Mildronate composition indications for use. Mildronate: description, indications for use, general properties and effect. Dosage for various pathologies

What kind of drug is Mildronate, instructions for using intramuscular and intravenous injections, what advice does it give, what are the indications and contraindications for using the drug? Especially for readers of “Popular about Health” I will consider the features of this medicine.

Mildronate - composition and release form

The active component in the drug Mildronate is represented by meldonium dihydrate, in an amount of 100 mg per milliliter of solution. Auxiliary components consist only of water for injection.

The drug Mildronate is available in the form of an absolutely transparent solution, sold in ampoules of 5 milliliters, 2 and 5 pieces per package. To purchase, you will need a prescription from your doctor.

Mildronate - action

Mildronate is a general stimulant drug intended to increase exercise tolerance and accelerate the recovery process after severe somatic diseases.

The active substance of the drug Mildronate (meldonium dihydrate) is a chemical compound that is an analogue of gamma-butyrobetaine. This substance is found in varying amounts in every cell of the human body.

The effect of gamma-butyrobetaine on the human body is quite multifaceted. First of all, the active substance is capable of stimulating the establishment of a relative balance between the processes of oxygen delivery and consumption by body tissues.

Secondly, the drug stimulates changes in the metabolic reactions of most tissues, which increases resistance to hypoxic changes (oxygen starvation) and activates the processes of biosynthesis of glucose and ATP.

In addition, the drug enhances the processes of oxygen capture in tissues, which helps to increase the energy potential of the body and at the same time stimulates the reactions of elimination of final metabolites (detoxification of the body).

The use of the drug Mildronate helps to increase exercise tolerance, and due to the rapid restoration of energy reserves, the time required for the body’s recovery period is reduced.

The drug Mildronate is widely used in cardiological practice, for example, in the acute period of myocardial infarction, the drug helps to reduce the area of ​​necrotic changes, and also has some vasodilating effect, which reduces the load on the myocardium.

In case of ischemic disease, meldonium dihydrate helps to increase exercise tolerance and is therefore used as a prophylactic agent, reducing the need for other medications.

Mildronate is often prescribed for cerebrovascular pathology, which is explained by the normalization of brain metabolism and increased mental abilities of the patient.

When administered intramuscularly or intramuscularly, high concentrations of meldonium dihydrate are formed in the blood and biological media of the body after a few minutes. The half-life is from 3 to 6 hours. Excretion is carried out in the urine, in the form of inactive metabolites.

Mildronate - indications for use

The use of the drug Mildronate is indicated in the following cases:

Myocardial infarction and ischemic disease;
Retinopathy of any etiology;
Reduced performance;
Mental and physical stress;
Cardiomyopathy;
Heart failure;
Vascular diseases of the brain;
Alcohol withdrawal;
Retinal vascular thrombosis.

In sports practice, the use of the drug has recently been unacceptable, since it is included in the list of prohibited drugs.

Mildronate - contraindications for use

The use of the drug Mildronate is contraindicated in the following cases:

Intolerance to meldonium dihydrate;
Conditions occurring against the background of increased intracranial pressure;
The patient's age is less than 18 years.

In addition, the use of meldonium dihydrate solutions is unacceptable during pregnancy and lactation.

Application of Mildronate and dosage

The drug is used in the first half of the day. Methods of administration: intravenous, intramuscular, and also parabulbar (in the tissue of the lower eyelid). The dosage regimen, as well as the route of administration, depends on the diagnosis and other factors.

For cerebrovascular diseases, the drug can be administered both intravenously and intramuscularly, in the amount of 5 milliliters once a day, for 10 days. The technique was repeated 2–3 times a year.

In case of physical overexertion, the drug Mildronate is prescribed 1 ampoule, mainly intramuscularly, 1 time per day, for 14 days. The course can be repeated after 3 weeks.

Mildronate - drug overdose

Symptoms: headache, weakness, tachycardia, dizziness, decreased blood pressure. No special treatment is required. As a rule, after stopping the medication, the body will fully recover after 2 to 3 days.

Mildronate - side effects

The use of the drug Mildronate may lead to the following side effects: increased blood pressure, general weakness, changes in laboratory blood parameters, nausea, constipation, vomiting, abdominal pain, emotional agitation, allergic reactions on the skin.

Mildronate - analogues

Mildroxin, Midolat, Medatern, Meldonium-DECO, Meldonium Organica, Cardionate, Vazomag, Meldonium, Meldonium-SOLOpharm, Melfor, Angiocardil, Meldonium dihydrate, Idrinol.

Conclusion

As a reminder, all professional athletes should refrain from using this drug. Not so long ago, meldonium was included in the list of so-called doping (prohibited drugs). If it is detected in the athlete’s blood, he will be disqualified.

It is also prescribed for the treatment of certain ophthalmological pathologies, increasing endurance, both physical and intellectual.

There are several forms of release of Mildronate, each of which can be prescribed based on the severity of symptoms, the patient's condition or his personal preferences. Doctors usually prescribe Mildronate injections in cases where it is necessary to quickly achieve a therapeutic effect or if the patient cannot take pills. Usually, the course of treatment can be continued in the future, switching from the injection to the oral form of the drug.

