graph
Drug Name		Trandolapril				Irbesartan
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 Irbesartan

Recommended Action
Management		Dual blockade of the renin-angiotensin-aldosterone system by adding an ACE inhibitor to an angiotensin II receptor antagonist is not recommended, especially in patients with diabetic nephropathy. Routine monitoring of electrolytes and renal function may be indicated in the elderly or patients with worsening heart failure or a risk for dehydration. Potassium supplementation should generally be avoided unless it is closely monitored, and patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as weakness, listlessness, confusion, tingling of the extremities, and irregular heartbeat.

References
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9	EMA. European Medicines Agency "PRAC recommends against combined use of medicines affecting the renin-angiotensin (RAS) system: recommendation will now be considered by CHMP for final opinion." .
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