Mildronate: instructions for use, what is prescribed, contraindications, composition, analogues

Mildronate is an artificially created vitamin-like substance similar to those synthesized by our body. It participates in chemical transformations inside the cells and compensates for the lack of oxygen. Due to this action, the drug has a number of therapeutic properties: it relaxes the walls of blood vessels, normalizes blood flow, protects tissues from harmful metabolites formed during oxygen starvation, and increases the endurance of the heart muscle.

Composition and release forms

Outside of our country, the drug is called "Meldonium." Under this word lies both the international name and the name of the active substance.

The pharmaceutical industry has mastered the production of three dosage forms of the drug, including capsules with a fine crystalline loose soluble powder inside, a syrup and a ready-made solution for injection into a vein or lower eyelid.

From the description of the capsule it follows that the colors of its body and lid match. Both parts are white with a slightly cream tint. The shell is made from gelatin with the addition of a titanium dioxide stabilizer. A colloidal form of silicon, calcium stearic salt and potato starch are introduced into the powder inside.

Packaging for capsules is made of PVC film and food foil.The buyer comes across boxes of 40 capsules, with a dosage of 250 mg (free sale) and cardboard packs with 60 capsules, with a dosage of 500 mg (dispensing only on a prescription form).

In a syrup with a pronounced cherry flavor, several flavors and sweeteners, glycerin, citric acid, propylene glycol and two types of benzoate are found in the composition. The medicine is packaged in tinted darkened glass bottles with a plastic cap.

Five ml of liquid contains a quarter mg of meldonium. For ease of dispensing, a measuring spoon is placed in a cardboard box along with a bottle and a description.

In the liquid for injection there is only the substance itself and purified water. The pharmacological form is poured into ampoules of five milliliters. Each ampoule contains half a gram of a metabolic compound.

Ampoules are either sealed in a contour substrate covered with foil, or placed in unopened pallets made of PVC. This form is distributed to prescription buyers only. There are packages of ten and twenty ampoules.

Pharmacological properties and pharmacokinetics

The action of meldonium is based on its structural similarity to human gamma-butyrobetaine. This substance prevents the absorption of carnitine from food and its synthesis inside the body.

Carnitine is the main transport agent of fatty acids. It promotes the penetration of compounds through the membranes of mitochondria located inside cardiac cells.

Under conditions of oxygen starvation, fatty acids are not completely oxidized. The result of this process is the formation of toxic substances.

Reducing the concentration of carnitine, meldonium slows down the transfer of fatty acids, and thereby protects the cells of the heart muscle from products of incomplete oxidation.

In addition, meldonium helps to saturate tissues with energy. Slowing down the oxidation of fatty acids, it activates the breakdown of carbohydrates. Compared to fatty acids, carbohydrates are more energy intensive, and a significant number of ATP molecules are released during their oxidation.

The compound acts in two ways: it activates hexokinase, an enzyme that catalyzes glycolysis (oxidation of carbohydrates), and redistributes scarce oxygen from fatty acids to hydrocarbons.

During the tests, a side beneficial effect was found. Against the background of a decrease in carnitine concentration, tissue tolerance to glucose increases. Hydrocarbon is actively absorbed from the blood and consumed more efficiently by cells. As a result, with a constant indicator of insulin, the sugar level decreases. In patients with type 1 diabetes, trophism improves (a process aimed at maintaining structure and function) and tissue sensitivity.

With accelerated production of gamma-butyrobetaine, the muscles that line the blood vessels relax. The lumen of the veins, arteries and small capillaries increases. The delivery of all nutrients is improved.

In the area of ​​action of the drug, the process of tissue death during a heart attack slows down. Timely use of the drug stops the spread of necrosis, reduces the area of ​​damage. The metabolite redistributes the blood flow in favor of the affected tissues, contributing to their speedy recovery.

Pharmacological evaluation showed the effectiveness of the drug in angina pectoris, ischemia, heart failure and disorders of the nervous system. The medicine improves contractility of the heart muscle and cerebral circulation. It helps to reduce the frequency of attacks, increase stamina, activity and reduce nervous tension.

There are indications that this drug should be used in combination with other drugs to relieve symptoms of alcohol dependence.

According to various estimates, the bioavailability of the compound is from 80 to 100%. The highest concentration in the blood is noted at the time the drug is injected into the vein, after which this value immediately begins to decrease.

At therapeutic doses, the drug is completely excreted after three to six hours. However, cases of its accumulation in the use of increased concentrations are known. Under these conditions, traces of the substance can remain in the body for up to six months.

What is Mildronate prescribed?

The drug is included in complex therapy in the treatment of vascular disorders of the heart and brain. It is prescribed for angina pectoris, ischemia, heart attack, heart failure, cardiomyopathy, stroke, cerebrovascular insufficiency.

Parabulbar administration (through the lower eyelid to the area under the eyeball) is indicated for disorders of the blood supply to the retina due to hemorrhage, clogging of blood vessels, and also due to the development of diabetes and hypertension.

Therapists in general have a positive attitude towards this drug for its ability to increase endurance, stress resistance, and restore mental and physical strength. With the help of the drug, overwork is treated. Mildronate is prescribed for increased physical exertion, including those involved in professional sports.

Instructions for use of the drug

In general clinical practice, to combat overfatigue and vegetovascular disorders, as well as to increase overall tone while reducing working capacity, a quarter-gram dosage in the form of capsules or syrup is more often prescribed. The form of the drug is selected depending on the preferences of the patient himself. If the patient, for example, is difficult to swallow capsules, then they are prescribed syrup to replace them.

