- Latin name: Mildronate
- ATX code: S01EB
- Active ingredient: Meldonium
- Manufacturer: JSC “Grindeks”, Latvia
Compound
One hard gelatin capsule of Mildronate contains 250 or 500 mg Meldonia in the form of a dihydrate as an active component and excipients: Amylum solani (potato starch), Silicii dioxydum colloidale (colloidal silicon dioxide), Calcium stearate (calcium stearate).
Gelatinum (gelatin) and Titanium dioxyde (titanium dioxide) are used to make the gelatin shell.
One milliliter of injection solution Mildronate contains 100 mg Meldonia and water for injection as an auxiliary component.
One Mildronate tablet contains 500 mg Meldonia in the form of phosphate and auxiliary components: Mannitum (E421; mannitol), Povidonum K-29/32 (povidone K-29/32), Amylum solani (potato starch), Silicii dioxydum (silicon dioxide), Cellulose microcristalline (microcrystalline cellulose), Magnesium stearate (magnesium stearate).
Release form
The drug Mildronate is produced by the manufacturer in the form:
- clear colorless solution for injection;
- hard gelatin capsules No. 1 and No. 2, filled with hygroscopic crystalline powder white. The powder contained in the capsules has a weak characteristic odor and a sweetish taste (the capsule itself has a neutral taste);
- tablets Mildronate Gx 500 mg (tablet taste slightly sour).
The solution is sold in 5 ml ampoules (500 mg/5 ml). One cardboard package contains: 2 blister packs with 5 ampoules of Mildronate in each and instructions for use of the drug.
Capsules are packaged in blisters of 10 pieces each. One cardboard box contains 4 blisters and instructions for use of the drug.
Pharmacological action
Meldonium is a synthetic drug that has a similar effect to γ-butyrobetaine (GBB; a substance that is a precursor to hydroxytrimethylaminobutyric acid, a natural vitamin-like substance related to B vitamins ).
According to Wikipedia, meldonium characterized by the ability to improve the energy supply of cells and is used as:
- cardioprotective ;
- antihypoxic ;
- angioprotective ;
- antianginal means.
Mechanism of action Meldonia determines a wide range of its pharmacotherapeutic properties. Taking this drug helps improve performance, reduces the severity of manifestations of mental, intellectual and physical stress, activates fabric And humoral .
In patients suffering from heart failure , increases the strength of contractions heart muscle , reduces frequency heart attacks (attacks), and also increases the body’s tolerance to physical activity.
For acute injuries myocardium application Meldonia slows down the formation of necrotic areas, shortens the duration of the rehabilitation period, normalizes blood circulation in the area of ischemic damage and redistributes blood in favor of the ischemic area.
Under conditions of increased loads meldonium helps restore the balance between the transport of oxygen into cells and the cells' need for it, prevents the accumulation of cellular metabolic products and toxic substances in cells, protects cells and cellular structures from damage, ensures the body quickly compensates for its energy reserves and maintains the highest rate of metabolic processes.
Toning CNS , meldonium effectively eliminates violations functional state somatic and vegetative (autonomous) departments nervous system , including violations that accompany withdrawal syndrome in patients suffering from chronic alcoholism.
In addition, the substance has a beneficial effect on the condition dystrophically altered retinal vessels , which allows it to be used for treatment vascular and dystrophic pathologies of the fundus .
Pharmacodynamics and pharmacokinetics
The action of the active substance of the drug is aimed at inhibiting the enzymatic activity of γ-butyrobetaine hydroxylase, which is the last enzyme in the chain reaction of synthesis.
Meldonium helps reduce the concentration of free , prevents transportation through cell membranes long chain fatty acids, prevents the accumulation in cells of activated forms of unoxidized fatty acids, which are derivatives acylcarnitine And acyl coenzyme .
In ischemic tissues, it restores the balance between the transport of oxygen and its absorption by cells, prevents disruption of the transport of adenosine triphosphate, while simultaneously activating glycolysis, which occurs without additional oxygen consumption.
The result of a decrease in concentration carnitine is the enhanced synthesis of the vasodilator γ-butyrobetaine.
After taking the Mildronate tablet per os, it contains meldonium quickly absorbed in the digestive tract. The drug is characterized sufficiently high rate bioavailability. The latter is approximately 78%.
Concentration Meldonia reaches its maximum values an hour or two after administration. In the body meldonium metabolized to non-toxic products - glucose, succinate, 3-hydroxypropionic acid.
It has not been established whether meldonium excreted into the milk of a nursing woman. Therefore, if treatment with Mildronate is indicated for the mother, she needs stop .
Reviews of Mildronate
Reviews of Mildronate on forums for the most part positive. The unique mechanism of action of this drug allows it to be widely used to eliminate problems with cardiovascular system , and also as a means of increasing performance in healthy people who are subject to frequent physical and intellectual overload.
Both patients in cardiology departments, doctors, and athletes note the fact that Mildronate provokes a tonic effect. Its use significantly improves memory function, accelerates thought processes, increases dexterity, endurance and the degree of body resistance to adverse factors.
Reviews from cardiologists confirm the data of numerous studies that have shown that the use of Mildronate in capsules and in the form of a solution for injections can reduce the incidence of recurrent episodes by more than nine times myocardial infarction .
Reviews from patients about Mildronate allow us to conclude that the drug is simply necessary for people whose activities are associated with increased stress on the body, as well as during the recovery period after prolonged alcohol abuse, with pain and burning in the heart area, VSD and other pathologies cardiovascular system .
Average rating for this product 4,8-5 out of 5 points.
However, sometimes you come across negative reviews about Mildronate. It is important to remember that, like any other medicine, Mildronate gives good result only if its dose and concomitant treatment (if necessary) are selected correctly.
Mildronate price
Price of the drug on the Ukrainian market
The average price of Mildronate 250 mg tablets is 214.1 UAH. The price of Mildronate ampoules of 5 ml is 383.95 UAH. Capsules 500 mg cost 323-325 UAH per package. Mildronate Gx is sold for an average of 233-240 UAH.
