Ekvator tabs 10mg + 20mg #30

Ekvator instruction

You can buy Ekvator here

Composition

Each tablet contains
active ingredients: amlodipine besylate 13.88 mg, equivalent to 10.00 mg of amlodipine and lisinopril; dihydrate 21.76 mg, equivalent to 20.00 mg of lisinopril;
excipients: microcrystalline cellulose 101 181.08 mg, microcrystalline cellulose 12 173.28 mg, sodium carboxymethyl starch 8.00 mg, magnesium stearate 2.00 mg.

Description

White or almost white round flat tablets with a facet, with a risk on one side and engraved with “A + L” on the other.
Pharmacotherapeutic group:
combined antihypertensive agent (angiotensin-converting enzyme inhibitor and blocker of "slow" calcium channels).
ATH code:
C09BB03.

Pharmacodynamics

Combined product containing active ingredients: lisinopril and amlodipine.
Lisinopril - an inhibitor of the angiotensin-converting enzyme (ACE), reduces the formation of angiotensin II from angiotensin I. A decrease in the content of angiotensin II leads to a direct decrease in the release of aldosterone. Reduces the degradation of bradykinin and increases prostaglandin synthesis. Reduces - general, peripheral vascular resistance (OPS), arterial pressure (BP), preload, pressure in the pulmonary capillaries, causes an increase in the minute volume of blood and an increase in myocardial tolerance to stress in patients with chronic heart failure. Expands arteries to a greater extent than veins. Some effects are attributed to the effects on the tissue renin-angiotensin-aldosterone system (RAAS).
With prolonged use, hypertrophy of the myocardium and the walls of resistive arteries is reduced. Improves blood supply to ischemic myocardium.
ACE inhibitors prolong life expectancy in patients with chronic heart failure, slow down the progression of left ventricular dysfunction in patients who have had a myocardial infarction without clinical manifestations of heart failure. Onset of action - -1 h after ingestion. The maximum antihypertensive effect is determined after 6 hours and lasts for 24 hours. With arterial hypertension, the effect is observed, in the first days after the start of treatment, a stable effect develops after 1-2 months. With a sharp withdrawal of the drug is not marked pronounced increase in blood pressure.
Despite the primary effect, which is manifested in the effects on the RAAS, it is also effective for hypertension with low renin activity. In addition to lowering blood pressure, lisinopril reduces albuminuria. Lisinopril does not affect the concentration of glucose in the blood of patients with diabetes mellitus and does not lead to an increase in cases of hypoglycemia.
Amlodipine is a dihydropyridine derivative, a “slow” calcium channel blocker (BMCC), and has antianginal and antihypertensive effects. Blocks calcium channels, reduces the transmembrane transition of calcium ions into the cell (to a greater extent in vascular smooth muscle cells than in cardiomyocytes).
Antianginal action due to the expansion of the coronary and peripheral arteries and arterioles with angina reduces the severity of myocardial ischemia; expanding peripheral arterioles, reduces the round focal disease, reduces the afterload of the heart, reduces the need for myocardium in oxygen. Expanding coronary arteries and arterioles in unaltered and ischemic areas of the myocardium increases the oxygen supply to the myocardium (especially in vasospastic angina) prevents spasm of the coronary arteries (including caused by smoking). In patients with stable angina, a single daily dose increases exercise tolerance slows down the development of angina and ischemic depression - the ST segment, reduces the incidence of seizures, angina, and the consumption of nitroglycerin and other nitrates.
It has a long dose-dependent antihypertensive effect. The antihypertensive effect is due to the direct vasodilating effect on vascular smooth muscle.
In case of arterial hypertension, a single dose provides a clinically significant reduction in blood pressure for 24 hours (in the patient's position "lying" and "standing"). Orthostatic hypotension, with the appointment of amlodipine is quite rare. Does not cause a decrease in exercise tolerance, left ventricular ejection fraction. Reduces the degree of hypertrophy of the left ventricular myocardium. Does not affect the contractility and conductivity of the myocardium, does not cause - a reflex increase in heart rate (HR), inhibits platelet aggregation, increases the glomerular filtration rate, has - a weak natriuretic effect. In diabetic nephropathy does not increase the severity of microalbuminuria. It does not have any adverse effect on the metabolism and plasma lipid concentration and can be used in the treatment of patients with bronchial asthma, diabetes mellitus and gout.
A significant decrease in blood pressure is observed after 6-10 hours, the duration of the effect is 24 hours.

