Meldonium
Meldonium: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Meldonium
ATX code: C01EB22
Active ingredient: Meldonium (Meldonium)
Manufacturer: Ellara (Russia); Pharmstandard - Ufa Vitamin Plant (Russia); Pharmstandard - leksredstva (Russia); Biochemist (Russia); Atoll (Russia); Biosynthesis (Russia)
Description and photo update: 2018-27-11
Prices in pharmacies: from 79 rubles.
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Meldonium is a metabolic agent.
Release form and composition
- solution for injection: transparent colorless liquid (5 ml each in colorless glass ampoules with a dot and a notch / break ring, or without a dot and a notch / break ring, 5 or 10 ampoules in a blister strip / cardboard tray with cells, in a cardboard box 1 or 2 contour packs / cardboard trays; ampoules with a break ring or dot and notch are supplied with an ampoule knife / scarifier);
- capsules: hard gelatine, 250 mg - size No. 1, with a white body and a cap, 500 mg - size No. 00, with a white body and a yellow cap; content - white hygroscopic crystalline powder with a specific odor (10 pcs. in blisters, in a cardboard box 3 or 6 packs).
Each pack also contains instructions for the use of Meldonium.
Composition of 1 ml solution:
- active substance: meldonium dihydrate - 100 mg;
- auxiliary component: water for injection - up to 1 ml.
Composition of 1 capsule:
- active substance: meldonium dihydrate - 250 or 500 mg;
- auxiliary components: calcium stearate, colloidal silicon dioxide (aerosil), potato starch;
- the composition of the capsule shell of 250 mg: body and lid - gelatin and titanium dioxide;
- the composition of the capsule shell of 500 mg: body - gelatin and titanium dioxide; cap - gelatin, titanium dioxide, dyes sunset yellow and quinoline yellow.
Pharmacological properties
Pharmacodynamics
The active ingredient of the drug, meldonium dihydrate, is a structural analogue of gamma-butyrobetaine. The substance prevents the accumulation of activated forms of unoxidized fatty acids (derivatives of acylcarnitine and acylcoenzyme A) in cells, reduces the transport of long-chain fatty acids through the cell membranes, reduces carnitine synthesis, and inhibits gamma-butyrobetaine hydroxinase. Due to a decrease in the concentration of carnitine, an increased synthesis of gamma-butyrobetaine, a substance that has vasodilating properties, occurs.
Under conditions of ischemia, Meldonium restores the balance of the processes of oxygen delivery to cells and its consumption, and also prevents disruption of the transport of angiotensin-converting enzyme (ATP). In addition, the drug activates the glycolysis process, which takes place without additional oxygen consumption.
As a result of the described mechanism of action, Meldonium has the following pharmacological effects: it increases efficiency, reduces manifestations of physical and mental stress, activates tissue and humoral immunity, and has cardioprotective properties.
In acute ischemic myocardial injury, the drug inhibits the formation of a necrotic zone and shortens the duration of the rehabilitation period. In ischemic disorders of cerebral circulation (both acute and chronic), it promotes blood redistribution in favor of the ischemic area and improves blood circulation in the ischemic focus. In case of heart failure, it increases myocardial contractility, reduces the frequency of angina attacks, and increases exercise tolerance.
The effectiveness of Meldonium in the case of dystrophic and vascular pathology of the fundus has been confirmed.
The drug has a tonic effect on the central nervous system. Eliminates functional disorders of the autonomic and somatic nervous systems during the period of abstinence in patients with alcoholism.
Pharmacokinetics
When administered intravenously, meldonium is characterized by absolute bioavailability - 100%. The maximum concentration (Cmax) in blood plasma is reached immediately after injection.
When taken orally, the bioavailability of meldonium is 78%. Cmax in plasma is observed 1-2 hours after taking the capsule.
The drug is metabolized to form two main metabolites, which are excreted by the kidneys. Depending on the dose administered, the half-life (T 1/2) can range from 3 to 6 hours.
