Release form and composition of the drug
Trimetazidine with modified release of the active substance is produced in the form of round, biconvex, white tablets, which are coated with a pink film. The tablets are placed in cellular transparent blisters in the amount of 10 pcs. The package may contain 3, 6 and 12 blisters, as well as instructions for use.
The therapeutic effect of the tablets is ensured by the following composition:
| Component name | Action of components |
| Main element | |
| Trimetazidine dihydrochloride in the amount of 35 mg per 1 tablet | The substance normalizes oxygen supply to organs and tissues, and also regulates energy metabolism. |
| Auxiliary components of the tablet core | |
| Anhydrous calcium hydrogen phosphate | The element activates the transmission of nerve impulses, restores the functioning of the heart and blood vessels, and also participates in the processes of bone tissue growth. |
| Hypromellose | The component is a stabilizer and thickener. |
| Colloidal silicon dioxide | The substance attracts poisons, allergens and toxins and removes them from the body. Additionally, the element gives the tablets the necessary strength and improves their disintegration in the digestive tract. |
| Crospovidone | Gives tablets the desired texture and also improves the disintegration of tablets in the digestive tract. |
| Talc | Used in the tablet core as an anti-inflammatory and antibacterial component. Additionally, the substance is a source of magnesium and silicon. |
| Magnesium stearate | A thickener gives the tablets the desired texture and allows them to maintain their desired shape. |
| Shell components | |
| Polyvinyl alcohol | Creates the necessary protective film on the tablet. |
| Titanium dioxide | The dye gives the shell the desired shade. |
| Macrogol | Facilitates the sliding of the tablet along the digestive tract. |
| Talc | The coated substance makes it easier to swallow the tablet and allow it to slide further along the digestive tract. |
| Iron oxide dye yellow, red and black | Dyes give the shell the required shade and additionally normalize the iron level in the blood. |
Auxiliary components of the tablet core improve the absorption of the main element of the tablets.
Pharmacological properties
Preparations containing trimetazidine dihydrochloride are classified as partial inhibitors of fatty acid oxidation. They are characterized by the following properties that affect mitochondria and the process of energy metabolism:
- inhibition of the process of cellular oxidation of all fatty acids by blocking the main oxidation enzyme (3-ketoacylthiolase);
- increased glycolysis (utilization of glucose, even with reduced oxygen supply);
- stimulation of ATP production, the main source of energy for all biochemical processes in cellular structures;
- suppression of free radical oxidation and interaction of metabolites with free oxygen, which is necessary to prevent the formation of toxic compounds in cells;
- decrease in the concentration of ADP, AMP, lactic acid (lactate);
- prevention of acidosis, which is accompanied by the accumulation of toxic metabolic products and a decrease in oxygen levels in tissues and organs.
The combination of the properties of Trimetazidine allows you to increase the level of oxygen, reduce its consumption by myocardial cells and normalize the functioning of cardiomyocytes and neurons of the brain.
Of clinical importance is the ability of the drug to reduce the frequency and duration of attacks in coronary heart disease and angina. When treating ischemic heart disease, an antiplatelet effect is observed, since the active substance prevents the increase in dynamic blood viscosity. It is also known that Trimetazidine tablets help not only against cardiovascular diseases, but also have a positive effect on other organs.
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Pharmacodynamics and pharmacokinetics
Trimetazidine MB 35 mg (reviews from cardiologists describe the high effectiveness of the drug) restores oxygen supply to organs and tissues due to the following effects of the active substance on the body:
- the activity of the muscle cells of the heart is normalized, due to which blood enriched with oxygen flows better to the tissues;
- protects the tissues of the heart and blood vessels;
- the functioning of nerve cells in the brain is activated, ultimately optimizing the functioning of organs and tissues of the whole body;
- restores the condition of eye tissue, including the retina;
- red blood cells are more actively involved in oxygen transport;
- tissues use oxygen better and “more rationally”;
- metabolic processes and energy metabolism are normalized;
- reduces the harmful effects of free radicals by strengthening cell membranes;
- coronary reserve increases, thereby reducing the risk of blood supply disruption during intense physical activity;
- regulates the concentration of potassium, calcium and sodium in cells;
- eliminates chest pain caused by cardiac dysfunction;
- prevents the development of pressure surges during physical activity.