Amlodipine + lisinopril

The combination of lisinopril with amlodipine in a single drug can prevent the development of possible undesirable effects caused by one of the active substances. So, BCCA, directly expanding arterioles, can lead to sodium retention and body fluids, and, therefore, can activate the RAAS. ACE inhibitor. blocks this process.

Pharmacokinetics

Lisinopril

Suction
After oral administration, lisinopril is absorbed from the gastrointestinal tract (GIT); its absorption can vary from 6 to 60%. Bioavailability is 29%. Meal does not affect the absorption of lisinopril.
Distribution
Almost does not bind to plasma proteins. The maximum concentration (C max) in the blood plasma of 90 ng / ml is reached in 6-7 hours. The permeability through the blood-brain and placental barrier is low.
Metabolism
Lisinopril is not biotransformed in the body.
Removal
Excreted by the kidneys in unchanged form. The half-life (T½) is 12.6 h.

Pharmacokinetics in selected groups of patients

Elderly patients have lisinopril concentration in the blood plasma and the area under the concentration-time curve (AUC) is 2 times greater than in young patients. In patients with chronic heart failure, absorption and clearance of lisinopril are reduced.
In patients with renal insufficiency, lisinopril concentration is several times higher than plasma concentration in healthy volunteers, with an increase in the time to reach the maximum plasma concentration and an increase in the half-life.
Lisinopril is eliminated from the body by hemodialysis.

Amlodipine

Suction
After oral administration, amlodipine is slowly and almost completely (90%) absorbed from the gastrointestinal tract. The bioavailability of amlodipine is 64% -80%. Food intake does not affect the absorption of amlodipine.
Distribution
Most of the drug in the blood (95% -98%) is bound to plasma proteins. Cs in serum is observed after 6-10 hours. Equilibrium concentrations (Css) are reached after 7-8 days of therapy. The average volume of distribution is 20 l / kg of body weight, which indicates that most of the drug is in the tissues, and a smaller part is in the blood.
Metabolism
Amlodipine undergoes a slow / active metabolism in the liver in the absence of a significant “first pass” effect. Metabolites do not have significant pharmacological activity.
Removal
Withdrawal consists of two phases, T½ of the final phase is 30-50 hours. About 60% of the ingested dose is excreted by the kidneys mainly as metabolites, 10% as unchanged, and 20-25% as metabolites through the intestine with bile. The total clearance of amlodipine is 0.116 ml / s / kg (7 ml / min / kg, 0.42 l / h / kg).

Pharmacokinetics in selected groups of patients

In elderly patients (over 65), the elimination of amlodipine is slow (T½ - 65 h) compared with young patients, but this difference has no clinical significance.
In patients with hepatic impairment, T½ lengthening suggests that with prolonged use, the cumulation of the drug in the body will be higher (T½ to 60 hours). Renal failure has no significant effect on the kinetics of amlodipine.
Amlodipine penetrates the blood-brain barrier. Hemodialysis is not removed.
Amlodipine + lisinopril
The interaction between the active ingredients that make up Ekvator is unlikely. AUC, time-to-reach and maximum concentration values, half-life periods do not undergo changes in comparison with the indicators of each individual active ingredient. Meal does not affect the absorbability of active substances.

Indications for use

Essential hypertension (for patients who are recommended combination therapy).