Indications for use
For solution and capsules:
- ischemic heart disease (angina pectoris, myocardial infarction), chronic heart failure, cardiomyopathy against the background of dyshormonal manifestations - as part of complex therapy;
- acute and chronic disorders of cerebral circulation (cerebrovascular insufficiency, stroke) - as part of complex therapy;
- withdrawal syndrome in chronic alcoholism - in addition to specific therapy for chronic alcoholism;
- reduced performance, mental and physical stress (including among athletes).
Additionally for the solution - as part of complex therapy:
- hemophthalmos and retinal hemorrhage of various etiologies;
- retinopathy of various etiologies (including diabetic and hypertensive);
- thrombosis of the central retinal vein and its branches.
Additionally for capsules: postoperative period (in order to accelerate the rehabilitation processes).
Contraindications
- increased intracranial pressure (due to impaired venous outflow and intracranial tumors);
- age up to 18 years;
- pregnancy;
- lactation period;
- hypersensitivity to the components of the drug.
Meldonium should be used with caution in patients with chronic liver and / or kidney disease.
Meldonium, instructions for use: method and dosage
Injection
Meldonium injections are administered intramuscularly (i / m), intravenously (i / v) or parabulbar.
The introduction of the drug is recommended in the first half of the day, due to the possible development of an exciting effect.
The method of administration, the dose of Meldonium and the duration of its use, the doctor sets individually, taking into account the indications and the severity of the condition.
Complex therapy of cardiovascular diseases:
- myocardial infarction: intravenous stream, 500-1000 mg per day in one or two injections;
- stable angina pectoris in ischemic heart disease, chronic heart failure and cardiomyopathy due to hormonal disorders: intravenous stream, 500-1000 mg per day in one or two injections for 10-14 days, then the patient is transferred to the oral form of the drug. The general course of treatment is 4-6 weeks.
Complex therapy of disorders of cerebral circulation:
- acute phase: intravenous 500 mg 1 time per day for 10 days with further transfer of the patient to the oral form of the drug. The general course of treatment is 4–6 weeks;
- chronic form of the disease: intravenous 500 mg once a day for 10 days, followed by the transfer of the patient to the oral form of the drug. The general course of treatment is 4-6 weeks, on the recommendation of a doctor, repeated courses are carried out 2-3 times a year.
Other indications:
- ophthalmic disorders: parabulbar 50 mg for 10 days;
- chronic alcoholism: intravenously or intramuscularly, 500 mg 2 times a day for 7-10 days;
- mental and physical overload: intravenous or intramuscularly, 500 mg once a day for 10-14 days. If necessary, a second course is carried out after 2–3 weeks.
Capsules
In the form of capsules, Meldonium should be taken orally before meals.
Recommended dosage regimens:
- disorders of the blood supply to the brain: 500-1000 mg per day (preferably in the first half of the day) for 4-6 weeks;
- chronic heart failure, stable angina (as part of complex therapy): 500-1000 mg per day in one or two doses for 4-6 weeks;
- cardialgia due to dyshormonal myocardial dystrophy: 250 mg 2 times a day for 12 days;
- alcohol withdrawal syndrome: 500 mg 4 times a day for 7-10 days;
- decreased performance, mental and physical overload, acceleration of rehabilitation in the postoperative period: 250 mg 4 times a day for a course of 10-14 days, if necessary, after 2-3 weeks, the treatment is repeated;
- physical overload in athletes: 500-1000 mg 2 times a day before training, a course of 14-21 days during the preparation period, 10-14 days during the competition.
Side effects
Meldonium is generally well tolerated, in rare cases (<1/1000) the following side effects occur:
- from the gastrointestinal tract: dyspeptic disorders;
- from the nervous system: psychomotor agitation;
- from the cardiovascular system: decrease or increase in blood pressure, tachycardia;
- from the immune system: allergic reactions: skin rash, redness of the skin, pruritus, angioedema, eosinophilia;
- general disorders: general weakness.
Overdose
Symptoms: headache, dizziness, tachycardia, decreased blood pressure, general weakness.
Treatment: symptomatic.
special instructions
Meldonium is not a first-line treatment for acute coronary syndrome, so its use is not strictly necessary.
Meldonium dihydrate can give a positive result during doping control, therefore, from 01.01.2016 it is included in the list of prohibited substances of the World Anti-Doping Agency.