In this article you can read the instructions for use of the drug Meldonium. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Meldonium in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications were observed and side effects, perhaps not stated by the manufacturer in the annotation. Analogues of Meldonium in the presence of existing structural analogues. Use for the treatment of coronary artery disease, fatigue, recovery of athletes in adults, children, as well as during pregnancy and lactation. Composition of the drug.
Meldonium- a drug that improves metabolism, an analogue of gamma-butyrobetaine. Suppresses gamma-butyrobetaine hydroxinase, inhibits the synthesis of carnitine and the transport of long-chain fatty acids through cell membranes, and prevents the accumulation in cells of activated forms of unoxidized fatty acids - derivatives of acylcarnitine and acyl coenzyme A.
Under conditions of ischemia, it restores the balance of the processes of oxygen delivery and its consumption in cells, prevents disruption of ATP transport; At the same time, it activates glycolysis, which occurs without additional oxygen consumption. As a result of a decrease in carnitine concentration, gamma-butyrobetaine, which has vasodilating properties, is intensively synthesized. The mechanism of action determines the variety of its pharmacological effects: increased performance, reduced symptoms of mental and physical stress, activation of tissue and humoral immunity, cardioprotective effect.
In case of acute ischemic damage to the myocardium, it slows down the formation of the necrotic zone and shortens the rehabilitation period. In case of heart failure, it increases myocardial contractility, increases exercise tolerance, and reduces the frequency of angina attacks. In acute and chronic ischemic disorders of cerebral circulation, it improves blood circulation in the ischemic area and promotes the redistribution of blood in favor of the ischemic area. Effective for vascular and dystrophic pathology of the fundus. It has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.
Compound
Meldonium dihydrate (trimethylhydrazinium propionate dihydrate) + excipients.
Pharmacokinetics
After oral administration, it is quickly absorbed from the gastrointestinal tract. Bioavailability is about 78%. Cmax in plasma is achieved 1-2 hours after administration. It is biotransformed in the body to form two main metabolites, which are excreted by the kidneys.
Indications
For oral or intravenous administration:
- as part of complex therapy for coronary artery disease (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy;
- as part of complex therapy for acute and chronic cerebrovascular accidents (stroke and cerebrovascular insufficiency);
- decreased performance;
- physical overexertion (including among athletes);
- postoperative period to speed up rehabilitation;
- withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism).
For parabulbar administration:
- acute circulatory disorder in the retina;
- hemophthalmos and retinal hemorrhages of various etiologies;
- thrombosis of the central retinal vein and its branches;
- retinopathy of various etiologies (including diabetic and hypertensive) - only for parabulbar administration.
Release forms
Capsules 250 mg and 500 mg (sometimes mistakenly called tablets).
Solution for parabulbar and intravenous administration (injections in injection ampoules).
Instructions for use and dosage
Due to the possibility of developing an stimulating effect, it is recommended to use it in the first half of the day. The dose is set individually depending on the indications and route of administration.
When taken orally, a single dose is 0.25-1 g, the frequency of administration and duration of treatment depend on the indications.
When administered intravenously, the dose is 0.5-1 g once a day, the duration of treatment depends on the indications.
0.5 ml of injection solution with a concentration of 500 mg/5 ml is administered parabulbarically for 10 days.
Athletes are prescribed for rehabilitation therapy according to special regimens in combination with other means. Officially recognized as doping.
Side effect
- tachycardia;
- changes in blood pressure (hypotension);
- psychomotor agitation;
- dyspeptic symptoms;
- skin itching;
- redness;
- rash;
- edema.
Contraindications
- increased intracranial pressure (including in cases of impaired venous outflow, intracranial tumors);
- pregnancy;
- lactation period (breastfeeding);
- children's and adolescence up to 18 years old;
- hypersensitivity to meldonium.
Use during pregnancy and breastfeeding
During pregnancy and lactation (breastfeeding), the use of Meldonium is contraindicated.
Use in children
In children and adolescents under 18 years of age, the effectiveness and safety of meldonium have not been established.
Meldonium in capsule form is contraindicated for use in children and adolescents under 18 years of age; in syrup form - in children under 12 years of age.
Special instructions
Use with caution in case of liver and/or kidney disease, especially for a long time.
Many years of experience in the treatment of acute myocardial infarction and unstable angina in cardiology departments show that meldonium is not a first-line treatment for acute coronary syndrome.
Drug interactions
When used together, Meldonium enhances the effect of antianginal drugs, some antihypertensive drugs, and cardiac glycosides.
When Meldonium is used simultaneously with nitroglycerin, nifedipine, alpha-blockers, antihypertensive drugs and peripheral vasodilators, moderate tachycardia and arterial hypotension may develop (with these combinations, caution is required).
Analogues of the drug Meldonium
Structural analogues of the active substance:
- 3-(2,2,2-Trimethylhydrazinium)propionate dihydrate;
- Angiocardil;
- Vasomag;
- Idrinol;
- Cardionate;
- Medatern;
- Meldonium Organics;
- Meldonium Binergia;
- Meldonium Eskom;
- Meldonium dihydrate;
- Melfort;
- Midolat;
- Mildronate.
Analogs for therapeutic effect (medicines for the treatment of physical, mental overload and rehabilitation):
- Additive with iron;
- Antioxycaps with iodine;
- Asvitol;
- Ascovit;
- Berocca Plus;
- Vasomag;
- Vasoton (L-arginine);
- Valeocor Q10;
- Vitamax;
- Vitaspectrum;
- Vitatress;
- Vitrum Plus;
- Galavit;
- Hepargin;
- Heptolexin;
- Dibikor;
- Jeriton;
- Duovit;
- Idrinol;
- Inosine;
- Beresh Plus drops;
- Cardionate;
- Carnitine;
- Korilip;
- Coenzyme compositum;
- Cropanol;
- Kudevita;
- Kudesan;
- Lamivit;
- Leriton Active;
- Mexidol;
- Mexico;
- Metaprot;
- Mildronate;
- Nagipol;
- Neoton;
- Oligovit;
- Pantogam;
- Pantocalcin;
- Pikovit;
- Pikovit forte;
- Riboxin;
- Ribonosine;
- Selmevit;
- Trekrezan;
- Triovit;
- Ubiquinone compositum;
- Falkamin;
- Centrum;
- Cytoflavin;
- Cigapan;
- Eleutherococcus extract;
- Eltacin;
- Elkar;
- Encephabol;
- Yantavit.