After taking the tablets, the maximum amount of the active component is detected in the blood after approximately 5 hours and can persist for up to 24 hours. The drug is excreted from the body primarily through the kidneys (with urine).
Characteristics of the drug
Trimetazidine is one of the antihypoxic agents with a polyvalent effect. The medical purpose of this group of drugs is to saturate tissues and organs with oxygen. The use of this drug is of particular importance for patients with cardiac and neurovascular diseases.
The active substance affects neurons of the brain and cardiomyocytes - the cells that make up the myocardium.
The effective action of the drug is due to the following factors:
- Improving metabolic processes
. Trimetazidine reduces the risks of hypoxic damage to neurons and myocardial cells, optimizes the exchange of membrane phospholipids, and reduces the permeability of membrane walls. - Protection against the accumulation of toxic lipid peroxidation compounds
. Due to the normalization of the glycolysis process, the formation of lactate and phosphate compounds is reduced. - Anti-ischemic properties
. Both in monotherapy and in the complex of antianginal hemodynamic therapy, the contractility of the left ventricular myocardium is optimized and stress tolerance increases. In combination with non-selective beta-blockers and nitrates, the drug has a more pronounced effect.
One of the positive qualities of Trimetazidine is the absence of a pronounced effect on heart rate and blood pressure.
Indications for use
Trimetazidine VM tablets can be used only after a doctor’s prescription to eliminate the following pathologies:
- impaired blood supply to the myocardial heart muscle;
- to eliminate and prevent the appearance of pain in the heart area;
- violation of the condition of blood vessels, including inflammatory ones;
- impaired blood supply to the eye tissues;
- deterioration of the retina (in complex therapy);
- diagnosing oxygen starvation of brain tissue;
- the presence of tinnitus, impaired coordination of movement, severe dizziness caused by oxygen starvation of tissues.
The medication can also be prescribed to athletes to strengthen heart tissue.
Contraindications
Trimetazidine MB 35 mg (reviews from cardiologists warn of the dangers of using the medication if there are contraindications) should not be used in the following cases:
- increased sensitivity to the composition of the tablets;
- the presence of diseases that are accompanied by limb tremors or restless legs syndrome;
- renal failure in severe form or in the acute stage;
- low blood pressure;
- period of childbearing and breastfeeding. It is possible that the tablets may have a harmful effect on the fetus, as well as the penetration of the active component into breast milk.
For kidney pathologies of moderate severity, as well as after the age of 75, the medication can be used only under the supervision of a doctor and according to an individual dosage.
Instructions for use, dosage
Trimetazidine MB 35 mg is prescribed by the treating specialist (generalist, cardiologist) only after examining the patient in order to exclude the presence of contraindications and restrictions in the use of tablets. Compliance with the rules for using the drug ensures the high therapeutic effectiveness of the drug, which is reflected in numerous reviews.
The dosage of tablets and the required course of treatment depend on the age, purpose of administration, severity of the pathology, as well as the general condition of the patient. The following table shows the approximate dosages of Trimetazidine, taking into account the listed parameters. The exact dosage and course are prescribed only by the attending physician.