Description of the active substance

According to the instructions for use of Mildronate, the active ingredient in its composition is meldonium or trimethylhydrazinium propionate dihydrate. In structure, it is an analogue of gamma-butyrobetaine, which is present in all human cells. The mechanism of action of meldonium is to block the production of carnitine, as a result of which the synthesis of gamma-butyrobetaine increases. It promotes vasodilation and more efficient blood supply to tissues, especially those under hypoxic conditions.

The drug protects cells from the aggressive effects of catabolic products and toxins, accelerating the elimination of these agents from the body. With ischemia of tissues and organs (for example, myocardium, brain, retina), meldonium changes the blood flow ratio in favor of areas with hypoxia. Thus, its anti-ischemic and antihypoxic effect is manifested.

In conditions of acute lack of myocardial blood circulation, Mildronate helps slow down the formation of necrotic damage and shortens the rehabilitation period. For angina pectoris, the drug reduces the number of attacks of anginal pain and increases cardiac output. Thanks to it, the stimulation of neurons increases, the motor sphere and physical endurance are activated. It also has an anti-stress effect.

Meldonium improves the course of the rehabilitation period in patients who have suffered vascular, inflammatory diseases of the brain or had injuries to the central nervous system. It reduces movement disorders (paresis), improves coordination, and reduces the severity of vegetative manifestations. The use of the drug helps improve the condition of patients with alcohol dependence and reduces the manifestations of withdrawal syndrome.

Pharmacokinetics

The maximum plasma concentration of Mildronate for injection is achieved almost immediately after its parenteral administration. It is quickly distributed in tissues and binds to blood plasma proteins. The bioavailability of the drug is 100%.

Attention! The drug partially penetrates the hematoplacental barrier, and has also been found to pass into breast milk.

Metabolism of Mildronate occurs in the liver

The drug and its metabolites are excreted primarily by the kidneys. The half-life is 3-6 hours.

Indications

What is Mildronate used for, and when can it be useful? Indications for the use of the drug are the following pathological conditions:

• cardiovascular pathology: chronic ischemic heart disease, angina pectoris, myocardial infarction, chronic heart failure;
• dyshormonal cardiomyopathy;
• vegetative-vascular dystonia;
• chronic circulatory disorders in the brain;
• cerebral stroke;
• pathology of peripheral arterial vessels;
• postoperative recovery period;
• bronchial asthma and chronic obstructive pulmonary disease as a component of complex treatment;
• eye diseases of various origins: hemorrhage in the retina and vitreous body of the eye, retinopathy (hypertensive and diabetic), thrombosis of the central retinal vein, impaired blood supply to the retina.
• chronic alcoholism and withdrawal syndrome in alcohol addicts in combination with other types of treatment;
• high physical fatigue and overstrain;
• low productivity of physical and intellectual labor.

Attention! For diseases of the organ of vision, the use of Mildronate injections only parabulbarly is indicated.

In case of cardiovascular pathology, Mildronate injections are part of the complex therapy of these diseases and cannot replace constant treatment with basic drugs

Among the indications for the use of Mildronate, sports training has also found its niche in order to increase endurance, for quick recovery after hard and long-term sports.

How to take the drug?

Mildronate solution has a meldonium concentration of 10%. It is produced in ampoules of 5 ml. Accordingly, 1 ml of solution contains 100 mg of meldonium, and one ampoule contains 500 mg. The box contains 10 ampoules. The drug is prescribed 1 or 2 times a day. The drug solution can be administered in several ways:

• intramuscularly;
• intravenously;
• parabulbar (near the eyeball).

Mildronate is usually administered intravenously in a jet manner, this way the desired effect can be achieved faster. If there is no urgent need for immediate action of the drug, then it can be injected into a vein using a dropper.

The drug in the form of a solution does not need to be diluted before administration.

Mildronate solution is available in a sufficient concentration of the active substance and does not require additional dilution. This applies to all methods of injection delivery of the drug. However, doctors may prescribe its administration, for example, with saline solution. If Mildronate is nevertheless diluted, then the absolute amount of the active substance will not change, only its concentration will decrease, which may affect the speed of onset of the drug’s action.

In cases where rapid action is not required, Mildronate can be diluted. For this purpose only, it is better to use a 0.9% sodium chloride solution (saline). Mixing with other solvents may affect the properties of the drug, which is extremely undesirable.

Mildronate activates nervous activity, so it should be taken at least 4-6 hours before bedtime. Otherwise, sleep disturbance in the form of insomnia may occur. The daily dose can be taken in one injection or divided into two doses.