If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.
⭐⭐⭐⭐⭐ Mildronate: instructions for use, why take the tablets? Method of administration and dose. Before starting treatment, you should study mildronate instructions for use and recommendations. Mildronate (meldonium, cardinate) is a drug that improves metabolism and energy supply to tissues and is available strictly according to a doctor’s prescription. The medicine was created in the 70s of the 20th century, and was developed by Professor Ivars Kalvins.
What is mildronate: report
There is a misconception among non-professionals that taking Mildronate can provoke growth muscle mass. The opinion is completely wrong; this medication has no effect on muscle volume. Athletes take Mildronate only as a means to restore strength, strengthen the body and increase resistance to stress.
But the statement that Mildronate helps tissues regenerate is absolutely correct. Indeed, when taking this drug, cells are restored faster, as the flow of oxygen to the tissues is activated. Metabolism also becomes more active. Mildronate is available for sale in the form of ampoules, tablets and capsules. The ampoules contain a special liquid that is completely ready for use.
Against the background of increased load, the drug balances the processes of oxygen delivery to cells and its consumption at the destination, prevents the accumulation of toxic breakdown products in cells, protecting them from damage, has a tonic effect and mildronate confirms this.
Thanks to mildronate, the body is endowed with the ability to withstand increased stress and quickly restore its energy reserves. In this regard, mildronate is used in the treatment of various cardiovascular pathologies, cerebrovascular accidents, and increasing mental and physical performance. And such a drug, as a metabolic regulator, normalizes and activates the processes of protective inhibition in the central nervous system.
The vasodilating properties of mildronate are due to its ability to reduce the concentration of carnitine while increasing the synthesis of gamma-butyrobetaine.
- In case of heart failure, mildronate helps the myocardium to contract better and withstand physical activity;
- In ophthalmology, mildronate is used in cases of vascular and dystrophic pathology of the fundus;
- In case of acute ischemia of the heart muscle, the drug slows down the necrotic degeneration of myocytes and accelerates the rehabilitation process;
- In acute and chronic cerebral ischemia, the drug improves cerebral circulation and optimizes microcirculation in favor of the tissue area most affected by ischemia.
Due to its ability to eliminate functional disorders of the central nervous system in persons suffering from alcoholism, the drug is effective in treating withdrawal symptoms. This drug goes well with the following medications:
- Diuretics (Diacarb, Veroshpiron);
- Bronchodilators (Berotec, Ventolin);
- Antiplatelet agents (Aspirin Cardio, Prostacyclin);
- Antiarrhythmic drugs (Ritalmex, Difenin, Cordarone);
- Antianginal drugs (Riboxin, Sustak, Trendal).
In some cases, Mildronate enhances the effect of other drugs. This is observed when taking this simultaneously medicine m with the following medications:
- Cardiac glycosides (Digoxin, Strophanthin);
- Beta-adrenoblockers (Metaprolol, Atenolol, Propranolol);
- Medicines that lower blood pressure.
Indications for use
Indications for use of Mildronate (for all dosage forms of the drug):
- Reduced performance;
- Physical overload (including in sports);
- COPD;
- Heart disease, including ischemic;
- Hemorrhage into the vitreous cavity of the eye (hemophthalmos);
- Peripheral artery disease;
- IHD (in combination with other drugs and treatment methods);
- Cardialgia (pain in the left side of the chest) caused by dishormonal myocardiopathy;
- Stroke;
- Thrombosis and occlusion of the central retinal vein or its branches;
- Discirculatory encephalopathy;
- Postoperative period (to speed up the recovery of the body);
- Respiratory tract diseases;
- Bronchial asthma;
- Hemorrhage into the retina of the eye;
- Mental disorders caused by drinking alcoholic beverages.
The absolute safety of Mildronate in the treatment of pregnant women has not yet been proven. In order to prevent the negative impact of the drug on the full and healthy development of the fetus, you should not use Mildronate during pregnancy. We found out what the remedy helps with, but you should still refrain from such treatment during pregnancy.
It is also unknown whether meldonium is present in breast milk women. Therefore, when treating with Mildronate, doctors advise stopping breast-feeding for women. Mildronate interacts freely with various drugs and does not conflict with them.
Mildronate is often used for sleep disorders. Why is the remedy prescribed in such cases? To combat insomnia or overly vivid, aggressive dreams, dizziness, noise in the ears and head, and frequent fainting.
Mildronate has the ability to increase a person’s endurance, so after using the drug, physical and intellectual stress is much easier to bear. Mildronate is often used by athletes. After all, it improves the nutrition of the heart, helps reduce fatigue, and therefore increases the intensity physical training. Mildronate promotes rapid restoration of body cells and faster metabolism.
Release form and composition
- Active ingredient: Meldonium;
- ATX code: C01EV;
- Manufacturer: JSC “Grindeks”, Latvia;
- Latin name: Mildronate.
Dosage and rules of use depend on the form of the medicine. One hard gelatin capsule of Mildronate contains 250 or 500 mg. Meldonium in the form of dihydrate as an active component and excipients: Amylum solani (potato starch), Silicii dioxydum colloidale (colloidal silicon dioxide), Calcium stearate (calcium stearate). Gelatinum (gelatin) and Titanium dioxyde (titanium dioxide) are used to make the gelatin shell.
