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trandolapril-verapamil

trandolapril-verapamil
  • Restricted Medications Non-Formulary / Not-stocked
Brand names: Tarka
No brands, forms, or strengths have been added for this generic.
Display Class IV Antiarrhythmics, Vasodilating Agents, Miscellaneous, Calcium-Channel Blocking Agents, Angiotensin-Converting Enzyme Inhibitors Class: 24040424, 241292, 242800, 243204
Medication comments:

Calcium Channel Blockers (non-dihydropyridine) require the following prior to each administered dose:
1) Nursing staff shall obtain the patient’s pulse and record in the EMR.
2) If the pulse is less than 50, the nurse shall obtain an apical heart rate. If the apical heart rate is less than 50, the nurse shall hold the dose and notify the provider for further orders.
3) This is applicable to all routes of administration
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication: trandolapril-verapamil (Tarka)
Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Drug(s) ⇆ disease or syndrome non-dihydropyridine calcium channel blockers (CCBs) ⇄ Heart failure
Rationale Potential to promote fluid retention and/or exacerbate heart failure.
Recommendation Avoid in heart failure with reduced ejection fraction.
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 4: Potentially clinically important drug-drug interactions that should be avoided in older adults. (Table 5)
Interacting drug(s) or class(es) RAS inhibitors (ACEIs ARBs, ARNIs, aliskiren) ⇄ Another RAS inhibitor or a potassium-sparing diuretic
Risk Rationale Increased risk of hyperkalemia.
Recommendation Avoid routinely using 2 or more RAS inhibitors, or a RAS inhibitor and potassium-sparing diuretic, concurrently in those with chronic kidney disease Stage 3a or higher.
 Quality of evidence: Moderate, Strength of Recommendation: Strong
Pediatric Pharmacy Association 2025 KIDs List of Key Potentially Inappropriate Drugs in Pediatrics 
Medication: trandolapril-verapamil (Tarka)
Key Potentially Inappropriate Drugs in Pediatrics (KIDs) List: Second Edition (Table 1)
Drug verapamil
Risk/Rationale Cardiovascular collapse
Recommendation Caution in younger than 1 yr
 Quality of evidence: Low, Strength of Recommendation: Weak
Last updated: Mar. 14, 2026
UpToDate Lexidrug

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Clinical Coordinator - Laura Rollings, PharmD: ext 4597
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