Mildronate injections are used in acute situations, in cases where it is necessary to restore blood flow as soon as possible, to stop the process of tissue death. Intraocular and intravenous injections are delivered exclusively by professional medical personnel in a clinic setting.

Since the drug stimulates brain activity, the last daily dose should be taken at least five hours before bedtime. If a single dose is indicated, it must be transferred to the morning.

Mildronate Injection Ampoules

An opened ampoule should never be stored for longer than twenty minutes under any circumstances. During this time, it should be either used or thrown away. Since muscle administration often causes allergic reactions, the drug is preferred to be injected into a vein. Intraocular administration is used only in the treatment of diseases of appropriate localization.

In the acute stage of a heart attack or cardiac ischemia, one or two ampoules are injected into a vein. The entire dose can be administered at a time or divided into two.

A similar scheme is used in the treatment of chronic heart disease. After fourteen days of such therapy, the patient may switch to capsules. The total duration of treatment is up to six weeks.

If cerebral blood flow is disturbed in both the acute and chronic phases, the same dose is prescribed - one ampoule once for ten days. Subsequently, patients who cope with an acute illness can switch to capsules, receiving a daily dose of up to one gram. And those who continue to treat chronic illness should take half a gram per day in capsule form. The total duration of therapy is one and a half months.

In ophthalmology, injections are given once a day, using a tenth of the volume of the ampoule. Such treatment is carried out for ten days.

To strengthen mental and physical endurance, a whole ampoule is prescribed once a day for two weeks.

In alcohol dependence, the drug is injected twice a day in a whole ampoule for one week.

Mildronate tablets 250 mg

Capsules and syrup are taken separately from food, either half an hour before meals, or after the same time after. The daily dose of metabolism is half a gram. Two capsules and the appropriate amount of syrup are drunk in one or two doses.

Capsules must not be opened and broken. They are swallowed whole.The amount of syrup is measured with a measuring spoon or a teaspoon, which holds 5 ml of the drug.

The treatment lasts for ten days. The effect of the use of oral forms is not immediately apparent, but after accumulation.

Mildronate 500 mg capsule

In coronary heart disease, chronic vascular insufficiency and hormone-dependent myocardial diseases, an entire capsule is swallowed once a day, mainly in the morning for two weeks and a half months.

Chronic disorders of cerebral circulation are treated for a month and a half with one capsule per day, taken in the morning. The same regimen is prescribed during maintenance therapy at the end of the course of injections after an acute stroke.

In the complex treatment of chronic alcoholism, the drug is added on a capsule four times a day for a week.

Physical fatigue and mental strain are treated with a dose of one capsule. One tablet is taken in the morning, the other until five in the evening. Frequency observed for ten days.

During pregnancy and lactation

It is known that some doctors use the drug during pregnancy. Such therapy is prescribed to compensate for blood flow in placental disorders. However, the manufacturer itself does not confirm the safety of such treatment.

Pregnant and lactating women did not participate in clinical trials. Therefore, it is not possible to argue that the medicine is completely harmless for these categories of patients.

Can I drink alcohol while taking the drug

There is no direct prohibition on the use of alcohol during treatment in the description of the drug. However, alcohol abuse can erase the full effect of therapy. Alcohol increases the likelihood of unnecessary reactions. Alcohol consumed with the drug can provoke a heartbeat, shortness of breath, increased pressure, accelerated heart rate, facial redness and allergies.

Drug interaction

The medicine is combined with lowering blood pressure, relaxing vascular muscle, and anti-arrhythmia medications. Compatible with medical devices that redistribute blood flow in the myocardium, relieve bronchospasm, prevent blood clots, thin the blood and increase the outflow of urine.

Taking a drug with calcium antagonists and nitroglycerin is not directly prohibited, but it can provoke the appearance of tachycardia.

Contraindications, side effects and overdose

With upset kidney and liver function during treatment, laboratory data of urine blood tests are constantly evaluated. The doctor may adjust the dose or duration of the course in the direction of reduction.

This medicine is absolutely not suitable for people with allergies to any of its components. It should not be prescribed to patients under the age of eighteen, since the safety of the drug was not checked in this group of persons.

The administration of patients suffering from brain tumors or excessive intracranial pressure can lead to negative consequences.

The medicine can provoke a very strong response. The list of side effects, along with skin itching and a small-caliber rash, includes angioedema.

Very rarely, intestinal upsets appear in response to treatment. Some patients experience an increase in heart rate, an increase or vice versa, a decrease in blood pressure, severe weakness or attacks of nervous excitement.

Exceeding the prescribed doses leads to a sharp drop in pressure, headaches and physical weakness. Having discovered signs of an overdose, the patient should seek medical help, where he will be prescribed treatment that is adequate to his symptoms.

Analogs of the drug Mildronate

 

Mildronate analogues are marketed under the commercial names:

• Idrinol, ready-made liquid in ampoules;
• "Cardionate", gelatin capsules and injection;
• "Meldonium Organics" in the form of capsules;
• "Midolat" is a metabolite in the form of gelatin capsules;

All these drugs are produced in our country.

Mildronate is a controversial, but very interesting development of the domestic pharmaceutical industry. Not all doctors agree with the need for its use. Some see it as a dummy. Others note a persistent positive effect.

The metabolic process cannot be invaded without meaning. Any appointment should be made only by a specialist with the appropriate qualifications.