Contraindications for Ekvator

    Hypersensitivity to lisinopril or other ACE inhibitors;
    Hypersensitivity to amlodipine or other dihydropyridine derivatives;
    Hypersensitivity to other components of the drug;
    Quincke's edema in history, including during the use of ACE inhibitors;
    Hereditary or idiopathic angioedema;
    Hemodynamically significant stenosis of the aorta or mitral valve;
    Hypertrophic obstructive cardiomyopathy;
    Severe arterial hypotension (systolic blood pressure less than 90 mm Hg);
    Cardiogenic shock;
    Unstable angina (with the exception of Prinzmetal stenocardia);
    Heart failure after acute myocardial infarction (during the first 28 days).
    Pregnancy and lactation;
    Age up to 18 years (efficacy and safety have not been established).

Carefully

Severe renal dysfunction, bilateral renal artery stenosis or arterial stenosis of a single kidney with progressive azotemia, a condition after kidney transplantation, azotemia, hyperkalemia, primary, hyper aldosteronism, liver dysfunction, arterial hypotension, cerebrovascular diseases (including insufficiency of the cerebral blood circulation). ischemic - heart disease ,, coronary insufficiency / sick sinus syndrome (severe bradycardia, tachycardia), CHF nonischemic etiology III-IV f National Class according to the NYHA classification, aortic stenosis, mitral stenosis, acute myocardial infarction (and within 1 month after myocardial infarction), autoimmune systemic diseases of the connective tissue (including scleroderma, systemic lupus erythematosus), bone marrow hematopoiesis depression, diabetes mellitus, diet with limited salt, hypovolemic states (including as a result of diarrhea, vomiting), old age, hemodialysis using high-permeability high-permeability dialysis membranes (AN69®).

Use during pregnancy and lactation

Use of the drug Ekvator is not recommended during pregnancy.
At. Pregnancy Diagnosis, you should stop taking Ekvator immediately.
Acceptance of ACE inhibitors in the II and III trimester of pregnancy has an adverse effect on the fetus (pronounced reduction in blood pressure, renal failure, hyperkalemia, hypoplasia of the skull bones, fetal death) are possible. There are no data on the negative effects of the drug on the fetus in the case of use during the first trimester of pregnancy. For newborns and infants who have been exposed to intrauterine effects of ACE inhibitors, it is recommended to conduct careful monitoring for. timely detection of pronounced decrease in blood pressure, oliguria, hyperkalemia.
The safety of using amlodipine during pregnancy has not been established; therefore, the use of amlodipine is not recommended during pregnancy.
Lisinopril crosses the placenta and may be excreted in breast milk. There is no evidence of the release of amlodipine in breast milk. However, it is known that other BCCA-derivatives of dihydropyridine are excreted in breast milk.
Use of the drug Ekvator in the period of breastfeeding is not recommended.
If the use of the drug is necessary during lactation, breastfeeding should be stopped.

Dosage and administration

Ekvator tablets are taken orally, once a day, regardless of the time of meals, drinking plenty of fluids.
The recommended dose is 1 tablet of Ekvator 1 time per day. The maximum daily dose is 1 Ekvator tablet.
At the beginning of therapy with Ekvator, symptomatic arterial hypotension may develop, which often occurs in patients with impaired water and electrolyte balance, due to previous diuretic therapy. Diuretic therapy should be stopped 2-3 days before the start of therapy with Ekvator. In cases where diuretic cancellation is not possible, the initial dose of Ekvator is ½ tablet 1 time per day, after which it should be monitored for a few hours due to the possible development of symptomatic arterial hypotension.

Patients with renal failure

To determine the optimal initial and maintenance dose for patients with renal insufficiency, doses should be titrated and determined individually using lisinopril and amlodipine separately. Ekvator is indicated only for those patients in whom the optimal maintenance dose of lisinopril and amlodipine is titrated to 10 mg and 5 mg, respectively. During treatment with Ekvator, it is necessary to monitor kidney function, the content of potassium and sodium in blood serum. In case of deterioration of the function - the kidneys, taking Ekvator should be discontinued and replaced with lisinopril and amlodipine in adequate doses.