Dosage for various pathologies

The dose of the drug depends on the specific disease and is selected by the doctor individually:

• Unstable angina and myocardial infarction. In such cases, intravenous administration of the drug is indicated, since these conditions are acute and require immediate intervention. 5-10 ml of Mildronate are administered intravenously. If injections are poorly tolerated, the entire dose is administered once; in other cases, dividing it into two injections is indicated. The duration of parenteral administration of drugs ranges from 1 to 10 days. In the future, you can switch to oral forms of Mildronate and take it in a general course lasting up to 4-6 weeks.
• Chronic circulatory failure. Use 5-10 ml IV once a day or 5 ml twice a day IM. The course lasts up to 2 weeks with a transition to syrup or tablets.
• Ophthalmological pathology. In this case, Mildronate is used parabulbarly at 0.5 ml per day (50 mg meldonium) for 10 days.
• Brain stroke in the acute phase. To achieve a quick effect from the use of the drug, it is administered intravenously at a dose of 5 ml per day for 10 days. You can also inject it intramuscularly at a dose of 500 mg once a day for 2-3 weeks.
• Chronic cerebrovascular insufficiency. For this pathology, the drug is administered either intramuscularly or in tablet form. Inject 5 ml of solution intramuscularly 1 time for 14 days. Reception is extended if necessary up to 4 weeks.
• Dyshormonal cardiomyopathy. Apply 5-10 ml intravenously in one injection per day or 5 ml intramuscularly 2 times a day. The course is 14 days, and if oral administration is continued, it is recommended to take Mildronate for another 2 weeks.
• Chronic alcoholism. Patients receive Mildronate intravenously, 5 ml 2 times a day to relieve neurological symptoms. Continue therapy for up to one week.
• Increased fatigue during periods of high physical and intellectual stress. There is no urgent need for parenteral administration of Mildronate for such indications, but it all depends on which method is more acceptable to the patient and how quickly the effect is expected. The drug is taken intramuscularly, 1 ampoule 1 or 2 times a day. It is also possible to take Mildronate intravenously in a similar dosage regimen. The course of treatment is up to 2 weeks. If there is a need, it can be repeated after another 2-3 weeks.

If, in chronic cerebrovascular accidents, there are swallowing disorders or digestive problems, you should choose the parenteral route of administration of Mildronate

Interaction

Mildronate, interacting with other drugs, can cause both desirable and dangerous reactions in the body. Many patients are interested in whether it is possible to combine meldonium with other drugs. Only a doctor can give a definite answer to this question.

Meldonium increases efficiency:

• antiplatelet agents;
• anticoagulants;
• bronchodilators;
• antiarrhythmics;
• antianginal drugs;
• diuretics.

When prescribing Mildronate, always warn your doctor about taking any medications and about concomitant diseases.

The drug potentiates the effect of beta blockers and cardiac glycosides. Particular caution should be taken when taking Mildronate with the following drugs:

• alpha blockers;
• nitrates;
• calcium channel antagonists;
• peripheral vasodilators.

Taking these drugs together can lead to a sharp decrease in blood pressure and tachycardia.

Contraindications

According to the instructions for use of the drug, it is not prescribed in the following cases:

• pregnancy;
• lactation period;
• children under 12 years of age;
• increased intracranial pressure;
• allergy or the presence of individual hypersensitivity to meldonium.

Side effects and drug overdose

Typically, patients experience a high degree of tolerability of the drug, but sometimes there are cases of adverse reactions to Mildronate:

• skin allergic manifestations in the form of rash, urticaria, rarely - angioedema;
• dyspepsia;
• fluctuations in blood pressure;
• increased heart rate;
• insomnia and psychomotor agitation;
• weakness;
• change in blood count (increased level of eosinophils).

special instructions

In patients who have serious kidney and liver diseases with insufficiency of the functions of these organs, biochemical blood parameters should be monitored. If long-term use of meldonium is necessary, consultation with the attending physician is required to adjust the dose of the drug.

A person taking Mildronate may be allowed to drive vehicles and operate machinery, since the drug does not cause a slowdown in reactions. Elderly patients should reduce the therapeutically effective daily dose.

Application in sports

Due to Mildronate's ability to increase the absorption of oxygen by tissues, it can be recommended for increasing tolerance to physical activity. It improves nutrition of the myocardium and peripheral muscles. This helps reduce fatigue and speed up recovery after training.

Until recently, meldonium was not considered doping, but since 2016 it has been included in the list of drugs that are considered doping in sports

Storage conditions

After opening the ampoule, the solution cannot be stored under any circumstances. A refrigerator is also not suitable for this purpose. After 20 minutes or more have passed after the seal has been broken, the ampoule should be discarded.

Reviews of Mildronate

Patient reviews of this drug are mostly positive. Doctors' opinions on Mildronate are somewhat different.

On the other hand, there are supporters of Mildronate therapy who note the high effectiveness of the drug in their patients.

Since there is almost no evidence base for the drug Mildronate, its effect is equivalent to the placebo effect

I took Mildronate to improve my performance during exams at the institute. I can only say good things: the drug greatly helps overcome fatigue and improve memorization of material. I could stay awake for a long time and still feel relatively alert. Its action is similar to that of an energy drink, only without the side effects.

Valentina, 58 years old

The doctor advised me to take Mildronate after an increase in angina attacks. At first I received intravenous injections for a week, then I drank syrup for another 3 weeks. During this period, the attacks of pain stopped, and there was almost no shortness of breath.

Irina, 42 years old, cardiologist

Mildronate increases exercise tolerance in patients with coronary artery disease. It has a good effect on the well-being of patients with vegetative-vascular dystonia. During therapy with the drug, the symptoms regress completely, but a course of treatment is required, which should be repeated from time to time.