In 1 ml. Mildronate injection solution contains 100 mg. Meldonium and water for injection as an auxiliary component. 1 tablet Mildronate contains 500 mg. Meldonium in the form of phosphate and auxiliary components: Mannitum (E421; mannitol), Povidonum K-29/32 (povidone K-29/32), Amylum solani (potato starch), Silicii dioxydum (silicon dioxide), Cellulose microcristalline (microcrystalline cellulose) , Magnesium stearate (magnesium stearate).
The drug Mildronate is produced by the manufacturer in the form:
- Mildronate Gx 500 mg tablets. (the taste of the tablet is slightly sour);
- Transparent colorless solution for injection;
- Hard gelatin capsules No. 1 and No. 2, filled with hygroscopic white crystalline powder. The powder contained in the capsules has a weak characteristic odor and a sweetish taste (the capsule itself has a neutral taste).
Capsules are packaged in blisters of 10 pieces each. One cardboard box contains 4 blisters and instructions for use of the drug. The solution is sold in 5 ml ampoules. (500 mg/5 ml). One cardboard package contains: 2 blister packs with 5 ampoules of Mildronate in each.
Directions for use and doses
Before starting treatment, you should study mildronate instructions for use and recommendations. manufacturer. When choosing a drug in tablet form, you need to remember: the drug is swallowed whole, it should not be chewed. The same applies to capsules. Tablets should be stored in their original packaging in a place protected from light, away from children. Usually capsules and tablets are recommended to be taken if Mildronate is prescribed as an element of complex therapy against cardiovascular pathologies.
Often there are questions “ Is it possible to administer Mildronate intramuscularly?" or " How to inject the drug intramuscularly". The instructions for medical use indicate that the drug in injection form is intended for intravenous administration, it should be administered separately from other drugs, dilution with an aqueous solution of sodium chloride is not required (however, in some cases it is allowed), and capsules and tablets are intended for oral administration (per os).
The manufacturer recommends taking no more than 1 g of Mildronate per day. Mildronate is usually used twice a day. The duration of the course is 30 days, but sometimes a longer duration is required. When injected into a muscle, the injection solution has an irritating effect and can provoke local pain and local allergic reactions. For this reason, the drug Mildronate is usually injected into a vein.
The dose and route of administration of Mildronate depend on the disease:
- Athletes are recommended to take 500 mg-1 g 2 times a day before training. The duration of the course in the preparatory training period is 14-21 days, during the competition period - 10-14 days;
- For reduced performance, mental and physical stress (including athletes), 500 mg is prescribed orally. 2 times/day. The course of treatment is 10-14 days. If necessary, therapy is repeated after 2-3 weeks;
- For chronic cerebrovascular accidents, take 1-2 tablets of Mildronate (500 mg each) per day for a course of 4 to 6 weeks. In some cases, the doctor recommends taking a second course, but no more than three in a year;
- For disorders caused by chronic alcoholism, usually take 1 tablet of Mildronate (500 mg) 4 times a day for 10 days;
- In the acute phase of cerebrovascular accident, Mildronate is administered intravenously for 10 days, 500 mg according to the instructions. once a day. After this, you can switch to taking Mildronate tablets, 0.5-1 g per day. The general course of use is up to 6 weeks;
- After a heart attack, 500-1000 mg is administered intravenously on the first day. solution. Then the patient is transferred to tablets. They should be taken 2 times a day, 250 mg. Next, you need to take the drug three times a day (the dosage is the same), but this should be done twice a week. The duration of therapy is 4-5 weeks;
- Bronchial asthma - the drug is used in complex therapy with bronchodilators. It is prescribed once a day for 3 weeks;
- Asthenic syndrome - it is recommended to take 5 ml syrup. 5 times a day. The duration of therapy is 14 days;
- For cardialgia developing against the background of dishormonal myocardial dystrophy, Mildronate is recommended to be taken twice a day for 12 days, 250 mg;
- Stable angina – 1 tablet 250 mg. or 5 ml. syrup three times a day. You need to take this regimen for 3-4 days. After this, the dosage and number of doses remain the same, but you should take the drug only 2 times a week. The duration of therapy varies from 1 to 1.5 months;
- Unstable angina and myocardial infarction. 0.5-1 g intravenously once a day, after which the patient is prescribed the drug orally at 0.25 g 2 times a day for the first 3-4 days;
- For increased mental or physical stress, take 1 tablet of Mildronate 250 mg, up to 4 times a day for two weeks. A repeat course can be taken no earlier than 2 weeks;
- At cordially- vascular diseases Mildronate is indicated as part of complex therapy, up to 2 times a day, 0.5-1 g. Treatment is usually carried out from a month to 6 weeks;
- Patients with acute heart failure are additionally prescribed fast-acting cardiac glycosides (strophanthin, corglycon, celanide) and diuretics;
- Acute phase of cerebrovascular pathology. 5 ml. A 10% solution once a day intravenously for 10 days, after which the drug is prescribed to the patient orally at 0.5 g per day. The course of treatment is 2-3 weeks.
Mildronate is indicated for use in the first half of the day and no later than 17:00 when taken several times a day due to the possibility of developing an stimulating effect. Adults: 15 to 20 mg. per kg. weights 1 time per day, preferably 30 minutes before training.
Mildronate tablets: instructions for use and dosage
Mildronate tablets have a wide range of applications. The drug is effective in treating many diseases. The instructions for the drug indicate that the drug is available both in the form of an injection solution and in the form of tablets for oral administration.
The tablets must be taken whole and should not be chewed or crushed. It is forbidden to spill Mildronate tablets from the capsule. Indications for use in diseases of the heart and blood vessels - the medicine is prescribed in the form of tablets and capsules. The recommended daily dose does not exceed 1000 mg. You can divide the required dose of the drug into 2 applications. Therapeutic treatment with Mildronate in tablet form lasts on average about 30 days.
This medicine can be used for cardialgia, which is a consequence of hormonal disorders. In this case, it is necessary to use the drug once a day if the dosage of the drug is 500 mg. If the tablets have a dosage of 250 mg, then you need to take the drug 2 times a day.
