Delving into the Latest Updates on Trandolapril/Verapamil Hydrochloride with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Ocadrik, Tarka, Trandolapril/verapamil

+ [1]

Target

ACE x VDCCs

Action

inhibitors, blockers

Mechanism

ACE inhibitors(Angiotensin-converting enzyme inhibitors), VDCCs blockers(Voltage-gated calcium channel blockers)

Therapeutic Areas

Cardiovascular Diseases

Active Indication

Hypertension

Inactive Indication-

Originator Organization

AbbVie, Inc.

Active Organization

Viatris Pty Ltd.

Inactive Organization

AbbVie, Inc.

Drug Highest PhaseApproved

First Approval Date

United States (22 Oct 1996),

Hypertension

Regulation-

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Structure/Sequence

Molecular FormulaC24H34N2O5

InChIKeyVXFJYXUZANRPDJ-WTNASJBWSA-N

CAS Registry87679-37-6

View All Structures (2)

INTRODUCTIONTarka (trandolapril/verapamil hydrohloride extended-release) is a fixed-dose combination antihypertensive drug formed from verapamil hydrochloride and trandolapril. Toxicologic manifestations of Tarka overdose are altered mental status, bradycardia, hypotension, atrioventricular block (first-degree), hyperglycemia, metabolic acidosis, and shock.CASE PRESENTATIONWe report a case of Tarka toxicity in a 2-year-old girl who presented with altered mental status, cardiogenic shock, hypotension, bradycardia, severe metabolic acidosis, hyperglycemia, and first-degree atrioventricular block. We started fluid resuscitation, epinephrine, norepinephrine, and insulin. Because of the patient's hyperlactatemia and hypotension despite standard therapies, we initiated intravenous lipid emulsion (ILE) therapy, after which her condition improved promptly.DISCUSSIONTarka overdose may be life-threatening as it can cause cardiogenic shock. In our patient, the regression of lactate elevation in a short time with ILE therapy and the improvement of her general condition highlight the importance of ILE.CONCLUSIONSILE is an alternative treatment method for acute lipophilic drug intoxications, such as Tarka.

01 Sep 2011·Human & Experimental ToxicologyQ4 · MEDICINE

Tarka® overdose in a young child

Q4 · MEDICINE

Article

Author: Uner, Abdurrahman ; Caksen, Huseyin ; Doğan, Murat ; Basaranoglu, Murat ; Sahin, Musa ; Peker, Erdal ; Akbayram, Sinan

Tarka® is a combination antihypertensive medication composed of verapamil hydrochloride and trandolapril. A 3.5-year-old female was brought to our hospital due to a sleepy condition 7 hours after an accidental ingestion of six tablets of Tarka® containing 240 mg verapamil hydrochloride and 4 mg trandolapril in each tablet. Five hours after hospitalization, her condition deteriorated and arterial pressure progressively decreased despite the treatment. Finally, a temporary pacemaker was implanted, after which the vital findings began to return to normal values. The pacemaker was removed 13 hours after implantation as normal heart rhythm was observed. There are no reports of intoxication with fixed-dose combination products, especially Tarka®, in young children in the literature. Therefore, we believe that our report can provide an insight on the toxic dose of this drug in younger children. Clinicians should keep in mind that lethargy can be the first symptom of a possible clinical deterioration, even in normotensive and normorhythmic individuals.

01 Mar 2011·The Journal of Emergency MedicineQ4 · MEDICINE

Tarka® (Trandolapril/Verapamil Hydrochloride Extended-Release) overdose

Q4 · MEDICINE

Review

Author: Menachem Wakslak ; Geetanjli Sangwan ; Lydia Fancher ; Victor Cohen ; Elizabeth Marquart ; Cyrus Farahani ; Samantha P. Jellinek

BACKGROUNDPatients with fixed-dose combination product overdoses involving verapamil and trandolapril may present differently than sole calcium channel blocker (CCB) or angiotensin-converting enzyme inhibitor (ACE-I) overdose alone, and may have implications for the toxicological management. The ACE-I component may confound the traditional response to antidotal and supportive therapy recommended for CCB overdoses. In such cases, it may be prudent to manage the trandolapril component concurrently while administering traditional CCB antidotes.OBJECTIVESTo report a probable case and review the toxicological management of a fixed-dose antihypertensive combination product toxicity involving verapamil and trandolapril (Tarka®).CASE REPORTA 60-year-old man experienced dizziness and fell after ingesting five tablets of Tarka®. Eight hours later, he was found to be hypotensive and bradycardic. Therapy for CCB toxicity was initiated, including fluids, modified hyperglycemia-euglycemia insulin therapy, calcium chloride, activated charcoal, and glucagon. The patient's blood pressure and heart rate stabilized only after the administration and titration of dopamine and episodes of profuse vomiting in response to glucagon. The patient was transferred to the Cardiac Intensive Care Unit for further monitoring. He was considered stable to the point of all therapies being discontinued only 12 h post-ingestion. The patient was discharged 40 h after ingestion with no further sequelae.CONCLUSIONSLack of familiarity with the components of fixed-dose combination products poses a problem during overdose situations and may confound the presentation and delay resuscitation and acute stabilization.

100 Deals associated with Trandolapril/Verapamil Hydrochloride

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