Meldonium capsules 500mg, No. 60

• As part of the combined therapy of coronary heart disease, chronic heart failure, cardialgia against the background of dyshormonal myocardial dystrophy.

• Violations of the blood supply to the brain (stroke, cerebrovascular insufficiency).

• Complex therapy of alcohol withdrawal syndrome.

• Reduced performance, chronic physical stress, postoperative period to accelerate rehabilitation processes.

Inside, before meals.

Stable angina pectoris, chronic heart failure - as part of complex therapy, 500-1000 mg per day, using the entire dose at once or dividing it by 2 times. The course of treatment is 4-6 weeks.

Cardialgia against the background of dyshormonal myocardial dystrophy - 250 mg 2 times a day (morning and evening). The course of treatment is 12 days.

Violations of the blood supply to the brain (stroke, cerebrovascular insufficiency) - 500-1000 mg per day, preferably in the morning. The course of treatment is 4-6 weeks. Withdrawal alcohol syndrome - 500 mg 4 times a day. The course of treatment is 7-10 days.

With a decrease in working capacity and chronic physical overstrain, in the postoperative period to accelerate the rehabilitation processes - 250 mg 4 times a day. The course of treatment is 10-14 days. If necessary, repeat the treatment after 2-3 weeks. Athletes are prescribed 500-1000 mg 2 times a day before training. The duration of the course in the preparatory period is 14-21 days, during the competition period - 10-14 days.

Active substance:

meldonium dihydrate (trimethylhydrazinium propionate dihydrate) - 250 mg.

Excipients: potato starch, colloidal silicon dioxide (aerosil), calcium stearate. Composition of the capsule shell: Hard gelatin capsules No. 1 Body and cap: gelatin, titanium dioxide

• Hypersensitivity to the drug,

• increased intracranial pressure (with impaired venous outflow and intracranial tumors),

• pregnancy,

• lactation period,

• age up to 18 years (efficacy and safety have not been established).

Pharmacodynamics

Meldonium - an analogue of gamma-butyrobetaine, inhibits gamma-butyrobetaine hydroxinase, reduces 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. with vasodilating properties.

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 activates glycolysis, which proceeds without additional oxygen consumption.

The mechanism of action determines the variety of its pharmacological effects: increased efficiency, reduced 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 in the case of vascular and dystrophic pathology of the fundus. It is also characterized by a tonic effect on the central nervous system,elimination of functional disorders of the somatic and autonomic nervous systems in patients with alcoholism during the period of abstinence.

Pharmokinetics

After oral administration, the drug is rapidly absorbed, bioavailability is 78%. The maximum concentration in blood plasma is reached within 1-2 hours after ingestion. It is metabolized in the body with the formation of two main metabolites, which are excreted by the kidneys. The half-life for oral administration depends on the dose, is 3-6 hours.

Side effects

Rarely - allergic reactions (skin redness, itching, swelling), dyspeptic symptoms, tachycardia, agitation, decreased blood pressure.

Drug interactions

Strengthens the effect of coronary dilating and some antihypertensive drugs, cardiac glycosides. It can be combined with antianginal drugs, anticoagulants, antiplatelet agents, antiarrhythmics, diuretics, bronchodilators. Due to the possible development of moderate tachycardia and arterial hypotension, caution should be exercised when combined with peripheral vasodilators and antihypertensive drugs (including nifedipine, alpha-blockers).