| Limiting Factors | Single and daily dosage | Features of application |
| Impaired blood supply to the myocardium (pills should be taken until the condition normalizes) | ||
| Age from 18 to 75 years | You need to take 1 tablet 2-3 times a day | Depending on the severity of the pathology, the doctor may prescribe complex medications. |
| Moderate renal failure | Use 1 tablet in the morning | Taking the pills should be strictly under the supervision of a doctor, especially the first 3 days. If necessary, the doctor may adjust the dosage. |
| Age over 75 | You should take 1.5 tablets per day. 1 tablet should be taken with breakfast and 1/2 tablet with dinner. | If the patient does not have chronic pathologies and the body reacts normally to taking the tablets, then the doctor can increase the dosage to 2 tablets per day. |
| For mild angina (pain in the heart after physical and emotional stress) | ||
| Age from 18 to 75 years | You need to take 1 tablet morning and evening | Trimetazidine MB should be used for 15-20 days. Further continuation of the course may be prescribed by the doctor based on the dynamics of treatment. |
| Moderate renal failure | Use 1 tablet, only in the morning | The duration of use of the drug is 7-14 days. Next, treatment is adjusted based on the patient’s general condition. The doctor also determines the possibility of continuing the course of therapy. |
| Age over 75 | Prescribe 1 tablet in the morning | In case of severe pain and if the patient tolerates taking the tablets normally, the doctor can increase the dosage to 1.5 tablets per day. The daily dosage can be divided into 2-3 doses. The duration of the course of treatment is selected individually. |
| To prevent the development of angina pectoris | ||
| Age from 18 to 75 years | It is recommended to take 1 tablet 1-2 times a day | The exact dosage depends on how much the patient has a tendency to this pathology. The tablets should be taken for 14-20 days. Next, a break of 1 month is required. |
| Moderate renal failure | Use 0.5 tablets 1 time per day | The possibility of taking the drug for the purpose of preventing pathology, as well as the duration of the treatment course, must be clarified with the attending physician. |
| Age over 75 | Prescribe 0.5 tablets 1-2 times a day | The dosage and duration of therapy are selected according to the general condition of the patient. |
| In case of retinal impairment | ||
| Age from 18 to 75 years | It is recommended to take 1 tablet 2-3 times a day | The treatment is complex, with the selection of medications carried out by the treating specialist. |
| Moderate renal failure | Allowed to use 0.5 tablets 1-2 times a day | If complex therapy is required, the specialist must confirm or deny the possibility of using Trimetazidine. |
| Age over 75 | Use 0.5 tablets 2 times a day | The effectiveness of using the drug at a given age is determined by an ophthalmologist. |
| With oxygen starvation of brain cells | ||
| Age from 18 to 75 years | It is recommended to take 1 tablet 3 times throughout the day | The duration of Trimetazidine administration depends on the dynamics of therapy. |
| Moderate renal failure | Prescribe 1 tablet, which should be taken in the morning | The duration of the course depends on the reaction of the kidneys to the use of the medication. |
| Age over 75 | Use 1 tablet 1-2 times a day | The dosage of the medication depends on the general condition of the patient. |
| Impaired blood supply due to deterioration of blood vessels | ||
| Age from 18 to 75 years | Prescribe 1 tablet 2 times a day | The duration of use of the tablets can be about 30 days. Depending on the severity of the pathology, complex treatment may be prescribed. |
| Moderate renal failure | Use 0.5 tablets morning and evening | If the body reacts normally to taking the pills, the course duration can be approximately 3 weeks. |
| Age over 75 | You need to take 1 tablet in the morning | After 75 years, comprehensive treatment is recommended, which is selected by a specialist based on the general condition of the patient. |
| For athletes to strengthen heart tissue | ||
| Age from 18 to 75 years | You need to take 1 tablet once a day, approximately 4 hours before training. | The duration of treatment is approximately 30 days. |
| Moderate renal failure | It is recommended to use 1 tablet approximately 2 hours before the start of physical activity. | Trimetazidine should be taken for approximately 14-20 days. Longer use should be checked with your doctor. |
Trimetazidine MB tablets should be taken during meals and washed down with approximately 100 ml of water.
Trimetazidine or Mildronate – which is better for the heart?
Manufacturer: Latvia, Poland, Slovakia
Release form: capsules, solution
Active ingredient: meldonium
Synonyms: Cardionate, Idrinol, Meldonium
The drugs differ in the mechanism of action on lipids. If Mildronate affects the intensity of fatty acid metabolism, then Trimetazidine changes the rate of their utilization.
Both drugs equally increase the physical endurance of the body. But for angina pectoris, the dose of Trimetazidine will be lower compared to its analogue, with the same effect.
Mildronate is more suitable for healthy people experiencing intense physical activity.