Influence on the ability to drive vehicles and complex mechanisms
There is no evidence of a negative effect of meldonium on the psychophysical and cognitive abilities of a person.
Application during pregnancy and lactation
The drug is not recommended for use during pregnancy because its safety has not been studied.
It is not known whether meldonium penetrates into breast milk, therefore, breastfeeding should be discontinued for the period of treatment.
Pediatric use
The drug is contraindicated in patients under 18 years of age.
With impaired renal function
With caution, Meldonium capsules and injections are prescribed for chronic kidney disease.
For violations of liver function
Meldonium should be used with caution in chronic liver diseases.
Drug interactions
The simultaneous use of diuretics, antiplatelet agents, anticoagulants, bronchodilators, antiarrhythmic and antianginal agents is allowed.
Caution should be exercised if the combined use of peripheral vasodilators and antihypertensive drugs (including nifedipine, alpha-blockers) is necessary, since this combination can cause the development of moderate tachycardia and arterial hypotension.
Meldonium enhances the effect of coronary dilating agents, cardiac glycosides and some antihypertensive drugs.
Analogs
The analogues of Meldonium are Angiocardil, Vazomag, Idrinol, Cardionat, Meldonium-Binergia, Meldonium-DEKO, Meldonium Organics, Meldoniy-Eskom, Meldoniy-SOLOpharm, Melfor, Mildronat, etc.
Terms and conditions of storage
Store at temperatures up to 25 ° C in a dry, dark place, out of reach of children.
Shelf life of solution for injection is 4 years, capsules - 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Meldonia
According to the doctors, the use of Meldonium as part of the complex therapy of cardiological pathologies allows to reduce the frequency of angina attacks by 55.6%, and to reduce the daily need for nitroglycerin by 55.1%. Doctors note that the drug reduces fluctuations in blood pressure, improves myocardial contraction, without causing changes in heart rate. Meldonium is low-toxic, therefore it practically does not cause the development of side effects.
Reviews of Meldonia from patients are also predominantly positive: the drug significantly improves the condition, is well tolerated.
In rare cases, there are reports of the development of unwanted reactions, including increased appetite and dizziness.
The price of Meldonium in pharmacies
The price of Meldonium for a pack of 10 ampoules of 5 ml is approximately 130–272 rubles.
Meldonium: prices in online pharmacies
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Drug name Price Pharmacy |
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Meldonium 100 mg / ml injection 5 ml 10 pcs. 79 RUB Buy |
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Meldonium 100 mg / ml injection 5 ml 10 pcs. 114 RUB Buy |
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Meldonium solution for in. 100mg / ml 5ml amp. 10 pieces. 130 RUB Buy |
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Meldonium 100 mg / ml injection 5 ml 10 pcs. 134 r Buy |
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Meldonium Organic 100 mg / ml solution for injection 5 ml 10 pcs. 166 r Buy |
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Meldonium 250 mg capsule 30 pcs. 175 RUB Buy |
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Meldonium 100 mg / ml solution for intravenous and parabulbar administration 5 ml 10 pcs. RUB 176 Buy |
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Meldonium Organic 250 mg capsules 40 pcs. 179 r Buy |
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Reviews Meldonium Organic 179 r Buy |
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Meldonium capsules 250 mg 30 pcs. RUB 181 Buy |
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Meldonium 250 mg capsule 40 pcs. 189 r Buy |
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Meldonium solution for injection 100 mg / ml ampoule 5 ml 10pcs 195 RUB Buy |
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Meldonium caps. 250 mg 40 pcs. 209 RUB Buy |
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Meldonium 250 mg capsule 40 pcs. 209 RUB Buy |
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Meldonium 250 mg capsule 60 pcs. 362 r Buy |
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Meldonium capsules 250mg 60pcs 387 r Buy |
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Meldonium Organic 500 mg capsules 60 pcs. 420 RUB Buy |
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Meldonium 500 mg capsule 60 pcs. 435 r Buy |
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Meldonium caps. 500 mg 60 pcs. RUB 470 Buy |
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Meldonium 500 mg capsule 60 pcs. RUB 470 Buy |
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Meldonium organic capsules 500 mg 60 pcs. 547 r Buy |
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Meldonium capsules 500 mg 60 pcs. 566 r Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
