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MAVIK
CHF and arrhythmias
Hypertension
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Drug Name:

MAVIK Rx

Generic Name and Formulations:
Trandolapril 1mg+, 2mg, 4mg; tabs; +scored.

Company:
AbbVie

Therapeutic Use:

Indications for MAVIK:

In stabilized patients after MI, who have LV systolic dysfunction or CHF symptoms.

Adult:

Initially 1mg once daily; titrate to 4mg once daily as tolerated. Renal dysfunction (CrCl <30mL/min) or hepatic cirrhosis: initially 0.5mg once daily.

Children:

Not established.

Contraindications:

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan.

Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Renal or hepatic impairment. Salt/volume depletion; correct prior to initiation. CHF. Avoid hypotension in CHF, aortic stenosis, ischemic heart disease, or cerebrovascular disease. Renal artery stenosis. Dialysis (esp. high-flux membrane). Diabetes. Surgery. Discontinue if laryngeal edema, angioedema, or jaundice occurs. Monitor WBCs in renal or collagen vascular disease. Monitor BP, electrolytes and renal function. Black patients may have higher risk of angioedema than non-black patients. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.

Interactions:

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus, sirolimus, everolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Hyperkalemia with K+ supplements, K+-sparing diuretics, or salt substitutes. Excessive hypotension with diuretics, inhalation anesthetics. May increase lithium levels. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function in elderly and/or volume-depleted). Potentiates insulin or oral hypoglycemic agents. Nitritoid reactions with injectable gold (sodium aurothiomalate); rare.

Pharmacological Class:

ACE inhibitor.

Adverse Reactions:

Cough, dizziness, hypotension, syncope, hyperkalemia, myalgia; anaphylactoid reactions; rare: hepatic failure.

Metabolism:

Hepatic.

Elimination:

Fecal, renal.

Generic Availability:

YES

How Supplied:

Tabs—100

Indications for MAVIK:

Hypertension.

Adult:

If not on diuretic: initially 1mg once daily in non-black patients; 2mg in black patients. If on diuretic: suspend diuretic for 2–3 days before starting therapy; resume diuretic if BP not controlled with trandolapril alone. If diuretic cannot be discontinued (supervise closely until stabilized), or in renal impairment (CrCl <30mL/min) or hepatic cirrhosis: initially 0.5mg once daily. For all: adjust at 1-week intervals; usual range 2–4mg once daily; usual max 8mg/day; may give in 2 divided doses.

Children:

Not established.

Contraindications:

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan.

Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Renal or hepatic impairment. Salt/volume depletion; correct prior to initiation. CHF. Avoid hypotension in CHF, aortic stenosis, ischemic heart disease, or cerebrovascular disease. Renal artery stenosis. Dialysis (esp. high-flux membrane). Diabetes. Surgery. Discontinue if laryngeal edema, angioedema, or jaundice occurs. Monitor WBCs in renal or collagen vascular disease. Monitor BP, electrolytes and renal function. Black patients may have higher risk of angioedema than non-black patients. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.

Interactions:

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus, sirolimus, everolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Hyperkalemia with K+ supplements, K+-sparing diuretics, or salt substitutes. Excessive hypotension with diuretics, inhalation anesthetics. May increase lithium levels. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function in elderly and/or volume-depleted). Potentiates insulin or oral hypoglycemic agents. Nitritoid reactions with injectable gold (sodium aurothiomalate); rare.

Pharmacological Class:

ACE inhibitor.

Adverse Reactions:

Cough, dizziness, hypotension, syncope, hyperkalemia, myalgia; anaphylactoid reactions; rare: hepatic failure.

Metabolism:

Hepatic.

Elimination:

Fecal, renal.

Generic Availability:

YES

How Supplied:

Tabs—100

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