Patients with liver failure

Removal of amlodipine may be slowed down in patients with impaired liver function: Clear recommendations on the dosing regimen in such cases have not been established, therefore Ekvator should be prescribed with caution in patients with hepatic insufficiency.

Elderly patients (over 65)

No age-related changes in efficacy or safety profile for amlodipine and lisinopril were detected in clinical studies. To determine the optimal maintenance dose, it is necessary to determine 1 regimen - dosing individually, using lisinopril and amlodipine separately. Ekvator is indicated only for those patients in whom the optimal maintenance dose of lisinopril and amlodipine is titrated to 10 mg and 5 mg, respectively.

Side effect

The frequency of adverse reactions in patients receiving the combined drug was not higher than in patients who received one of the active ingredients. Adverse reactions were consistent with previously obtained data for amlodipine and / or lisinopril. Adverse reactions were mild, transient and rarely required discontinuation of treatment. The most frequently encountered adverse reactions when taking a combination of drugs were: headache (8%), cough (5%), dizziness (3%).
The frequency of adverse reactions is given separately for lisinopril and amlodipine.
Data are presented by system-organ classes in accordance with the MedDRA classification and with the following frequency: very often (> 1/10); often (from> 1/100 to <1/10); infrequently (from> 1/1 000 to <1/100); rarely (from> 1/10 000 to <1/1 000); very rarely (<1/10 000); frequency unknown (cannot be set based on available data).

Overdose

Symptoms: Overdose can lead to excessive peripheral vasodilation with severe hypotension, collapse, impaired water and electrolyte balance, renal failure, shortness of breath, tachycardia, bradycardia, dizziness, anxiety, cough.
Treatment: symptomatic therapy, control of cardiac activity, blood pressure, diuresis and water-electrolyte balance, if necessary, its correction. With a marked decrease in blood pressure, the patient is given a horizontal position with the legs raised; if necessary, intravenous infusion of 0.9% sodium chloride solution; if these measures have not led to sufficient results, it may be necessary to use a peripheral vazopressor (dopamine) to maintain circulation. Intravenous administration of calcium gluconate can have a positive effect on the reverse development of the effects caused by the blockade of calcium channels. If necessary, intravenous angiotensin II.
Because of the slow absorption of amlodipine, in some cases, the stomach is washed using activated charcoal.
Lisinopril is eliminated by hemodialysis. Because of the strong association of amlodipine with blood proteins, hemodialysis of amlodipine is ineffective. .