The duration of taking the drugs differs: Trimetazidine is taken in a course
6 months, Mildronate – 6 weeks.
It is possible to take these drugs together. Moreover, this combination protects myocardial cells after coronary artery bypass surgery and other types of angioplasty.
Side effects
Taking Trimetazidine MB tablets may cause the following side effects:
- nausea, abdominal pain, vomiting;
- constipation or vice versa diarrhea;
- development of inflammatory processes in the liver;
- headache and severe dizziness;
- tremor of the limbs and the appearance of an unsteady gait;
- imbalance;
- impaired sleep quality, expressed by insomnia or, conversely, increased sleepiness;
- skin rashes, itching, tissue swelling and other signs of an allergic reaction, including Quincke's edema;
- feeling of heartbeat;
- violation of muscle tone;
- flushed face;
- increased heart rate;
- decrease in blood pressure;
- a decrease in the number of platelets in the blood, which is dangerous due to the development of bleeding.
The most common development is severe fatigue, without increased physical or mental stress. Side effects usually go away on their own (after stopping the medication) within 4 months.
Riboxin
Manufacturer: Russia, Belarus, China
Release form: tablets, solution for intravenous injection
Active ingredient: inosine
Synonyms: Inosine, Atorel, Inotin, Irpelen, Oxiamin, Trophicardyl, etc.
Riboxin is an antihypoxant and antiarrhythmic, a precursor of ATP. Improves metabolic processes in the myocardium, as a result of which the contractility of the heart increases.
Strengthens the ability of tissues to self-heal, especially the heart muscle and the mucous membrane of the digestive tract.
Riboxin is prescribed for the complex treatment of heart diseases such as coronary artery disease, angina pectoris, and arrhythmias. It is an adjuvant in the treatment of liver diseases.
Not a drug of choice for emergency use. Long-term use of this analogue requires monitoring the level of uric acid in the blood.
Overdose
Trimetazidine MB 35 mg (reviews from cardiologists about the drug are mostly positive) should be taken strictly in the dosage prescribed by the doctor. When using the medication in an excess dose, side effects may increase.
The exact clinical symptoms are not known, since no cases of tablet overdose have been reported to date. When using the medication in a large dose, gastric lavage is required, then treatment is carried out according to the symptoms.
special instructions
Before prescribing Trimetazidine MB tablets, the specialist should discuss with the patient the specifics of using the medication, which are as follows:
- Trimetazidine MB should not be used alone for severe attacks of angina;
- the drug is contraindicated for use when diagnosing myocardial infarction (in the first 2-3 days);
- if, when taking tablets, angina attacks do not go away or, on the contrary, progress, then a dosage adjustment or replacement of the medication with an analogue is required;
- patients over 60 years of age should undergo treatment under the supervision of a physician, as the drug can cause tremors of the limbs. This side effect occurs more often in older people and may progress;
- If there is severe tremors of the limbs or the development of a very unsteady gait, taking the pills should be stopped immediately.
Since the drug can cause drowsiness and tremors of the extremities, when taking the course you are required to drive vehicles and perform hazardous work with caution.
Analogs
Trimetazidine MV 35 mg (reviews from cardiologists prohibit replacing the drug yourself) if there are contraindications or a negative reaction occurs, you can cancel it and use the following analogues, which are discussed further in the table.