In a situation where acute pathologies of cerebral circulation have been eliminated, the patient is prescribed Mildronate in a daily dosage of 500-1000 mg. They drink the medicine either once a day, or divide the daily dose into several doses.
For patients with chronic changes in the blood supply to the brain, it is recommended to use the drug in an amount of 500 mg. per day. The duration of course therapy is on average 40 days. The treating doctor may prescribe the patient a second course of treatment. It is carried out no more than 3 times a year.
For patients suffering from arterial diseases, Mildronate is prescribed 2 times a day. For increased mental and physical stress, the drug is usually prescribed in a dosage of 1000 mg. The daily dose must be divided into several doses. The duration of treatment with Mildronate is on average three weeks. After the three-week period, the course can be repeated again.
Athletes can use the drug before sports training. The course of treatment in preparation for competitions lasts two weeks. During competitions, it can be used for no more than 15 days.
Mildronate injections, instructions for use of injections
Injections are given intravenously, parabulbarly or intramuscularly. In the first option, the drug is injected into a vein, so it immediately enters the blood. With intramuscular injections, the solution enters the thickness of the muscles, and then spreads evenly to the cells.
Parabulbar injections involve the injection of the drug into the eye tissue. The medicinal solution is available in ampoules with a capacity of 100 ml. They should be opened immediately before Mildronate injections are given. If the ampoule with the solution was opened in advance, it cannot be used: such a drug must be thrown away.
Before opening the medicinal product, the solution must be carefully inspected. You should make sure that there is no sediment or flakes in it. If they are present, the drug cannot be used for treatment. Only a clean, transparent solution can be used for injection.
Intramuscular injections can be done at home, but intravenous and parabulbar injections can be done in a hospital. They must be performed by a qualified nurse.
Directions for use and dosage:
Mildronate for injection is supplied completely ready for use. This drug is administered intravenously separately from other medications. Mildronate does not need to be diluted with sodium solution.
When the solution is administered intramuscularly, the injection agent often provokes pain. An allergic reaction may develop and skin irritation may occur. Therefore, Mildronate is most often injected directly into a vein. Mildronate injections can be used for progressive angina, heart attack, vascular diseases of the fundus and cerebrovascular accidents.
- For patients with vascular pathologies of the fundus, the medicine is administered retrobulbarly or subconjunctivally in a dose of 0.5 ml. for 10 days;
- Patients with chronic cerebral circulatory disorders are advised to administer Mildronate intramuscularly 1-3 times a day at a dose of 500 mg. (optimally - before lunch). The duration of the therapeutic course is from 2 to 3 weeks;
- For patients with coronary syndrome, the drug is injected into a vein in a dose of 500-1000 mg. 1 time per day. After this, therapy is continued by taking tablets or capsules;
- For patients with cerebral circulatory disorders in the acute stage, the solution is administered into a vein once a day at a dose of 500 mg. The duration of the therapeutic course is 10 days. Further treatment is carried out using oral dosage forms;
- For coronary syndrome, this drug is administered intravenously. The drug is used 1 time per day. Mildronate is administered in a uniform stream, the recommended dosage is no more than 1000 mg. After treatment with injections, Mildronate therapy should be continued. The patient takes the drug in the form of capsules or tablets;
- If the blood supply to brain cells is disrupted, patients with an acute form of the disease must be administered intravenously. Mildronate is used once a day. The dosage of the drug is 500 mg. Further therapy is carried out using tablets;
- If the patient suffers from chronic cerebrovascular accident, Mildronate should be administered intramuscularly. The drug is used on average twice a day at a dosage of 500 mg. It is best to use the medicine in the first half of the day. The duration of drug therapy is usually 3 weeks;
- If the patient has vascular changes in the fundus of the eye, the drug should be administered behind the eyeball area. The duration of treatment is at least ten days. In this case, the drug is used in a dosage of 0.5 ml.
Mildronate: what is it prescribed for and what do tablets and injections help with?
- After using Mildronate, you can withstand more stress on the body and recover quickly. Thanks to these properties, the drug is used to improve blood supply to the brain and treat various disorders of the cardiovascular system, as well as improve performance;
- In case of ischemic disorders of cerebral circulation, Mildronate is used to improve blood circulation in the area of ischemia, which promotes blood redistribution;
- The active ingredient Mildronate improves metabolism, promotes the removal of accumulated toxins from cells, has a tonic effect and protects cells from damage;
- In case of heart failure, Mildronate, according to the instructions, increases myocardial contractility, reduces the frequency of angina attacks, while increasing tolerance to physical activity;
- Also, according to reviews, Mildronate is effective for disorders of the nervous system with withdrawal syndrome and fundus pathology;
- Meldonium helps reduce the concentration of free carnitine, prevents the transport of long-chain fatty acids through cell membranes, prevents the accumulation in cells of activated forms of unoxidized fatty acids, which are derivatives of acylcarnitine and acyl coenzyme;
- In ischemic tissues, it restores the balance between the transport of oxygen and its absorption by cells, prevents disruption of the transport of adenosine triphosphate, while simultaneously activating glycolysis, which occurs without additional oxygen consumption. The result of a decrease in carnitine concentration is increased synthesis of the vasodilator γ-butyrobetaine;
- The action of the active substance of the drug is aimed at inhibiting the enzymatic activity of γ-butyrobetaine hydroxylase, which is the last enzyme in the chain reaction of L-Carnitine synthesis;
- After taking the tablet per os, the meldonium contained in it is quickly absorbed in the digestive tract. The drug is characterized by a fairly high bioavailability index. The latter is approximately 78%;
- The concentration of Meldonium in the blood plasma reaches its maximum values an hour or two after administration. In the body, meldonium is metabolized to non-toxic products - glucose, succinate, 3-hydroxypropionic acid;
- Metabolites are excreted by the kidneys. The half-life (T½), depending on the characteristics of the particular organism and the dose taken, can range from 3 to 6 hours;
- The drug in injection form is characterized by 100% bioavailability. The concentration of Meldonium in the blood plasma reaches its maximum values immediately after administration of the drug;
- The result of Meldonium metabolization is the formation of non-toxic metabolites (glucose, succinate, 3-hydroxypropionic acid), which are then excreted from the body by the kidneys.