I was prescribed Mildronate droppers along with Panangin, but after two droppers I began to have nightmares, my blood pressure rose and fell sharply and diarrhea appeared. Who can tell me whether to continue with the droppers or not.

Mildronate - instructions for use, reviews, analogs and release forms (capsules or tablets 250 mg and 500 mg, injections in injection ampoules, syrup) of a drug for the treatment of heart attacks and strokes in adults, children and pregnancy

In this article you can read the instructions for use of the drug Mildronate. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Mildronate 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 and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Mildronate in the presence of existing structural analogues. Use for the treatment of heart attacks and strokes and improvement of tissue metabolism in adults, children, as well as during pregnancy and lactation.

Mildronate is a drug that improves metabolism. Meldonium (the active ingredient of the drug Mildronate) is a structural analogue of gamma-butyrobetaine, a substance that is found in every cell of the human body.

Under conditions of increased stress, Mildronate restores the balance between the supply and need of cells for oxygen, eliminates the accumulation of toxic metabolic products in cells, protecting them from damage; also has a tonic effect. As a result of its use, the body acquires the ability to withstand stress and quickly restore energy reserves. Thanks to these properties, Mildronate is used to treat various disorders of the cardiovascular system, blood supply to the brain, as well as increase physical and mental performance.

As a result of a decrease in carnitine concentration, gamma-butyrobetaine, which has vasodilating properties, is intensively synthesized. In case of acute ischemic damage to the myocardium, Mildronate slows down the formation of the necrotic zone and shortens the rehabilitation period.

In heart failure, the drug 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.

The drug eliminates functional disorders of the nervous system that develop against the background of long-term alcohol consumption in patients with chronic alcoholism with withdrawal syndrome.

After oral administration, the drug is quickly absorbed from the gastrointestinal tract. Metabolized in the body to form two main metabolites, which are excreted by the kidneys.

• 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);
• reduced performance;
• physical overexertion (including among athletes);
• withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism);
• hemophthalmos, retinal hemorrhages of various etiologies;
• thrombosis of the central retinal vein and its branches;
• retinopathy of various etiologies (diabetic, hypertensive).

Capsules 250 mg and 500 mg (sometimes mistakenly called tablets, but there is no tablet form of Mildronate)

Solution for intravenous, intramuscular and parabulbar injections (injections in ampoules).

Instructions for use and dosage regimen

Due to the possibility of developing an stimulating effect, the drug is recommended to be used in the first half of the day.

For cardiovascular diseases, as part of complex therapy, the drug is prescribed orally at a dose of 0.5-1 g per day, frequency of use is 1-2 weeks.

For cardialgia against the background of dyshormonal myocardial dystrophy, Mildronate is prescribed orally at a dose of 250 mg 2 times a day. The course of treatment is 12 days.

In case of cerebrovascular accident in the acute phase, the drug is prescribed intravenously (in the appropriate dosage form - 500 mg once a day for 10 days), then the drug is taken orally at 0.5-1 g per day. General course of therapy: weeks.

For chronic cerebrovascular accidents, the drug is taken orally at 0.5-1 g per day. General course of therapy: weeks. Repeated courses are prescribed individually 2-3 times a year.

For mental and physical stress, 250 mg is prescribed orally 4 times a day. Course of treatment days. If necessary, therapy is repeated after 2-3 weeks.

For chronic alcoholism, the drug is prescribed orally at 500 mg 4 times a day. Course of treatment days.

For cardiovascular diseases, as part of complex therapy, the drug is prescribed at a dose of 0.5-1 g per day intravenously (5-10 ml of injection solution with a concentration of 500 mg/5 ml), frequency of use 1-2 times a day. Course of treatment: weeks.

In case of cerebrovascular accident in the acute phase, the drug is prescribed intravenously at 500 mg 1 time per day for 10 days, then switch to taking the drug orally (in the appropriate dosage form - 0.5-1 g per day). General course of therapy: weeks.

For vascular pathology and dystrophic diseases of the retina, Mildronate is administered parabulbarly in 0.5 ml of injection solution with a concentration of 500 mg/5 ml for 10 days.

For mental and physical stress, 500 mg is prescribed intravenously once a day. Course of treatment days. If necessary, therapy is repeated after 2-3 weeks.

For chronic alcoholism, the drug is prescribed intravenously at 500 mg 2 times a day. Course of treatment days.

• tachycardia;
• blood pressure changes;
• psychomotor agitation;
• headache;
• dyspeptic symptoms;
• allergic reactions (redness of the skin, rash or rash, itching, swelling);
• general weakness;
• edema.

• increased intracranial pressure (including in case of impaired venous outflow, intracranial tumors);
• children and adolescents up to 18 years of age;
• hypersensitivity to the drug.

Use during pregnancy and breastfeeding

The safety of Mildronate during pregnancy has not been proven. To avoid possible adverse effects on the fetus, the drug should not be prescribed during pregnancy.

It is not known whether the drug is excreted in breast milk. If it is necessary to use Mildronate during lactation, breastfeeding should be discontinued.

