Can I take Lisinopril and Amlodipine together? Judging by the fact that such combined preparations are presented on the pharmaceutical market, it is possible. There is a medicine, the name of which consists of the names of these two active ingredients, there is a medication "Equator". The drug is available in tablet form. Consider its main distinguishing features.
Technical aspects
Together, lisinopril and amlodipine are contained in the Equator preparation. There is another drug, no less popular in the market. It is presented under the name "Lisinopril Plus", is a tablet containing 10 mg of one component and 5 mg of the second. Amlodipine accounts for less. One package contains from three to six dozen capsules. Each instance is painted white, has a round shape of a flattened type. Risk foreseen, chamfer. In one tablet, amlodipine is presented as a besylate, the second ingredient is included in the form of a dihydrate. The manufacturer used cellulose, starch, magnesium and silicon substances as additional compounds.
Equator tablets, which also contain these two active ingredients, are made in the form of a flat circle. Chamfer, risks are foreseen. Hue - white or as close to it as possible. One of the surfaces is complemented by engraving. There are several dosage options. Amlodipine is included in the medication in the form of besylate, lisinopril is represented by dihydrate. There are dosage options: 5 and 10, 5 and 20, 10 and 10, 10 and 20 mg, respectively. In addition to amlodipine and lisinopril, the composition contains starch, cellulose, magnesium molecules in the form of stearate. One package contains from 10 to 60 tablets. The exact amount is mentioned on the outside of the package. Here, the dosage of the active ingredients in each copy is specified.
Pharmacology
The combination of lisinopril and amlodipine has a pronounced antihypertensive effect on the human body. The drug belongs to the combined group. One of the main ingredients is an ACE inhibitor. The second compound is from the BMKK class. To understand the features of the effect of the drug on the human body, it makes sense to consider both compounds separately.
Amlodipine
This active substance is one of those obtained by processing dihydropyridine. It belongs to the group of drugs that inhibit the slow calcium channels, that is, to the BMCC class. The substance blocks such channels and weakens the transition of calcium ions through the membrane into the cell structures. The effect is more pronounced in the smooth cells of the vascular muscles than in the structures of the heart. The antianginal result is explained by arterial expansion (on the periphery, coronary vessels), while the clearance of arterioles increases. In the case of angina pectoris, ischemic manifestations are weakened, arterioles on the periphery expand, OPSS and afterload on the cardiac system are lowered, the need of the heart for oxygen molecules is weakened.
Although it cannot be said that it is better - amlodipine or lisinopril - one can confidently talk about the reliable effect of the combined drug. Due to the content of amlodipine, such a drug prevents coronary spasms and expands arteries, arterioles, while affecting healthy areas and those already affected by ischemia. Myocardial oxygen supply activity is growing. Against the background of stable angina, resistance to physical exertion increases, attacks develop more slowly, depression of the heart segment due to ischemia is weakened. Attacks come less often, the need for nitroglycerin and other drugs from the class of nitrates decreases.
Amlodipine: features
Often, patients are prescribed combination drug therapy with the inclusion of amlodipine, indapamide and lisinopril in the program. The first substance from this list has a lasting effect (its strength depends on the dose) on pressure. This is due to the vasodilating effect on the muscle walls of the vascular system. In case of high blood pressure, a single dose of an adequate volume guarantees a clinically sufficient decrease in indicators for a day. This is fixed in position and standing, and lying down.
Orthostatic hypotension in patients undergoing a course with the inclusion of amlodipine is rarely recorded. The drug does not lower susceptibility to physical activity. With its use, the severity of hypertrophic processes in the ventricle of the heart on the left decreases. At the same time, conduction, contractility of the heart muscle do not deteriorate, there is no reflex growth in heart rate. The intake of tablets containing amlodipine and lisinopril leads to an increase in the filtration activity of the renal glomeruli and a slowing of platelet aggregation. There is an unexpressed natriuretic effect. There is no negative effect on the metabolism, blood fat profile. Amlodipine is acceptable for diabetes, gout, asthma. A pronounced effect on pressure is recorded after 6-10 hours, persists for a day.