Side effects after using the drug
Side effects caused by taking Mildronate occur quite often. Typically they are expressed as:
- Changes in blood pressure;
- Tachycardia;
- Psychomotor overexcitation;
- General weakness;
- Belching, flatulence and other symptoms of dyspepsia;
- Increased arousal;
- Dyspeptic symptoms, manifested by belching, attacks of nausea, vomiting, heartburn, a feeling of fullness in the stomach even after a small portion of food;
- A rapid increase in eosinophils in the blood;
- Also, according to reviews, Mildronate can cause allergic reactions in the form of swelling, rash, redness or itching of the skin.
In case of poor tolerability, you should immediately notify your doctor to adjust the chosen course or replace the drug.
Caution should be exercised when used simultaneously with certain antianginal and antihypertensive drugs, as well as cardiac glycosides, since Mildronate enhances their effect. When used simultaneously with Mildronate, antihypertensive drugs, nifedipine, nitroglycerin, peripheral vasodilators and alpha-blockers may develop moderate tachycardia and arterial hypotension.
Mildronate can be taken with anticoagulants and antiplatelet agents, as well as diuretics and antiarrhythmics. The safety of Mildronate is confirmed by periodically updated safety reports and the results of published clinical studies.
After Latvia joined the European Union, it became a mandatory requirement of regulatory authorities to have a Pharmacovigilance system responsible for monitoring and evaluating the use of medicines.
Since the beginning of monitoring (since March 21, 2006), Grindeks JSC has received 478 spontaneous reports (messages) about products containing meldonium. There have been no reports of the development of dependence or addiction to the drug after its use. There were no reports of adverse events or reactions from athletes.
Contraindications
According to the instructions for use, Mildronate is contraindicated for use in children under 18 years of age with hypersensitivity to the drug.
Reliable studies on the use of Mildronate during pregnancy and lactation have not been conducted, as a result of which the drug is not recommended for use during these periods. With caution: with liver and/or kidney diseases.
The instructions remind you that you cannot combine the use of medication and alcohol, especially if it is used to treat cardiovascular diseases. The drug is sold in pharmacies only with a prescription from the attending physician.
Price for Mildronate in pharmacies, how much the drug costs
The price of the medicine depends on the form of release. Average price for a pack of 250 mg capsules. – from 250 to 300 rubles, tablets of 500 mg. – from 559 to 655 rubles, injections for intravenous administration – 320-380 rubles, Mildronate Gx 500 mg. - 715-720 rub.
- Mildronate capsules 250 mg. No. 40 (Latvia) 297.00 rub.;
- Mildronate capsules 500 mg. No. 60 (Latvia) 646.00 rub.;
- Mildronate injections/ampoules 10% 5 ml. No. 10 (Lithuania) 401.00 rub.;
- Mildronate injections/ampoules 10% 5 ml. No. 20 (Lithuania) 751.00 rub.
Mildronate: cheap analogues and substitutes
Complete analogues for the active substance:
- Midolat;
- Meldonium dihydrate;
- Idrinol;
- Medatern;
- Melfort;
- Meldonium-Eskom;
- Meldonium;
- Vasomag;
- Trimethylhydrazinium propionate dihydrate;
- 3-(2,2,2-Trimethylhydrazinium)propionate dihydrate;
- Cardionate.
In pharmacies, prices for capsules start at 300 rubles for 40 tablets of 250 mg. For 10 injections of Mildronate 10% in ampoules of 5 ml. you need to pay 400 rubles.
Use of Mildronate during pregnancy and lactation
Mildronate should not be prescribed during pregnancy. This is due to the fact that the safety of the drug could not be fully proven. The components included in the composition penetrate the placental barrier, therefore, when using the drug, breastfeeding the baby must be stopped.
It has not been established whether meldonium can be excreted in the milk of a nursing woman. Therefore, if treatment with Mildronate is indicated for the mother, she must stop breastfeeding for the entire period of therapy.
Mildronate and alcohol: compatibility, can they be taken together?
Like some analogues, Mildronate (reviews, instructions confirm this) shows good results in the treatment of people suffering from addiction to alcoholic beverages.
In case of pronounced withdrawal syndrome, Mildronate is used 4 times a day. The maximum daily dose is doubled compared to other situations: it reaches 2 g. The duration of the course is one and a half weeks.
For alcohol dependence and severe intoxication of the body, Mildronate can be used in the form of injections. The drug is sold prepared for use. When administered into the body, Mildronate and other drugs should not be mixed. It is not recommended to use sodium solution to dilute the medication.
Administration into a vein is often recommended for coronary diseases, and the drug is administered once a day in an amount of up to 1 g. The active substance of Mildronate is excreted from the body within 12 hours, therefore, after this time, the risk of interaction of the drug with another active substance is extremely low or completely absent .
In general, drinking alcohol during treatment with Mildronate is not prohibited, however, if this drug is used to treat cardiovascular disease or cerebral circulatory disorders, the patient is still advised to stop drinking alcohol.
The poor compatibility of Mildronate with alcohol is due to an increased risk of various types of complications and the likelihood of a relapse of the disease. For patients with alcohol withdrawal caused by constant consumption of alcohol in large quantities, the drug should be used 4 times a day. The recommended dosage should not exceed 2000 mg. The duration of therapeutic treatment is on average one and a half weeks.
Cardionate or Mildronate - which is better?
Cardionate and Mildronate are synonymous drugs. They are based on the same active ingredient, so both products have a similar mechanism of action. The only difference is that, unlike Mildronate, Cardionate is available only in the form of 250 mg capsules. and solution for injection 500 mg/5 ml.