Interaction with other drugs

Lisinopril

Substances that affect potassium: potassium-sparing diuretics (for example, spironolactone, amiloride, and triamterene), potassium-containing dietary supplements, potassium-containing salt substitutes, and any other drugs that increase serum potassium (for example, heparin) can lead to hyperkalemia with combination with ACE inhibitors, especially in patients with acupuncture and other kidney diseases in history. When prescribing a drug that affects the potassium content, simultaneously with lisinopril, the content of potassium in the blood serum should be monitored. Therefore, the simultaneous appointment should be carefully justified and made with extreme caution and regular monitoring of both the content of potassium in the blood serum and kidney function.
Potassium-sparing diuretics can be taken together with Ekvator only with careful medical supervision.
Diuretics: in the case of diuretic prescribing to a patient receiving Ekvator, the antihypertensive effect is usually enhanced. Simultaneous use should be carried out with caution. Lisinopril softens the potassium uretic effect of diuretics.
Other antihypertensive drugs: simultaneous administration of these drugs can enhance the antihypertensive effect of Ekvator. Simultaneous administration with nitroglycerin, other nitrates, or vasodilators can lead to a pronounced decrease in blood pressure.
Tricyclic antidepressants / antipsychotics / general anesthetics / narcotic analgesics: Concomitant use with ACE inhibitors can lead to a pronounced decrease in blood pressure.
Ethanol enhances the antihypertensive effect.
Allopurinol, procainamide, cytotoxic drugs or immunosuppressants. (systemic glucocorticosteroids) may lead to an increased risk of developing leukopenia while being used with ACE inhibitors.
Antacids and colestyramine, while taking with ACE inhibitors, reduce the bioavailability of the latter.
Sympathomimetics can reduce the antihypertensive effect of ACE inhibitors; need to carefully monitor the achievement of the desired effect.
Hypoglycemic drugs: while taking ACE inhibitors and hypoglycemic drugs (insulin and hypoglycemic agents for oral administration) at the same time, the probability of reducing the glucose concentration in the blood and the risk of hypoglycemia may increase. Most often this phenomenon occurs during the first week of combined treatment in patients with renal insufficiency.
Non-steroidal anti-inflammatory drugs (NSAIDs): long-term use of NSAIDs, including high doses of acetylsalicylic acid over 3 g / day, may reduce the antihypertensive effect of ACE inhibitors. The additive effect of taking NSAIDs and ACE inhibitors is manifested in an increase in serum potassium and can lead to a deterioration in renal function. These effects are usually reversible. Very rarely, the development of acute renal failure is possible, especially in elderly and dehydrated patients.
Lithium preparations: the elimination of lithium can be slowed down during simultaneous administration with ACE inhibitors and therefore the concentration of lithium in the blood serum should be monitored during this period. When combined with the use of lithium preparations, it is possible to increase the manifestation of their neurotoxicity (nausea, vomiting, diarrhea, ataxia; tremor, tinnitus).
Gold preparations: with simultaneous use of ACE inhibitors and gold preparations (sodium aurothiomalate) intravenously, a symptom complex is described, including facial flushing, nausea, vomiting, and arterial hypotension.

Amlodipine

Inhibitors of CYP3A4 isoenzyme: studies among elderly patients have shown that diltiazem inhibits amlodipine metabolism, probably through CYP3A4 (plasma concentration rises by almost 50% and the effect of amlodipine increases). It is impossible to exclude the possibility that stronger inhibitors of CYP3A4 isoenzyme (i.e. ketoconazole, itraconazole, ritonavir) may increase serum amlodipine concentration to a greater extent than diltiazem. Simultaneous use should be carried out with caution.
Inductors of the isoenzyme CYP3A4: simultaneous use with antiepileptic drugs (for example, carbamazepine, phenobarbital, phenytoin, phosphinitoin, primidone), rifampicin, herbal preparations containing Hypericum perforatum, which can result in a reduction in the concentration of Hypericum perforatum, may result in an altogether, i.e. Clinical control is shown with possible dose adjustment of amlodipine during treatment with inducers of the CYP3A4 isoenzyme and after their withdrawal.
Simultaneous use should be carried out with caution.
As a monotherapy, amlodipine was well combined with thiazide and “loop” diuretics, general anesthesia agents, beta-adrenergic blockers, ACE inhibitors, long-acting nitrates, nitroglycerin, digoxin, warfarin, atorvastatin, sildenafil, antacid preparations, antacids, antacids, antacids, antacids, antacids, n-glycerol, digoxin, warfarin, atorvastatin, sildenafil. simethicone, cimetidine, nonsteroidal anti-inflammatory drugs, antibiotics and oral hypoglycemic agents.
Amlodipine has no significant effect on ethanol pharmacokinetics.
Calcium preparations can reduce the effect of “slow” calcium channel blockers.
Amlodipine does not cause significant changes in the pharmacokinetics of cyclosporine.
Perhaps a decrease in the antihypertensive effect of Ekvator when taken concomitantly with estrogenic agents, adrenostimulants.
Procainamide, quinidine, and other drugs that extend the QT interval can contribute to its significant lengthening.