Patients with chronic liver and kidney diseases should be careful with long-term use of the drug. If long-term (more than a month) use of the drug is necessary, you should consult a specialist.

Many years of experience in the treatment of acute myocardial infarction and unstable angina in cardiology departments show that Mildronate is not a first-line drug for acute coronary syndrome.

Use in pediatrics

In children and adolescents under 18 years of age, the effectiveness and safety of Mildronate in the form of capsules and injection solution have not been established.

Impact on the ability to drive vehicles and operate machinery

There is no data on the adverse effects of Mildronate on the speed of psychomotor reaction.

When used together, Mildronate enhances the effect of antianginal drugs, some antihypertensive drugs, and cardiac glycosides.

Mildronate can be combined with antianginal agents, anticoagulants and antiplatelet agents, antiarrhythmic agents, diuretics, and bronchodilators.

When used together with Mildronate, nitroglycerin, nifedipine, alpha-blockers, antihypertensive drugs and peripheral vasodilators may develop moderate tachycardia and arterial hypotension (care should be taken when using this combination).

Analogues of the drug Mildronate

Structural analogues of the active substance:

• 3-(2,2,2-Trimethylhydrazinium) propionate dihydrate;
• Vasomag;
• Idrinol;
• Cardionate;
• Medatern;
• Meldonium;
• Meldonium-Eskom;
• Meldonium dihydrate;
• Melfort;
• Midolat;
• Trimethylhydrazinium propionate dihydrate.

News edited by: admin017, 00:15

Mildronate - instructions for use, analogues, reviews

Mildronate is a drug designed to improve metabolic processes and provide energy to tissues and cells of all human organs. The drug is prescribed for various chronic pathologies and functional disorders, which are characterized by the accumulation of toxins in cells, loss of energy reserves, and decreased physical and mental performance.

Mildronate is a broad-spectrum remedy with a general strengthening effect, improves metabolic processes within tissues, and is used when there is an insufficient supply of nutrients to cells and the accumulation of harmful breakdown products in them.

Description

The drug is available in the form of capsules and solution for parenteral administration. The active component in Mildronate in all dosage forms is meldonium.

One capsule contains 250 or 500 mg of meldonium. Thanks to it, the medicine improves metabolism and has the following beneficial properties:

1. Providing cardioprotective effects.
2. Increasing the resistance of tissues and organs to hypoxia.
3. Reduced permeability of vascular walls.
4. Relief of angina attacks and other symptoms of coronary heart disease.

Mildronate is prescribed for the following pathologies:

• peripheral arterial disease;
• low physical performance;
• brain damage;
• heart failure at the chronic stage;
• bronchial asthma;
• myocardial damage associated with deficiency of sex hormones.
• stroke;
• alcohol withdrawal syndrome;
• bronchitis in chronic form.

Mildronate injections have additional indications:

• hemophthalmos;
• retinal hemorrhage;
• disturbance of venous blood flow;
• retinopathy.

You can buy Mildronate in pharmacies only upon presentation of a prescription from a doctor.

The price of the drug varies between rubles for packages of 40 and 60 capsules. The price of ampoules with injection solution is rubles. Mildronate is produced in Latvia.

Mildronate is available in the form of capsules and solution for injection.

How to take capsules?

If a patient is diagnosed with a disease of the cardiovascular system, then Mildronate is prescribed to him in combination with other medications. The daily dosage ranges from 500 to 1000 mg. It can be taken at once or divided into 2 doses.

On average, the course of treatment can last from 4 to 6 weeks.

Mildronate capsules are taken orally, the daily dose is 500–1000 mg, the entire dose can be taken in one dose or divided into two doses

Diseases should be treated according to the following schemes:

1. In case of myocardial damage, which is caused by a deficiency of sex hormones, the drug must be taken 1 tablet with a dosage of the active component of 500 mg or 2 tablets with a dosage of meldonium 250 mg.
2. If a patient is diagnosed with a disorder of cerebral blood flow, then the daily dosage ranges from 500 to 1000 mg, depending on the severity of the pathology.
3. In case of chronic cerebrovascular accident, it is necessary to take Mildronate 500 mg per day.
4. To treat alcohol withdrawal syndrome, the medicine should be taken at least 4 times a day, 500 mg. The course of therapy is 7-10 days.

The drug is often used by athletes before training, taking capsules 2 times a day. At the preparatory stage, the course of taking Mildronate lasts from 14 to 20 days, and during competitions it lasts for a day.

How to dose the solution for intravenous administration?

In case of acute coronary syndrome, a specialist administers the drug Mildronate intravenously in a dosage of mg. After the procedure, it is necessary to continue treatment with capsules.

If a patient is diagnosed with an acute disorder of cerebral blood flow, then Mildronate is administered intravenously at a dose of 500 mg per day. Treatment lasts 10 days. In the chronic form, the course of therapy ranges from 14 to 20 days, and the dosage of the drug remains unchanged.

Who is the drug contraindicated for?

According to the instructions, Mildronate should not be taken in the following cases:

• individual hypersensitivity to components;
• syndrome of increased intracranial pressure;
• pregnancy and breastfeeding period.

