Ecvator (lisinopril, amlodipine) 20 mg/10 mg. tablets №30

Description

Ecvator 20 mg/10 mg Storage
active substances: lisinopril, amlodipine;

1 tablet contains:

20 mg of lisinopril (as 21.76 mg of lisinopril dihydrate);

10 mg of amlodipine (as 13.88 mg of amlodipine besylate);

Ecvator 20 mg/10 mg Excipients: magnesium stearate, sodium starch glycolate (type A), microcrystalline cellulose.

Ecvator 20 mg/10 mg Dosage form
Tablets.

Main physical and chemical properties: white or almost white round biconvex tablets engraved with “CF3” on one side. Diameter: 11 mm.

Pharmacotherapeutic group
Angiotensin-converting enzyme (ACE) inhibitors in combination with calcium channel blockers. Lisinopril and amlodipine. ATX code C09B B03.

Pharmacological properties

Pharmacodynamics.

The equator is a combination drug with a fixed combination of doses of active substances – lisinopril and amlodipine.

Lisinopril

Lisinopril is an inhibitor of the enzyme peptidyl dipeptidase. It inhibits angiotensin converting enzyme (ACE), which catalyzes the conversion of angiotensin I to the vasoconstrictor peptide angiotensin II. Angiotensin II also stimulates the secretion of aldosterone by the adrenal cortex. Inhibition of ACE leads to a decrease in angiotensin II concentrations, resulting in reduced vasopressor activity and decreased aldosterone secretion. A decrease in the latter can lead to an increase in serum potassium.

Because the mechanism by which lisinopril lowers blood pressure is based on the inhibition of the renin-angiotensin-aldosterone system, lisinopril lowers blood pressure even in patients with low renin hypertension. ACE is identical to kininase II, an enzyme that causes bradykinin degradation. It is not yet clear whether elevated levels of bradykinin, a potent vasodilator peptide, play a role in the therapeutic effects of lisinopril.

Amlodipine.

Amlodipine is a dihydropyridine calcium ion inhibitor (a slow calcium channel blocker or calcium ion antagonist) that blocks their entry through membranes into myocardial and vascular muscle cells.

The mechanism of hypotensive action of amlodipine is due to the direct relaxing effect on vascular smooth muscle.

To date, the exact causes of the positive effect of amlodipine in angina have not been determined; however, it is known that the reduction of the total ischemic load occurs due to the following two mechanisms:

Amlodipine causes dilation of peripheral arterioles and thus reduces the total peripheral vascular resistance that the heart overcomes (postload). Because the heart rate remains stable, unloading the heart reduces myocardial energy intake and myocardial oxygen demand.
The mechanism of action of amlodipine may also include dilation of the main coronary arteries and arterioles, both normal and located in the area of ​​ischemia. The result is an increase in myocardial oxygen supply in patients with vasospastic angina (Princemetal angina, or variant angina).
Once daily administration of amlodipine results in a clinically significant reduction in blood pressure in patients with hypertension in both vertical and horizontal positions for 24 hours. Due to the slow onset of action, the rapid hypotensive effect does not occur.

In patients with angina, a single daily dose of amlodipine increases exercise tolerance, increases the duration of the interval before an angina attack, delays the development of ST-segment depression (by 1 mm), and reduces the frequency of angina and nitroglycerin.

Indication
Essential hypertension in adults.

Replacement therapy for patients with adequate blood pressure control on the background of concomitant use of lisinopril and amlodipine in these doses.

Contraindication
Related to lisinopril:

hypersensitivity to lisinopril or to any other ACE inhibitor;
a history of angioneurotic edema associated with the use of an ACE inhibitor;
hereditary or idiopathic angioneurotic edema;
pregnancy or planning pregnancy, breastfeeding (see section “Use during pregnancy or breastfeeding”);
Concomitant use of Equator with aliskiren-containing medicinal products is contraindicated in patients with diabetes mellitus or renal insufficiency (glomerular filtration rate <60 ml / min / 1.73 m2) (see section “Interaction with other medicinal products and other forms of interaction”). );
concomitant use with sacubitril / valsartan; It is not recommended to start taking Equator earlier than 36 hours after the last dose of sacubitril / valsartan (see sections “Interaction with other medicinal products and other forms of interaction” and “Special precautions for use”).
Related to amlodipine:

hypersensitivity to amlodipine or to any other derivatives of dihydropyridine;
severe hypotension;
shock (including cardiogenic);
left ventricular outflow tract obstruction (severe aortic valve stenosis);
hemodynamically unstable heart failure after acute myocardial infarction.
Associated with the drug Equator:

all the above contraindications associated with the use of individual components also apply to the combined drug Equator;
hypersensitivity to any of the excipients of the drug Equator (see section “Composition”).