TOP 10 analogues of the drug Preductal: list of available substitutes

Prohibited during breastfeeding

Prohibited for children

Has restrictions for older people

Prohibited for liver problems

Has limitations for kidney problems

Preductal (INN - Trimetazidine) is a cardiac drug based on the substance trimetazidine hydrochloride, which has antianginal and anti-ischemic effects. The product is sold in the form of tablets and capsules for oral administration.

There are several types of this medication:

1. Preductal is a short-acting medication. One tablet contains 20 mg trimetazidine.
2. Preductal MV is a long-acting drug. The concentration of trimetazidine in 1 tablet is 35 mg.
3. Preductal OD - is available in the form of white and orange capsules, with a gradual release of the active substance. One capsule contains 80 mg of trimetazidine and additional components.

Mechanism of action of Preductal MR

Thanks to the drug’s ability to improve blood circulation and normalize cellular metabolism, Preductal is used in cardiology, ophthalmology and otorhinolaryngology for the treatment of diseases resulting from ischemia.

Indications for use are the following diseases:

• stable angina;
• IHD;
• disorders of the vestibular apparatus (frequent dizziness, ringing in the ears);
• perceptual deafness;
• retinal pathologies, including macular degeneration.

Properties of trimetazidine

The medication is contraindicated for:

• intolerance to any component of the composition;
• diseases with impaired motor activity (parkinsonism);
• acute renal and liver failure;
• pregnancy and lactation.

You should also refrain from taking the drug for children under 18 years of age and elderly patients. The dosage regimen depends on the severity of the disease, the dosage form of the drug and is determined exclusively by a specialist. If it is necessary to replace the drug, the attending physician can select analogs of Preductal that are similar in the mechanism of action.

Table of analogues and prices:

Preparations containing Trimetazidine (ATC code C01EB15):

Commercial names abroad: Vastarel MR, Flavedon MR, Cardaptan, Idaptan, Carvidon MR, Trizedon MR, Vestar, Carmetadin.

All antianginal and metabolic drugs

All drugs used in cardiology

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Which generic is better?

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Russian-made analogues

The Russian pharmaceutical market has a number of analogues of Preductal from the Heart, which differ significantly in cost. Structural analogues of Preductal of domestic production include:

1. Triducard.
2. Deprenorm.
3. Trimetazidine.

All medications indicated in the table represent one pharmacological group - antihypoxic agents:

These similar products differ from Preductal only in price, auxiliary components and list of contraindications.

pharmachologic effect

Preductal® MB prevents a decrease in intracellular ATP content by maintaining the energy metabolism of cells in a state of hypoxia. Thus, the drug ensures the normal functioning of membrane ion channels, transmembrane transport of potassium and sodium ions and the preservation of cellular homeostasis.

Trimetazidine slows down the oxidation of fatty acids due to the selective inhibition of long-chain 3-ketoacetyl-CoA thiolase, which leads to increased glucose oxidation and restoration of the coupling between glycolysis and oxidative decarboxylation and protects the myocardium from ischemia. The switch from fatty acid oxidation to glucose oxidation underlies the antianginal effect of trimetazidine.

It has been experimentally confirmed that trimetazidine has the following properties:

• supports energy metabolism of the heart and neurosensory organs during ischemia;
• reduces the amount of intracellular acidosis and the degree of changes in the transmembrane ion flow that occurs during ischemia;
• reduces the level of migration and infiltration of polynuclear neutrophils in ischemic and reperfusion tissues of the heart;
• reduces the size of myocardial damage;
• does not have a direct effect on hemodynamic parameters.

In patients suffering from angina, trimetazidine:

• increases coronary reserve, thereby slowing down the development of ischemia caused by physical activity, starting from the 15th day of therapy;
• limits sharp fluctuations in blood pressure caused by physical activity, without any significant changes in heart rate;
• significantly reduces the frequency of angina attacks and the need for short-acting nitroglycerin;
• improves contractile function of the left ventricle in patients with ischemic dysfunction.

In clinical studies lasting 2 months, it was shown that the addition of Preductal® MB at a dose of 35 mg to therapy with atenolol at a dose of 50 mg after 12 hours led to a significant slowdown in the onset of ischemic depression of the ST segment during stress tests.

Cheap analogues of Preductal OD (80 mg) and MV (35 mg)

Preductal is an expensive medicine, so patients try to choose the closest analogues of Preductal in terms of action, but at a much lower cost. Currently, no pharmaceutical company produces analogues containing 80 milligrams of trimetazidine, in addition to the drug Preductal. However, it is successfully replaced by other similar long-acting drugs with a lower content of the active component.

Preductal MB (35 mg) is the most popular form of the drug due to the optimal content of trimetazidine in one unit of medication. Due to the popularity of Preductal, the demand for its inexpensive substitutes is growing.

Predisin

Predizin is a representative of the medicinal group of cardiac drugs, the action of which is based on the substance trimetazidine (35 mg). Available in the form of pink, double-layer, round tablets. The drug is taken orally, 2 times a day during meals. Single dose – 1 tablet. The minimum course of treatment is 3 months.