Note! The drug is prohibited for the treatment of children because there is no data on its safety.

It is recommended not to combine Mildronate with alcohol, especially if the patient is diagnosed with cardiovascular pathology or impaired blood flow to the brain. Taking medication with alcoholic beverages can cause the following unpleasant symptoms:

• allergic manifestations;
• digestive disorders;
• rapid heartbeat accompanied by pain.

If you drink alcohol during treatment, serious complications may occur and the risk of relapse of the disease increases.

Side effects

Quite often, patients treated with Mildronate complain of side effects:

• rash and itchy skin;
• swelling, redness of the skin;
• nausea and vomiting;
• heartburn;
• state of increased arousal;
• tachycardia;
• lowering blood pressure.

Why is Mildronate popular among athletes?

Mildronate is a drug that is capable of expanding dynamic and statistical indicators during physical activity not only in people with ischemic lesions, but also in those who are absolutely healthy.

Mildronate is used in sports to improve performance and reduce rehabilitation time after various injuries and operations.

This medicine is useful for athletes to strengthen the heart muscle and other muscles of the body, reduce fatigue, which leads to increased training efficiency.

Note! The use of Mildronate for the purpose of increasing muscle mass is prohibited. It can only be used to prevent fatigue and overtraining.

Mildronate also promotes accelerated removal of metabolic products from cells and restoration of cell energy.

There is an opinion that the drug can cause liver steatosis, but this has no scientific evidence.

Analogues

You can replace Mildronate with the following analogues:

Methonate

Metonate is a drug that has a pronounced cardioprotective effect. It improves the contractile function of the myocardium, increases tolerance to physical activity, and reduces the manifestations of mental stress.

With the same indications and contraindications, Metonate is less likely to cause side effects

Metonate and Mildronate have the same indications and contraindications, but Metonate is less likely to cause side effects.

The price of Metonate is rubles. The drug is produced in Ukraine.

Riboxin

Riboxin is a metabolic drug with anabolic and antihypoxic effects. It improves the metabolic process in conditions of low oxygen levels in the body and increases the strength of heart contractions.

Riboxin is produced in the form of tablets and ampoules. The active component is inosine. The drug is prescribed in the complex treatment of congenital and acquired heart defects, myocarditis, cardiac arrhythmias and other pathologies.

Unlike Mildronate, Riboxin is often well tolerated by patients.

Riboxin is contraindicated for people with gout, intolerance to components and hyperuricemia.

The price of the drug is rubles, depending on the form of release. Country of origin: Russia.

Cardionate

Cardionate and Mildronate are synonymous drugs. They have the same active ingredient, so both drugs have the same mechanism of action.

Cardionate can be combined with anticoagulants, bronchodilators and antianginal medications. It is produced in the form of capsules and solution for injection.

Important! The drug should be used with caution in people with kidney disease or liver failure.

The price of Cardionat fluctuates within rubles. The product is produced in Russia.

Trizipin

Trizipine is an angioprotective drug with cytoprotective and antihypoxic effects. The active ingredient in it is propionate dihydrate.

Unlike Mildronate, Trizipine is available only in the form of a solution for parenteral administration.

The drug normalizes vascular tone, regulates blood supply to the brain, slows down the formation of necrotic foci in the myocardium, and has a beneficial effect on dystrophic changes in the fundus.

The price of Trizipin is rubles. The drug is produced in Ukraine.

Melfort

Melfor is a Russian metabolic drug that has antihypoxic and antianginal effects. The active component in it is meldonium.

The drug is prescribed for physical overexertion, decreased performance, for the treatment of chronic cerebral circulatory disorders and withdrawal syndrome in people with chronic alcoholism.

The price of Melfor fluctuates within rubles.

Reviews from doctors

Oksana Anatolyevna Migal

Mildronate is an effective drug that is well tolerated by patients. If used correctly, you can achieve a positive result from treatment in a short time.

Mildronate eliminates the state of general weakness of the body, shortens the recovery period after prolonged alcohol intake, and has an antiarrhythmic effect. Some patients complained of a side effect of increased drowsiness.

Evgeniy Vladimirovich Popov

I did not see any clinical effect from the use of this drug. It is absolutely not clear how Mildronate works, because there is no reliable data confirming its effectiveness after clinical trials. I don’t use it in my practice and I don’t recommend it to my colleagues.

Irina Alekseevna Savchenko

Mildronate has established itself as a good medicine for asthenia to replenish energy. Its advantages are its affordable price and availability in many pharmacies. I do not recommend using the drug for elderly people, since patients with hypertension may experience dizziness.

Vladimir Aleksandrovich Tkachev

Mildronate has a quick and lasting effect. Some patients complain that the capsules are difficult to swallow because they are large, while others experience tachycardia and increased anxiety. I consider the drug an excellent general strengthening agent for increasing physical strength and endurance.