Preductal
| Name of analogue, price and terms of sale | Release form, active ingredient and its effect | Features and rules for using the analogue |
| Predisin. Cost for 60 tablets is 500 rubles. Sold by prescription. | Available in tablets. The active substance similar to Trimetazidine is contained in an amount of 35 mg per tablet. As a result, the effect of the medication on the body is completely identical to the original. | Indications and contraindications for the use of Predizin are similar to Trimetazidine. You need to take 1 tablet each. 1-2 times a day. The duration of treatment is selected individually. Side effects on the use of the medication are similar to the original. |
| Antisten MV. Cost for 60 tablets is 300 rubles. Dispensed by prescription. | Produced in tablets. The main element is identical to Trimetazidine. Therefore, the effect of the drug is similar to the original. | Contraindications, side effects and indications for taking Antisten MV tablets are completely similar to the original. The drug should be taken 1 tablet 1-2 times throughout the day. The duration of the course is set individually. |
| Rimekor. Price for 60 tablets 500 rub. Sold by prescription. | The medicine is produced in the form of tablets. The main component of the drug is also trimetazidine in the amount of 20 mg per tablet. The therapeutic effect of the product is similar to the original, but less pronounced due to the lower concentration of the main substance. | Indications for use of the tablets are similar to the original. Contraindications for use are also similar, only Rimecor cannot additionally be used for severe liver pathologies. The drug should be taken 2-3 tablets 2-3 times during the day. The duration of the course is selected individually. Side effects from using the product include itchy skin, nausea and increased heart rate. |
| Angiosil retard. Cost for 60 tablets is 500 rubles. Dispensed by prescription. | The drug is produced in the form of tablets, the active substance in which is also trimetazidine in an amount of 35 mg per tablet. As a result, the therapeutic effect of the drug is similar. | Indications, side effects and contraindications for the use of the drug are completely similar to the original. Angiosil retard should be taken 1 tablet 1-2 times a day. The duration of the course is selected according to the dynamics of treatment. |
| Preductal MV. Cost for 60 tablets is 1500 rubles. Sold by prescription. | The medicine is produced in the form of tablets with a similar active ingredient in the amount of 35 mg per tablet. The therapeutic effect of Preductal MV is identical to Trimetazidine. | Side effects, indications and contraindications for the use of Preductal MV tablets are identical to the original. Take 1 tablet 1-2 times a day. The duration of treatment is determined individually. |
| Medonium. Cost for 40 capsules 200 rubles. Sold by prescription. | The medicine is available in the form of capsules and solution for injection. The active ingredient of the drug (meldonium) normalizes heart function, also activates metabolism and prevents the development of oxygen starvation. | Indications for the use of capsules are similar to the original; in addition, the product is used to relieve hangovers and during the recovery period after operations. Contraindications to the use of capsules are similar to Trimetazidine. The dosage of capsules is selected according to the general condition of the patient. The duration of the course is from 4 to 6 weeks. Taking the medication may be accompanied by increased agitation, pressure surges and abdominal pain. |
The choice of analogue is selected strictly by the doctor, taking into account contraindications and the patient’s condition. If Trimetazidine needs to be replaced due to intolerance to the active substance, then analogues with a different active ingredient should be used.
Trimetazidine or Preductal - which is better and more effective, what is the difference
Manufacturer: Poland
Release form: capsules
Active ingredient: trimetazidine dihydrochloride
Synonyms: Angiosil retard, Antisten, Carditrim, Prekard, etc.
Preductal OD and Trimetazidine contain the same active ingredient and are used in the treatment of the same nosologies. Both are covered with a special coating, which ensures uniform absorption of the drug and constant concentration in the blood. If necessary, you can replace one product with another. But according to expert cardiologists, it is trimetazidine that is the ideal doping for the heart muscle.
The analogue has minor differences. Trimetazidine has 2 release forms - tablets and capsules. Preductal is available only in capsules.
The drugs differ in cost. Trimetazidine is cheaper than its analogue, and significantly: a package will cost 100–120 rubles. For Preductal you will have to pay about 1500 rubles.
Price
The average cost of tablets can be checked with your doctor after prescribing the medication. The price for Trimetazidine depends not only on the region where the drug was purchased and the type of pharmacy, but also on the number of tablets in the package. The table below shows the price range in Russia.
| Number of tablets | Minimum cost, rub. | Maximum cost, rub. |
| 30 | 115 | 140 |
| 60 | 150 | 185 |
Trimetazidine IM 35 mg is considered an effective drug for preventing the development of angina pectoris. According to reviews from doctors and patients, the medication eliminates the symptoms of oxygen starvation of tissues within approximately 3 days. It should be borne in mind that in order to achieve these results, it is necessary to strictly adhere to the dosage prescribed by the cardiologist or therapist.
Author: Kotlyachkova Svetlana