The use of mildronate during sports: features of use
Mildronate is widely known among professional athletes for its properties in helping the body recover after intense training. Meldonium helps oxygenate cells in need and removes breakdown products. In addition, it energetically nourishes cells. When an athlete recovers faster, he starts the next workout earlier, and then his productivity increases.
Indications for the use of the drug for athletes exist when he has a period of intense and frequent training, and he does not have time to recover between them. Capsules or tablets should contain up to 1 g of substance per day in a total dosage; take them 30 minutes before training.
Intravenous injections are more effective; the daily dose for an athlete is 5-10 ml. The course of treatment should last no longer than six weeks. The drug is not addictive. It should be remembered that taking an injection of medication or orally capsules or tablets will not replace the athlete with a nutritious diet rich in carbohydrates and proteins.
If you are on a very limited diet, there is no point in taking Mildronate, since it will not affect the exhausted body. The ability of the drug to prevent fatty acids from entering the body's cells helps to achieve a weight loss effect during intense exercise.
Features of use:
- Reduces fatigue;
- Under conditions of ischemia, it restores the balance of the processes of oxygen delivery and its consumption in cells, prevents disruption of ATP transport;
- Improves muscle nutrition;
- Prevents the accumulation of activated forms of unoxidized fatty acids in cells;
- Protects the heart and increases myocardial contractility;
- Increases the effectiveness of training;
- Activates glycolysis, which occurs without additional oxygen consumption.
Mildronate prevents fatty acids from penetrating into the cells and thus prevents the accumulation of fats in the liver. In addition, by burning predominantly sugars, the body spends a larger amount of raw materials, which are fats, for each molecule of adenosine triphosphate produced (that is, for energy production).
Meldonium was not classified as a doping drug until January 1, 2016, which made it possible to use it absolutely legally in all sports. However, after the introduction of a ban on the use of the drug by the World Anti-Doping Agency (WADA) at the beginning of 2016, a number of athletes, mainly from Russia and the former CIS countries, were caught using this drug. Mildronate also became the subject of a huge scandal when Maria Sharapova admitted using this doping on March 7, 2016.
Meldonium is a structural semisynthetic analogue of gamma-butyrojetaine, which is a precursor to carnitine. The drug is aimed at inhibiting gamma-butyrobetaine hydroxylase, reducing the production of carnitine and the transport of long-chain fatty acids across the cell membrane.
Thanks to the mechanism described above, the drug prevents the accumulation of fatty acid metabolites inside the cell, so ATP delivery occurs at a faster rate. Improving metabolic processes is the main effect of Meldonium.
If the blood supply to a certain organ is disrupted and ischemia occurs, the drug prevents disruption of adenosyl triphosphate synthesis and activates glucose oxidation, and a decrease in carnitine synthesis has a vasoconstrictor effect.
Preventing the formation of negative consequences of circulatory disorders in the brain tissue or myocardium is the main task of this drug. In acute and chronic disorders of blood supply in brain tissue, the Meldonium effect is aimed at redistributing blood flow in the area of ischemia, thereby improving its circulation in the damaged area. The drug improves cellular and humoral immunity, eliminates withdrawal symptoms from alcoholism, increases work capacity, endurance and reduces the symptoms of mental and physical fatigue.
With the development of acute myocardial infarction, Meldonium can significantly slow down tissue necrosis and reduce the rehabilitation period to a minimum. The mechanism of action of the drug is determined by its cardioprotective effect. In patients with exertional angina, the drug can significantly reduce the frequency of attacks, and against the background of heart failure, it can improve the contractility of the muscle layer and increase resistance to physical activity.
The drug is also effective in the complex treatment of vascular and dystrophic diseases of the fundus of the eyeball.
Components included in the drug
The active ingredient of the drug is meldonium. One ml of solution contains 100 mg of meldonium, and 5 ml, respectively, 500 mg. The excipients of the drug include sodium hydroxide, diluted perchloric acid, solution for injection.
Indications for use
Meldonium is used for complex therapy of the following pathologies:
- Diseases of the cardiovascular system, which include stable angina pectoris, chronic heart failure of functional class 1-3, cardiomyopathies, functional disorders of the heart and vascular system.
- Cerebral circulation disorders leading to ischemia.
- Decline labor activity, physical or emotional stress.
- During recovery from cerebrovascular disorders, concussion and encephalitis.
When Meldonium was created, it was recommended as a means of controlling plant growth and stimulating muscle gain in livestock and poultry. However, eventually people began to use it as a medicine.
Pharmaceutical companies producing this drug view it as a metabolic modulator, with effects similar to insulin.
Research conducted in December '15 states that the use of Medonium by athletes significantly increases their endurance, accelerates recovery reactions after competition, prevents excessive susceptibility during stressful situations and increases the functional activity of the central nervous system. These positive effects were confirmed during the study by Latvian specialists.
Since January 1, 16, Meldonium has been included in the prohibited drugs for use during competitions and out of competition. Due to the fact that the metabolites of the drug are eliminated within 120 days, it can be easily detected in athletes who used this drug even a couple of months before the competition.
The main positive effects of Meldonium for athletes are:
- preventing the accumulation of active metabolites of under-oxidized long-chain fatty acids in cells;
- restoring the balance between oxygen consumption and its supply under ischemic conditions;
- prevention of adenosine triphosphate transport;
- activation of glycolysis, which occurs without additional exposure to oxygen;
- improvement of muscle tissue trophism;
- increasing the effectiveness of the training process;
- reduction of fatigue;
- protecting the heart muscle from ischemia and increasing cardiac output.
Instructions for use
The drug is administered intravenously and its use does not require special dilution before administration (the active substance is diluted in an ampoule with the required amount of solution for injection). Due to possible excitement, the drug is recommended to be used in the first half of the day.
Unnecessarily, the drug is not recommended for use in women during pregnancy and lactation. The fact is that a sufficient number of studies have not been conducted that could refute the information that the metabolites of this drug do not penetrate the blood-placental barrier or through mother's milk into the baby's body.