Lisinopril
In tablets "Lisinopril plus" amlodipine is not dominant, they have more than the first substance. Lisinopril is an ACE inhibitor. Such a compound prevents the transformation reaction of the first type of angiotensin into the second. A decrease in the concentration of this substance in the body is associated with a weakening of the release of aldosterone. Bradykinin degradation decreases, prostaglandins are more actively generated. OPSS, pressure, preliminary load on the heart are lowered, the rate of pressure in the capillary network of the respiratory system decreases. With a failure of the heart in the form of a chronicle, the drug increases the minute blood volume. At the same time, the resistance of the heart muscle to stress increases. Vasodilatation is more characteristic of arteries than veins. A number of effects of the drug are due to the indirect effect on the renin-angiotensin system. Long-term use allows you to weaken muscle cardiac hypertrophy. The state of arterial walls is corrected.
If the patient is prescribed combined treatment (for example, Amlodipine, Bisoprolol and Lisinopril at the same time), the inclusion of ACE inhibitors in such a system improves the quality of oxygen supply to the heart tissue. With insufficient heart function in the form of chronicles, ACE inhibitors can achieve an increase in life expectancy. If a person has previously suffered a heart attack, but there is no organ failure, lisinopril weakens the progress of impaired ventricular function on the left.
Lisinopril: features
As you can learn from the accompanying combination product containing lisinopril and amlodipine, instructions for use, the first ingredient mentioned shows a pronounced effect after an hour after ingestion. Maximum performance is recorded on average 6.5 hours after this point. The duration of the preservation of effectiveness reaches a day. With increased blood pressure, the effect is observed the first few days after the start of the course, after a month or two the condition finally stabilizes.
Cases of the need for abrupt withdrawal of a substance have been observed. There was no significant increase in pressure attributable to this cancellation. Under the influence of lisinopril, pressure drops, the effects of albuminuria decrease. With hyperglycemia, the drug helps to normalize the disturbed glomerular endothelium. In diabetes, it does not affect the glucose content in the circulatory system. The use of lisinopril does not increase the risks of hypoglycemia.
Combination of substances
Since lisinopril and amlodipine are compatible, effective combination agents have been developed. One of these is issued under the name "Equator". The substance contains both ingredients considered. This combination allows you to reduce the risk of side effects inherent in each of the active substances individually. Of course, the use of a combined agent is allowed strictly under the supervision of a specialist, since the risks are still great, but the drug in question is tolerated by patients better than each of the drugs separately.
When is it needed?
As can be concluded from the reviews, together “Amlodipine” and “Lisinopril” are often prescribed to people who need a drug to correct arterial hypertension. Previously, the doctor clarifies the reasonableness of the combined course. Use the medicine only according to the indications. Self-administration with a high degree of probability leads to the formation of undesirable effects. Hypertension is the only indication mentioned in the accompanying medication instructions.
Combination: is it dangerous?
Persons who have been prescribed a combination substance to control pressure indicators are sometimes interested in how great are the risks associated with the possibility of the mutual influence of the ingredients on each other. As tests have shown, the risk of such a chemical interaction is practically minimal. The dependence of the half-life, maximum concentration or distribution of substances in the body is checked. The correction of these parameters by the use of drugs in combination or separately has not been established. No dependence on the period of the meal. Food does not adjust the level of absorption of compounds. The prolonged circulation of the ingredients in the circulatory system allows you to use the drug once a day.
How to use?
The combined drug containing amlodipine and lisinopril must be taken orally. Reception does not depend on a meal. It is required to drink the medicinal composition with clean water without additives in a reasonable amount. The daily single recommended dose is one capsule. It is advisable to use the product daily at a stable time. More than one tablet should not be used per day.
A combined medication should be taken if the dosage of the active ingredients coincides with the optimal volume of each of them for a particular case. First, the doctor determines the fixed doses for a particular patient, then compares them with the developed options for combined medicines. The possible releases of the Equator and Lisinopril Plus medicines were indicated above. If it was not possible to find any suitable release format, you need to assign the patient a separate intake of these compounds.