Patient reviews

Marina, 32 years old. Six months ago I began to have trouble breathing. I felt tightness in my chest and could not breathe deeply. I suffered for two weeks, no relief came. I went to a paid doctor who diagnosed me with vegetative-vascular dystonia. He prescribed me Mildronate tablets in combination with Actovegin and Glycine. The drug seemed expensive to me, I paid 510 rubles for it. The package contained 40 capsules, which was just enough for me for a 14-day course. The effect came only after a month. It became easier for me to breathe, my nervousness and the feeling of eternal fatigue also disappeared, which I am very happy about.

Veronica, 25 years old. Last year I suffered a concussion. Afterwards I often felt dizzy. The doctor recommended that I take Mildronate. I was treated with the drug for 12 days. The dizziness went away, I noticed that I became more concentrated and attentive.

Daria, 40 years old. I decided to get rid of excess weight and began to play sports more actively. I signed up for swimming and go to the gym. I loved running and strength training. Since I am not young, a doctor I know advised me to take Mildronate to increase physical activity. After half a month, I noticed that I had become more resilient and did not get tired of exercise as quickly as before. In addition, I began to lose weight faster and lost 5 kg in 2 months. The drug, combined with exercise, accelerated my metabolism and led to good results.

Zhanna, 23 years old. My first acquaintance with Mildronate took place after graduating from school. Intensive classes with tutors before taking exams, psychological experiences and stress caused me sleep disturbances, worsening appetite, and a headache. The neurologist prescribed me this drug to increase mental activity and attention. I bought Mildronate 250 mg at a fairly affordable price - 300 rubles. The downside is that the capsules are hard to swallow and you have to wash them down with a cup of water. I noticed an increase in mental performance, I became less tired, I do everything with joy and cheerfulness. The drug did not cause any side effects for me.

Karina, 28 years old. It has always been a problem for me to get out of bed at the alarm clock in the morning. No matter what time I went to bed in the evening, in the morning I felt exhausted and wanted to lie down for at least another hour. This is due to the fact that as a child I was diagnosed with vegetative-vascular dystonia. I often feel dizzy and have pain in my temples when the weather changes, and I feel lethargic and weak in the fall and winter. The symptoms were not pleasant, so I decided to seek help from a doctor. To restore energy and vitality, he prescribed Mildronate for me. Literally on the second day from the start of treatment, I was able to get out of bed immediately in the morning. Now getting up in the morning has become much easier. My head has become clear and I don’t feel tired throughout the day. Now I recommend the drug to everyone I know who suffers from the same symptoms that I had before.

Mildronate

Description current as of 03/09/2016

• Latin name: Mildronate
• ATX code: C01EV
• Active ingredient: Meldonium
• Manufacturer: JSC “Grindeks”, Latvia

Compound

One hard gelatin capsule of Mildronate contains 250 or 500 mg of 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).

To make the gelatin shell, Gelatinum (gelatin) and Titanium dioxyde (titanium dioxide) are used.

One milliliter of Mildronate injection solution contains 100 mg of Meldonium and water for injection as an auxiliary component.

One Mildronate tablet contains 500 mg of 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 microcrystalline (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 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);
• 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.

pharmachologic effect

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 is characterized by its ability to improve metabolism and energy supply to cells and is used as:

The mechanism of action of Meldonium 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, and activates tissue and humoral immunity.

In patients suffering from heart failure, it increases the strength of contractions of the heart muscle, reduces the frequency of heart attacks (angina attacks), and also increases the body's tolerance to physical activity.

In case of acute myocardial damage, the use of Meldonium slows down the formation of necrotic zones, 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 stress, 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 rapid compensation by the body of its energy reserves and maintains the highest speed metabolic processes.

By toning the central nervous system, meldonium effectively eliminates disorders of the functional state of the somatic and autonomic (autonomic) parts of the nervous system, including disorders that accompany withdrawal syndrome in patients suffering from chronic alcoholism.

In addition, the substance has a beneficial effect on the condition of dystrophically altered retinal vessels, which makes it possible to use it for the treatment of 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 L-Carnitine synthesis.

Meldonium helps reduce the concentration of free carnitine, prevents the transport of long-chain fatty acids across cell membranes, and 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.

After taking Mildronate tablets per os, the meldonium it contains 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 three to six 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 half-life (T½), depending on the characteristics of the particular organism and the dose taken, can range from three to six hours.

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.

Indications for the use of Mildronate: what Mildronate tablets are for, what the medicine is for in the form of injections

All dosage forms of the drug are intended for the treatment of adult patients.

Indications for use of Mildronate (for all dosage forms of the drug):

• IHD (in combination with other drugs and treatment methods);
• peripheral arterial disease;
• reduced performance;
• encephalopathy;
• physical overload (including in sports);
• postoperative period (to speed up the recovery of the body);
• chronic heart failure;
• cardialgia (pain in the left side of the chest) caused by dishormonal myocardiopathy;
• bronchial asthma;
• COPD;
• alcohol withdrawal (as an addition to specific therapy);
• stroke.

Additional indications for the use of drug injections:

• hemorrhage into the vitreous cavity of the eye (hemophthalmos);
• hemorrhage in the retina of the eye;
• thrombosis and occlusion of the central retinal vein or its branches;
• retinopathy of various origins (for example, hemorrhagic or diabetic).

