{
 "query": "trandolapril / verapamil",
 "ingredient": "trandolapril / verapamil",
 "slug": "trandolapril-verapamil",
 "rxcui": "214866",
 "brands": [],
 "names": [
  "trandolapril / verapamil"
 ],
 "components": [
  {
   "ingredient": "trandolapril",
   "slug": "trandolapril",
   "grade": "C",
   "total": 72,
   "scores": {
    "safety": "C",
    "evidence": "F",
    "regulatory": "A",
    "conflict": "A",
    "options": "A"
   },
   "boxed": true,
   "controlled": false,
   "first_approval_fmt": "04/26/1996",
   "first_approval": "19960426"
  },
  {
   "ingredient": "verapamil",
   "slug": "verapamil",
   "grade": "A",
   "total": 89,
   "scores": {
    "safety": "A",
    "evidence": "D",
    "regulatory": "A",
    "conflict": "A",
    "options": "A"
   },
   "boxed": false,
   "controlled": false,
   "first_approval_fmt": "08/12/1981",
   "first_approval": "19810812"
  }
 ],
 "classes": [],
 "alternatives": [],
 "label": {},
 "faers": null,
 "faers_base": {
  "total": 20692304,
  "serious_share": 0.5742697381596559,
  "death_share": 0.09102355155810585
 },
 "recalls": [],
 "recall_total": 0,
 "drugsfda": {
  "first_approval": "19810812",
  "first_approval_fmt": "",
  "anda": 10,
  "nda": 0,
  "rems": false,
  "labeling_recent": 0
 },
 "trials": null,
 "pubmed": null,
 "payments": {
  "year": "2024",
  "usd": 0.0,
  "records": 0,
  "by_name": [],
  "names_checked": [
   "trandolapril / verapamil"
  ],
  "source": "bulk-index"
 },
 "partd": {
  "year": "2024",
  "claims": 5471,
  "beneficiaries": 1431,
  "spend": 1635783.81,
  "by_brand": [
   {
    "brand": "Trandolapril-Verapamil ER",
    "claims": 5471,
    "per_claim": 298.99174008,
    "is_generic": false
   }
  ],
  "per_claim": 298.9917400840797
 },
 "mdl": [],
 "dsc": [],
 "settlements": [],
 "prescrire": null,
 "eml": null,
 "exposure": null,
 "scores": {
  "safety": {
   "score": 65,
   "letter": "C",
   "why": [
    "Graded by its riskiest ingredient, trandolapril (65)",
    "Carries an FDA boxed warning, the strongest warning the FDA issues (-30)",
    "Death share in reports is near or below the FAERS average (1.0x)",
    "Off-label use is among the five most-reported items: widely used beyond its approved evidence (-5)"
   ],
   "weight": 0.35
  },
  "evidence": {
   "score": 37,
   "letter": "F",
   "why": [
    "Graded by its riskiest ingredient, trandolapril (37)",
    "98 randomized trials and 1 systematic reviews/meta-analyses indexed in PubMed",
    "No Cochrane review found (-5)",
    "Only 42% of completed registered trials posted results (-8)"
   ],
   "weight": 0.25
  },
  "regulatory": {
   "score": 98,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, verapamil (98)",
    "Recalls since 2016: 0 Class I, 1 Class II, 2 Class III across 62 generic makers (-2)"
   ],
   "weight": 0.15
  },
  "conflict": {
   "score": 100,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, trandolapril (100)",
    "Pharma paid doctors $0 tied to this drug last year: negligible",
    "Not named in any pending federal MDL"
   ],
   "weight": 0.15
  },
  "options": {
   "score": 90,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, verapamil (90)",
    "Generic versions approved (62 applications)",
    "2 same-class alternative(s) (-10)"
   ],
   "weight": 0.1
  }
 },
 "total": 71,
 "grade": "C",
 "questions": [
  "This is a fixed combination of trandolapril and verapamil. Why both together, instead of only the one I need?",
  "This drug carries a boxed warning. Which specific risk does it cover, and does it apply to me?",
  "The most-reported problems in FDA's adverse event data are dyspnoea, fatigue, cough. How would we recognize and handle those?",
  "Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?",
  "Why this one over benazepril, captopril, cilazapril? What would make you pick one of those instead?",
  "What result are we expecting, by when, and what is the plan if it does not happen?",
  "If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)",
  "The most-reported problems in FDA's adverse event data are dyspnoea, fatigue, nausea. How would we recognize and handle those?",
  "Why this one over etripamil, gallopamil? What would make you pick one of those instead?"
 ]
}