special instructions

Hypotension

A pronounced decrease in blood pressure with the development of clinical symptoms can be observed in patients with a decrease in circulating blood volume and / or sodium content due to diuretic administration, fluid loss, or for other reasons, for example, sweating, prolonged vomiting and / or diarrhea. Preferably, the recovery, loss of fluid and / or sodium was carried out before the start of therapy with Ekvator.
It is necessary to monitor blood pressure after taking the initial dose. Similar conditions apply to patients with ischemic, heart disease, or cerebrovascular diseases, in whom a pronounced decrease in blood pressure can lead to myocardial infarction or stroke.
Aortic and mitral stenosis.
Like all vasodilators, Ekvator should be administered with caution to patients with obstruction of the left ventricular output tract and mitral valve stenosis.

Renal impairment

In some patients with arterial hypertension without pronounced manifestations of renovascular diseases, an increase in serum creatinine and urea concentrations was observed, in most cases minimal or transient, more pronounced while taking an ACE inhibitor and a diuretic. This is most common in patients with a history of kidney disease.
To determine the optimal; maintenance dose dosing regimen should be determined individually, using lisinopril and amlodipine separately, with simultaneous monitoring of kidney function: Ekvator is indicated only for those patients who have the optimal maintenance dose of lisinopril and amlodipine titrated to 10 and 5 mg, respectively.
In the event of a decrease in renal function, taking Ekvator should be discontinued and replaced with monotherapy with drugs in adequate doses. In addition, you may need to reduce the dose or cancel diuretics.

Angioedema

Angioedema of the face, extremities, lips, tongue, vocal folds and / or larynx has been reported in patients taking ACE inhibitors, including lisinopril. In these cases, the administration of the drug Equator should be immediately stopped and the patient should be carefully monitored until the symptoms disappear.
Swelling of the face, lips, and limbs usually resolves on its own; however, antihistamines should be used to reduce the severity of symptoms.
Angioedema, accompanied by swelling of the larynx, can be fatal. If you detect edema of the tongue, pharynx, or larynx that causes airway obstruction, emergency measures should be started immediately. Appropriate measures include: application of a 0.1% solution of epinephrine (adrenaline) subcutaneously at a dose of 0.3-0.5 mg or 0.1 mg slowly intravenously, followed by the use of glucocorticosteroids (intravenously) and antihistamines and simultaneous monitoring of vital signs. important features.
In patients taking ACE inhibitors, angioedema was rarely observed. These patients complained of abdominal pain (with or without nausea and vomiting); in some cases, no previous angioedema of the face was observed, and C-1 esterase activity was within the normal range. Angioedema of the intestine was diagnosed according to computed tomography of the gastrointestinal tract or after ultrasound, or during surgery, the symptoms disappeared after discontinuation of the ACE inhibitor. When conducting a differential diagnosis of abdominal pain in patients taking ACE inhibitors, angioedema of the intestine should be considered.

Anaphylactic reactions in patients on hemodialysis

In patients who underwent hemodialysis through a polyacrylonitrile membrane (for example, AN-69) and who simultaneously received ACE inhibitors, cases of anaphylactic shock have been reported; therefore, such a combination should be avoided.
Patients recommended; use either another type of dialysis membrane or a hypotensive drug of another pharmacotherapeutic group.

Anaphylactic reactions in patients during apheresis of low-density lipoprotein (LDL)

Rarely in patients who received ACE inhibitors during apheresis. LDL of dextran sulfate, life-threatening anaphylactic reactions developed. These reactions were prevented by discontinuing the use of ACE inhibitors before each apheresis procedure.

Desensitization from wasp or bee venom

Sometimes patients taking ACE inhibitors, when desensitized by hymenoptera venom (for example, wasps or bees), developed anaphylactic reactions. Such life-threatening situations can be avoided with the timely cancellation of ACE inhibitors.

