Meldonium capsules 250mg, No. 40

• For oral administration or intravenous administration: as part of the complex therapy of ischemic heart disease (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy;

• as part of the complex therapy of acute and chronic disorders of cerebral circulation (strokes and cerebrovascular insufficiency);

• decreased performance, physical overstrain (including in athletes), the postoperative period to accelerate rehabilitation;

• withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism).

In connection with the possibility of developing an exciting 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 the duration of treatment depend on the indications.

When administered intravenously, the dose is 0.5-1 g 1 time / day, the duration of treatment depends on the indications.

active substance: meldonium dihydrate

Increased intracranial pressure (including in violation of venous outflow, intracranial tumors), pregnancy, lactation (breastfeeding), children and adolescents under 18 years of age, hypersensitivity to meldonium.

pharmachologic effect

An agent 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 the cell membranes, prevents the accumulation of activated forms of unoxidized fatty acids in cells - derivatives of acylcarnitine and acylcoenzyme A. Under ischemic conditions, it restores the balance of oxygen delivery and its consumption in cells, prevents transport disturbances ATP; at the same time activates glycolysis, which proceeds without additional oxygen consumption. As a result of a decrease in the concentration of carnitine, gamma-butyrobetaine, which has vasodilating properties, is intensively synthesized. The mechanism of action determines the variety of its pharmacological effects: increased efficiency,reduction of symptoms of mental and physical stress, activation of tissue and humoral immunity, cardioprotective effect. In the case of acute ischemic myocardial damage, it slows down the formation of a necrotic zone, 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 focus, promotes blood redistribution in favor of the ischemic area. Effective for vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.activation of tissue and humoral immunity, cardioprotective effect. In the case of acute ischemic myocardial damage, it slows down the formation of a necrotic zone, 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 focus, promotes blood redistribution in favor of the ischemic area. Effective in vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.activation of tissue and humoral immunity, cardioprotective effect. In the case of acute ischemic damage to the myocardium, it slows down the formation of a necrotic zone, 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 focus, promotes blood redistribution in favor of the ischemic area. Effective in vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.In the case of acute ischemic damage to the myocardium, it slows down the formation of a necrotic zone, 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 focus, promotes blood redistribution in favor of the ischemic area. Effective for vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.In the case of acute ischemic damage to the myocardium, it slows down the formation of a necrotic zone, 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 focus, promotes blood redistribution in favor of the ischemic area. Effective in vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.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 focus, promotes blood redistribution in favor of the ischemic area. Effective in vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.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 focus, promotes blood redistribution in favor of the ischemic area. Effective in vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.Effective for vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.Effective for vascular and dystrophic pathology of the fundus. Has a tonic effect on the central nervous system, eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.

Pharmacokinetics

After oral administration, it is rapidly absorbed from the gastrointestinal tract. Bioavailability is about 78%. Cmax in plasma is achieved within 1-2 hours after administration. It is biotransformed in the body with the formation of two main metabolites, which are excreted by the kidneys. T1 / 2 is 3-6 hours and depends on the dose.

Side effect

From the side of the cardiovascular system: rarely - tachycardia, changes in blood pressure. From the side of the central nervous system: rarely - psychomotor agitation. From the digestive system: rarely - dyspeptic symptoms. Allergic reactions: rarely - itching, redness, rash, edema.

Application during pregnancy and lactation

During pregnancy and lactation (breastfeeding), the use of the drug is contraindicated.

Application for violations of liver function

Use with caution in liver diseases, especially for a long time.

Application for impaired renal function

Use with caution in kidney disease, especially for a long time.

Application in children

In children and adolescents under the age of 18, the efficacy and safety of meldonium has not been established. Meldonium in the form of capsules is contraindicated for use in children and adolescents under the age of 18; in the form of a syrup - in children under 12 years of age.

special instructions

Use with caution in liver and / or kidney diseases, especially for a long time. Long-term experience in the treatment of acute myocardial infarction and unstable angina pectoris in cardiology departments shows that meldonium is not a first-line remedy for acute coronary syndrome.

Drug interactions

When used together, meldonium enhances the effect of antianginal drugs, some antihypertensive drugs, cardiac glycosides. With the simultaneous use of meldonium with nitroglycerin, nifedipine, alpha-blockers, antihypertensive drugs and peripheral vasodilators, moderate tachycardia, arterial hypotension may develop (with these combinations, caution is required).