In addition to the active ingredient, the medicine also contains cellulose, starch (corn), magnesium, talc, soy lecithin, polyvinyl alcohol, silicon dioxide and dyes (yellow and red).

Predisin has an identical mechanism of action and scope of application with Preductal, since these drugs are based on the same active ingredient. The medications differ in price category, as well as in the fact that Predisin is contraindicated for people with allergies to soy and/or peanuts.

Antisten

Antisten is a drug that restores metabolic processes in cardiomyocytes and neurons that have been subject to ischemia. The medication also maintains cell homeostasis by ensuring the proper functioning of ion channels. The active ingredient of the drug is trimetazidine (20 or 35 mg). It differs from Preductal OD in price and release form.

The medicine belongs to the therapeutic group of antihypoxic drugs. Available in the form of extended-release tablets for oral administration. Antisten is used for ischemic heart disease and chronic angina, and the medication also has a positive effect on hearing and vision, which began to deteriorate due to ischemia.

Description of the drug

The average daily dose ranges from 40-60 mg, which is divided into several doses. The medication is contraindicated for children, pregnant and breastfeeding women, the elderly, as well as patients with severe concomitant kidney and liver diseases. The drug is not recommended for use in patients with Parkinson's syndrome.

Angiosil

Angiosil has an antihypoxic effect, which is achieved by accelerating metabolic processes and improving the functional activity of cardiomyocytes and brain cells. Angiosil differs from the main medication in price and the presence of lactose in the composition.

Available in the form of round, film-coated tablets containing 0.035 g of trimetazidine. The form-modeling components are: glucose, silicon dioxide, hypromellose, triacetin, macrogol, MCC, as well as yellow and red dye.

Method of administration: orally, 1 tablet 2 times a day. The duration of therapy is determined by the attending physician depending on the patient’s condition. It is used for a long course of treatment of coronary artery disease, as well as as a prophylactic agent for stable angina pectoris. The medication is contraindicated in children, patients with parkinsonism, and people with severe liver and kidney dysfunction.

Trimetazid

Trimetazide is intended for the treatment of cardiac ischemia, chronic angina and dysfunction of the vestibular apparatus, as well as degradation of the lens due to impaired blood circulation. It is an antihypoxic agent and a complete structural analogue of Preductal. Sold in the form of round, red, film-coated tablets for oral administration.

The average therapeutic dose is 60 mg, which is divided into several doses.

The scope of application, list of contraindications and mechanism of action are completely similar to Preductal. These medications differ in the amount of active substance in the dosage form and the form of implementation itself. This analogue is not sold in the Russian Federation.

Trimectal

Trimectal is a medication with antihypoxic and antianginal action, based on trimetazidine dihydrochloride:

• 20 mg of the active substance provides a short effect of the medication (up to 5-7 hours);
• 35 mg – prolonged action. The tablets are film-coated, providing slow release of the active component.

Mechanism of action of the drug

Appearance of dosage forms:

1. Tablets, 20 mg – pink, round, marked with the trade name.
2. Tablets, 35 mg – white or yellow tablets, without inclusions or markings.

The drug helps restore metabolism and adequate transmembrane transmission of potassium and sodium ions in heart and brain cells impaired due to ischemia. By having a positive effect on coronary reserve, the medication stabilizes blood pressure levels and reduces the risk of angina.

Trimectal is used for ischemic heart disease and its consequences (dizziness, visual and hearing impairment), as well as for angina pectoris (to prevent attacks). The drug is contraindicated for the same diseases and conditions as Preductal, except for intolerance to milk sugar, since the second medication does not contain lactose.

Rimecore

Rimecor is a cardioprotector based on trimetazidine (20 mg), which directly affects the metabolism of cardiomyocytes and neurons. Helps eliminate oxygen starvation of heart cells by improving metabolic processes.

Widely used as a therapeutic agent for coronary artery disease, as well as for the prevention of angina attacks. The dosage form is pink biconvex tablets consisting of an active substance and a film shell. Rimecor is taken orally, 2-3 tablets per day.

Experts do not recommend taking Rimecor during pregnancy and lactation, as well as for minor patients. Contraindications to taking Rimecor are:

• Parkinson's syndrome;
• severe liver failure;
• kidney damage.

Unlike Preductal, it is contraindicated in patients with lactose intolerance and does not have modified sustained release trimetazidine.

Precard

Cardioprotective medication with modified release of the active ingredient. This substance has a positive effect on the metabolism and exchange of potassium and sodium in the muscle cells of the heart.

Sales form: tablets for oral administration. One tablet contains 35 mg trimetazidine. Therapeutic dose – 2-3 tablets per day. The course of therapy is determined by a specialist based on data about the disease. The drug is prohibited for use by people with renal dysfunction, liver dysfunction and secondary parkinsonism.

Pharmacological properties of trimetazidine

Precard is effective as:

• prophylactic for angina pectoris;
• the main medicine for ischemic heart disease and all somatic symptoms (dizziness, blurred vision and hearing) that arose against the background of ischemia.