The nuances of treatment
If the doctor prescribed a combination drug, which includes amlodipine and lisinopril, but at the very beginning of taking the medicine, blood pressure dropped sharply, the patient should take a supine position and stop taking it. It is necessary to seek help from a treating doctor. Usually the transistor phenomenon does not force to abandon the therapeutic course, but sometimes a dosage reduction is required. If it becomes necessary to experimentally select a dose, the ingredients are prescribed in the form of individual pharmaceutical products for the period of the course formation.
Sometimes the patient is prescribed a multicomponent course (for example, simultaneously amlodipine, lisinopril rosuvastatin). As practice shows, the more elements of the drug program the patient needs, the higher the risk of missing something. If the patient has missed the period of use of "Equator", you should wait for the next time. Each time a single serving is used. If the previous dose is skipped, it is not necessary to double the next. There is no need to refund the pass.
It is impossible!
A strict contraindication to taking "Equator" is the increased susceptibility of any ingredient included in the drug. This also applies to the main components and auxiliary compounds. You can not use the substance if the human body is characterized by an increased susceptibility of any product of the processing of dihydropyridine or ACE inhibitors. If the patient has previously used an ACE inhibitor and this provoked Quincke's edema, if this phenomenon was observed for other reasons, the "Equator" can not be used. It is forbidden to take the drug with angioedema of the idiopathic form or due to a hereditary factor, as well as in a shock state, with cardiogenic shock. The drug is not prescribed for angina pectoris of an unstable type. An exceptional case is a type of disease known as Prinzmetal disease. You can not prescribe a remedy for a severe form of reduced pressure in the arteries, when the indicators are less than 90 units, and in case of insufficient heart function in an unstable hemodynamic type if an acute heart attack has been previously transmitted. The drug is not used if it is necessary to take aliskiren or other pharmaceutical products in whose composition this substance is, with diabetes, moderate or severe renal impairment.
"Equator", "Equamer" (a drug containing both amlodipine, lisinopril rosuvastatin) is not used during pregnancy. You can not use a combined remedy for lactation and in adolescence, if you need antagonists of the receptor system for the perception of the second type of angiotensin for nephropathy due to diabetes. Limitations are imposed by the obstruction of the output left ventricular heart tract of a hemodynamically significant format, as well as mitral stenosis.
You can, but very carefully
Sometimes a combined remedy is prescribed for aortic stenosis, some types of myopathy, cerebrovascular pathologies. Such conditions require increased attention. It is important to regularly check the patient's condition, monitor the performance of internal systems and organs. Accuracy requires the case if the patient is obliged to use potassium-sparing diuretics, potassium preparations, potassium salt substitutes. Particularly noteworthy are individuals with an excess of potassium in the body, a lack of sodium, as well as those suffering from myelosuppression, diabetic disease, and symmetric renal arterial stenosis.
A very carefully combined medicine for high blood pressure is prescribed if a person has had a kidney transplant, is forced to undergo hemodialysis, suffers from primary type aldosteronism, or eats food with severe salt restriction. The need to use substances that inhibit the enzyme compound CYP3A4, inducers of this enzyme requires regular monitoring of the patient's condition.
Unwanted effects
Taking a combination drug, which includes amlodipine and lisinopril, can cause a decrease in the concentration of hemoglobin, hematocrit in the circulatory system. There is a danger of inhibition of hematopoietic function. There is a risk of an allergic reaction, an increase or decrease in blood glucose. Muscle hypertonicity, neuropathy, extrapyramidal disorders are extremely rare. There is a danger of problems with vision, sleep, consciousness. Depressed conditions, anxiety, lability are possible. Some noted tinnitus. Very rarely a heart attack was recorded. There is a risk of violation of the frequency and speed of the heartbeat, atrial fibrillation. Hypotension is possible, there is a danger of disturbance of blood flow in the brain. Raynaud's syndrome may form.
Cases of pneumonia, pancreatitis, hepatitis are recorded. There is a risk of liver failure, stool disorders, pain in the abdomen. Others had a cough, shortness of breath, and dry mouth. Tests may show increased liver enzyme activity.