Impact on the liver

In rare cases, the use of ACE inhibitors was accompanied by a syndrome that began with cholestatic jaundice or hepatitis and developed into fulminant necrosis of the liver and, in some cases, was fatal. The mechanism of this syndrome is unclear.
Patients receiving Ekvator, and who develop jaundice or an increase in the activity of “liver” enzymes, should be discontinued with the drug, followed by observation of their condition.

Liver failure

In patients with impaired liver function, the half-life of amlodipine is prolonged. Currently, recommendations on the dosage regimen have not been developed, and therefore this drug should be prescribed with caution, having previously determined the expected benefit and potential risk of treatment.

Neutropenia / Agraiulocytosis

In rare cases, patients receiving ACE inhibitors have neutropenia, agranulocytosis, thrombocytopenia and anemia. In patients with normal renal function and in the absence of other aggravating factors, neutropenia is rare. Neutropenia and agranulocytosis are reversible and disappear after discontinuation of the ACE inhibitor. Ekvator should be used with extreme caution in patients with systemic connective tissue diseases, during immunosuppressive therapy, during treatment with allopurinol or procainamide, or in the combination of these aggravating factors, especially in the presence of a previous renal dysfunction. Some of these patients developed serious infectious diseases, in which, in several cases, no response was received to antibiotic treatment.
Periodically, in such patients during treatment with Ekvator, it is recommended to conduct laboratory tests (a blood test with a count of leukocyte formula), and also to warn them about the need to report on the appearance of the first signs of an infectious disease.

Cough

During the use of ACE inhibitors, a cough was often recorded. As a rule, cough is unproductive, persistent and stopped after discontinuation of the drug. In the differential diagnosis of cough, it is necessary to take into account the cough caused by the use of ACE inhibitors.

Surgical intervention / general anesthesia

In patients undergoing extensive surgery or during general anesthesia with drugs leading to hypotension, lisinopril may block the formation of angiotensin II after compensatory renin release. If arterial hypotension develops, probably as a result of the above mechanism, a correction can be made by increasing the circulating blood volume.

Elderly patients

Elderly patients with impaired renal function should be adjusted to the dose of Ekvator.
Hyperkalemia:
In some patients receiving ACE inhibitors, an increase in serum potassium was observed. The risk group for the development of hyperkalemia consists of patients with renal insufficiency, diabetes mellitus, acute heart failure, dehydration, metabolic acidosis, or while taking potassium-sparing diuretics, potassium-containing dietary supplements, potassium-containing salt substitutes, or any other drugs leading to an increase in potassium serum (for example, heparin). If necessary, concomitant use with the above preparations, it is necessary to control the content of potassium in the blood serum.
Patients with low body mass, patients who are not tall are sick, with severe liver dysfunction may require a dose reduction.
Ekvator does not have any adverse effect on the metabolism and plasma lipids and can be used in the treatment of patients with bronchial asthma, diabetes mellitus and gout.
During treatment, body mass monitoring is necessary; observation by a dentist (to prevent soreness, bleeding and gingival hyperplasia).

The effect of the drug on the ability to drive motor vehicles and to work with mechanisms with an increased risk of injury

The use of Ekvator may affect the ability to drive vehicles and complex mechanisms. Transient hypotension and dizziness may occur predominantly at the beginning of treatment. Therefore, at the beginning of treatment it is recommended to avoid driving, working with mechanisms and doing other work that requires high concentration of attention.

Release form

Tablets, 5 mg + 10 mg.
10 tablets in a white PVC foil / polyethylene / PVDH blister and varnished solid aluminum foil. 1, 2, 3 or 6 blisters in a carton box with attached instructions for use.

Storage conditions

Store in a dark place at a temperature not exceeding 25 ° C.
Keep out of the reach of children!
Shelf life - 3 years.
Do not take after the expiration date printed on the package.

Sales conditions

You can buy Ekvator without a prescription.