The main difference from Preductal is that Precard is prohibited for people with an allergy to milk sugar.

Pharmacokinetics

Suction

After taking the drug orally, trimetazidine is rapidly absorbed. Cmax is reached after 5 hours. For more than 24 hours, the plasma concentration remains at a level exceeding 75% of the concentration determined after 11 hours. Food intake does not affect the pharmacokinetic properties of the drug.

Distribution

Css is achieved after 60 hours. Vd is 4.8 l/kg, which indicates good distribution of trimetazidine in tissues.

Plasma protein binding is low, about 16% (in vitro).

Removal

It is excreted from the body mainly by the kidneys unchanged. T1/2 - about 7 hours, in patients over 65 years old - about 12 hours.

Renal clearance of trimetazidine directly correlates with creatinine clearance; hepatic clearance decreases with age.

It has been shown that in elderly patients with a daily dose of 2 tablets in 2 divided doses, an increase in plasma exposure does not lead to any significant effects compared to placebo.

Preductal - instructions for use

According to the instructions for use, Preductal is taken 1 tablet 2 times a day in the morning and evening. The duration of treatment is determined individually by a cardiologist. The therapeutic effect of treatment with Preductal can be assessed only after 3 months.

How to take Preductal: before or after meals

Preductal is taken with meals. The tablet is not crushed into pieces or chewed, but is swallowed as a whole and washed down with a sufficient amount of water.

Side effect

Determination of the frequency of adverse reactions: very often (>1/10), often (>1/100, <1/10), infrequently (1/1000, <1/100), rarely (1/10,000, <1/ 1000); very rare (<1/10,000), including isolated cases.

From the digestive system: often - abdominal pain, diarrhea, dyspepsia, nausea, vomiting.

From the side of the central nervous system: often - dizziness, headache; very rarely - extrapyramidal symptoms (tremor, rigidity, akinesia), reversible after discontinuation of the drug.

From the cardiovascular system: rarely - orthostatic hypotension, flushing of the face.

Allergic reactions: often - skin rash, itching, urticaria.

Other: often - asthenia.

Preductal or Predisin – which is better?

Manufacturer: GEDEON RICHTER (Hungary)
Release form: tablets

Active ingredient: trimetazidine

Both drugs have the same active ingredient. Preductal is used to treat coronary artery disease and prevent the development of angina attacks. Predisin has great indications for therapy. It can be used not only for cardiac diseases, but also for dysfunction of the vestibular apparatus caused by ischemia.

In the presence of such a pathology, Predizin will be the best analogue of Preductal.

Description and composition

The drug Preductal is presented as round, biconvex, red, film-coated tablets. It is white at the break. The active element of the drug is trimetazidine dihydrochloride. 1 tablet of Preductal contains 20 mg of the substance.

Excipients:

• colloidal silicon dioxide;
• povidone;
• titanium dioxide;
• macrogol-6000;
• hypromellose;
• calcium hydrogen phosphate dihydrate;
• magnesium stearate;
• red dye iron oxide;
• glycerol

Deprenorm or Preductal – which is better?

Manufacturer: KANOPHARMA (Russia)
Release form: tablets

Active ingredient: trimetazidine

Preductal and its analogue contain the same active ingredient and indications for use. Deprenorm improves metabolic processes in the myocardium and increases the supply of oxygen to the heart muscle, which has a positive effect on its function.

The advantage of Deprenorm is that it can be used for vestibular and chorioretinal disorders of an ischemic nature. Deprenorm better stabilizes blood pressure and pulse.

Comparison, differences, what and who is better to choose

Since these products contain the same active ingredient, there is practically no difference between them. Minor differences include:

1. Release form . Trimetazidine is available in the form of tablets and capsules; Preductal has only one dosage form.
2. Price . The price of Trimetazidine is much lower and is about 130 rubles per pack of 60 capsules. Preductal will cost 1,400 rubles.

Both medications are equally effective and do their job perfectly. Their advantage is that they are coated with a special substance that allows the drug to be slowly released and distributed evenly. This allows you to increase the effect of the drug for a longer time.

Since the cost of Trimetazidine is significantly lower, it is recommended to make a choice in its favor. The efficiency will be the same, and money will be saved. After the first unpleasant symptoms appear, you should immediately consult a doctor. The sooner he can make a diagnosis, the faster he can get better.

Preductal or Trimetazidine – which is better?

Manufacturer: KANOPHARMA (Russia)
Release form: tablets

Active ingredient: trimetazidine

Preductal and its substitute Trimetazidine are in the same pharmacological group. They have 1 active ingredient. These medications are aimed at improving the function of the cardiovascular system in ischemia, angina, and chronic heart failure. According to patient reviews, Preductal gives a good effect in long-term treatment of cardiac pathologies.

According to the expert, Preductal has a positive effect and is more effective as monotherapy. According to cardiologists, both drugs provide an equivalent effect in the treatment of coronary heart disease and angina. The difference in medications lies in their cost. In practice, doctors prefer Preductal, as it is a more proven drug compared to its analogue Trimetazidine.