Contraindications
- Hypersensitivity to the active substance of the drug or additional components.
- Increased intracranial pressure due to impaired venous outflow or cancer.
- Severe liver or eye failure (not enough studies have been conducted to determine the excretion of metabolites in patients with these diseases).
- Pregnancy and lactation period.
- Use is contraindicated in patients under the age of majority.
Changes in laboratory tests may also be observed: dyslipidemia and an increase in the quantitative content of C-reactive protein.
If you experience any discomfort, headache or obvious allergic reactions you need to stop using the drug and consult a specialist as soon as possible. The main thing is to remember that only the attending physician can make any adjustments to the treatment plan.
Price
The pricing policy of Meldonium in all pharmacy chains ranges from 515-630 rubles.
In 1 ml solution - meldonium dihydrate 100 mg.
B 1 capsule - meldonium 250 mg or 500 mg. Magnesium stearate, potato starch, silicon dioxide - as excipients.
Release form
- capsules 500 mg and 250 mg;
- injection solution.
Pharmacological action
Anti-ischemic, cardioprotective (improves metabolism and energy supply to the myocardium).
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
It has a cardioprotective effect, in addition to being membrane-stabilizing and immunotropic. Limits the rate of synthesis from γ-butyrobetaine , which leads to disruption of the transport of fatty acids into mitochondria . Under the influence of the drug, the level increases γ-butyrobetaine , which enhances education nitrogen oxides , which entails a decrease OPSS And vasodilation .
Meldonium reduces the ability to aggregate and improves membrane elasticity. In conditions of ischemia, prevents transport disruption ATP . In case of ischemic damage to the heart muscle, it slows down the formation of a necrosis zone. In heart failure, it increases myocardial contractility and reduces the number of attacks. Effective for pathology of fundus vessels. Increases performance. Eliminates nervous system disorders in patients with chronic alcoholism.
Pharmacokinetics
Well absorbed when taken orally. Bioavailability with this method of administration is 78% and 100% with intravenous administration. Cmax is determined in the blood after 1-2 hours. It is metabolized to form two metabolites, they are excreted unchanged by the kidneys.
Indications for use
Complex therapy:
- decreased performance;
- dishormonal cardiomyopathy ;
- postoperative rehabilitation;
- cerebrovascular accidents;
- physical stress;
- withdrawal syndrome for chronic
Parabulbar administration:
- retinal hemorrhage;
- circulatory disorders in the retina;
- retinal vein thrombosis;
- retinopathy (and hypertensive).
Contraindications
- Increased ;
- breastfeeding;
- increased sensitivity;
- under the age of 18 (capsules).
Side effects
All adverse reactions rare:
- psychomotor agitation ;
- changes HELL (decrease or increase);
- skin itching;
- rash.
Meldonium, instructions for use (Method and dosage)
Capsules Meldonium-MIC taken orally and due to the possibility of an stimulating effect, they are recommended to be taken in the morning. The dose and frequency of administration are selected individually.
For cardiac diseases - 500 mg-1000 mg per day. Treatment lasts up to 6 weeks.
For cerebrovascular accidents - 500 mg once a day, for a course of 4–6 weeks.
At withdrawal syndrome - 500 mg 4 times a day.
For physical overload - 250 mg 4 times a day, for a course of 14 days.
Solution for injection
Typically the dose is 0.5-1 g per day daily. The drug is administered in 10 ml of 0.9% solution NaCl .
Unstable, condition after an illness - administer 1-2 ampoules (500-1000 mg) intravenously 1 time per day for 4 days in a row. Stable angina pectoris : dosage and frequency of administration are the same.
0.5 ml of solution is injected parabulbarically.
Overdose
The drug is slightly toxic and cases of overdose do not occur or are extremely rare. Development is theoretically possible hypotension , and general weakness. Symptomatic treatment is carried out.
Interaction
Enhances the effect of antihypertensive, antianginal drugs, cardiac glycosides.
Possible combination with antianginal drugs, anticoagulants, antiarrhythmic drugs and diuretics.
When used simultaneously with, alpha-blockers , Nifedipine , peripheral vasodilators are likely to cause arterial hypotension .
Do not use simultaneously with other drugs containing meldonium .
Terms of sale
Dispensed with a doctor's prescription.
Storage conditions
Storage temperature up to 25°C.
Best before date
Meldonium's analogs
Level 4 ATX code matches:, Midolat , Vasomag .
Reviews about Meldonia
The use of this drug in the complex treatment of cardiac pathology reduces the number of attacks by 55.6% angina pectoris And daily requirement V nitroglycerin by 55.1%. Significantly improves contractions myocardium no influence on heart rate, limits fluctuations HELL . The drug is low-toxic and does not cause significant adverse reactions.
Judging by the reviews of patients, this remedy was prescribed for IHD in combination with antianginal and antihypertensive drugs. It is important that the drug was prescribed to patients of older age groups and they tolerated it well.
- «. .. I was added Meldonium tablets for angina pectoris, to other tablets. Noticed improvement after 3 weeks»;
- « ... After a micro-stroke, I took it in capsules 2 times a day. I drank it for a month and a half - my speech improved and I became more energetic»;
- « ... I take courses three times a year. I can describe it as vital for everyone. I have angina and slightly elevated blood pressure»;
- « ... The child is one year old, I’m very tired. On the recommendation of a neurologist, I take Meldonium twice a day. I've only been drinking for a week and I already feel better.»;
- « ... I was recommended by a neurologist (diagnosed with “chronic fatigue”). They gave injections. Excellent drug, quickly returns strength»;
- « ... I noticed that taking Meldonium slightly increases my appetite, I even gained a little weight»;
- « ... After 7 days of taking this drug, I started feeling dizzy».
Meldonium price, where to buy
You can buy the drug at any pharmacy. More often the drug is offered in the form of injections, the cost of which ranges from 135-169 rubles. for 10 ampoules.
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