Use of Mildronate in sports

Mildronate is a drug that is characterized by the ability to expand the range of tolerance to physical (both dynamic and static) stress and intellectual function not only in ischemic injuries, but also in healthy people.

The drug is very useful for athletes due to its properties to improve the nutrition of the heart muscle and other muscles of the body and reduce fatigue, while simultaneously increasing the effectiveness of sports training.

Contrary to popular belief, Mildronate is not used as a means to increase muscle mass. Its task in sports and in bodybuilding in particular is somewhat different: Mildronate for athletes is indicated as a prophylactic agent that prevents fatigue (including the heart muscle) and overtraining.

In addition, by promoting faster removal of breakdown products from cells and accelerating the restoration of cellular energy resources, Mildronate improves metabolism at the cellular level and accelerates muscle recovery in athletes after physical activity. Moreover, the latter applies to both strength loads and physical loads on the speed and/or endurance of the body.

There is an opinion that the use of Mildronate in sports can provoke fatty liver hepatosis. However, it is unfounded.

Mildronate prevents fatty acids from penetrating into the cells and thus prevents the accumulation of fats in the liver. In addition, by burning predominantly sugar, 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.

Mildronate: contraindications for use

Contraindications to the use of Mildronate (for all forms of the drug):

• increased individual sensitivity to Meldonium or any of the auxiliary components of the drug;
• intracranial hypertension, including those caused by intracranial tumors and disorders of venous outflow.

Side effects

Side effects caused by taking Mildronate occur quite often. Typically they are expressed as:

• allergic reactions (redness, skin rashes, itching and swelling);
• dyspeptic symptoms, manifested by belching, attacks of nausea, vomiting, heartburn, a feeling of fullness in the stomach even after a small portion of food;
• tachycardia;
• increased arousal;
• decrease in blood pressure.

Instructions for use of Mildronate

You can often come across the questions “Can Mildronate be administered intramuscularly?” or “Can the drug be injected intramuscularly?”

The instructions for medical use indicate that the drug in injection form is intended for intravenous administration, and capsules and tablets are intended for oral administration (per os).

Dosage forms for oral administration should be taken whole, without chewing, crushing or pouring out the contents of the capsules.

Mildronate for intravenous administration is produced in finished form. Mildronate should be administered intravenously separately from other drugs; dilution with an aqueous solution of sodium chloride is not required (however, in some cases it is allowed).

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.

Mildronate injections: instructions for use, why they are prescribed and how to dose the injection solution

Indications for the use of Mildronate injections: unstable (progressive) angina pectoris, myocardial infarction, vascular pathologies of the fundus and cerebral circulatory disorders.

For patients with coronary syndrome, the drug is injected into a vein in a dose equal to mg, once a day. After this, therapy is continued by taking tablets or capsules.

For patients with vascular pathologies of the fundus of the eye, the medicine is administered retrobulbarly (behind the eyeball) or subconjunctivally (under the outer shell of the eyeball) 0.5 ml for 10 days.

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.

Patients with chronic cerebral circulatory disorders are advised to administer Mildronate intramuscularly one to three times a day at a dose of 500 mg (optimally before lunch). The duration of the therapeutic course is from 2 to 3 weeks.

Mildronate tablets: instructions for use

For patients with diseases of the cardiovascular system, Mildronate tablets and capsules are indicated in combination with specific therapy. The drug is taken 1 mg per day. The entire dose can be taken either at once or divided into two doses.

As a rule, the course of treatment lasts from 4 to 6 weeks.

For cardialgia caused by dyshormonal myocardiopathy, Mildronate is taken once a day, one 500 mg tablet or 2 250 mg tablets.

For patients with cerebral circulatory disorders, after eliminating acute disorders, the drug is recommended to be used at a dose equal to mg per day. Take it in one dose or divided into two doses.

Patients with chronic cerebral circulatory disorders are recommended to take 500 mg of Mildronate per day.

The duration of treatment varies from 4 to 6 weeks. At the discretion of the attending physician, the patient may be prescribed repeated courses of treatment (usually two or three times a year).

Patients with pathologies of peripheral arteries are prescribed to take the drug twice a day, 500 mg. The recommended dose for increased intellectual and physical stress on the body (including athletes) is mg, which should be divided into two doses.

The duration of treatment is from 10 to 14 days. If necessary, the course is repeated after a two- or three-week interval.

In the period before training, athletes are recommended to take Mildronate twice a day at a dose equal to mg. The duration of treatment in the preparatory period is usually from two to three weeks, during the competition period its duration varies from 10 to 14 days.

For alcohol withdrawal, patients suffering from chronic alcoholism should take Mildronate 500 mg four times a day. The duration of the course is from 7 to 10 days.

The maximum permissible daily dose is considered to be 2000 mg.

Overdose

No cases of overdose have been recorded. The drug Mildronate is characterized as low-toxic and does not provoke side effects that could threaten the patient's health.

Interaction

Combination of Mildronate with antianginal, antiarrhythmic, anticoagulant, antiplatelet and diuretic drugs, cardiac glycosides, bronchodilators and other drugs is allowed.

Mildronate has the ability to potentiate the effect of Nitroglycerin, β-adrenergic blockers; nifedepine and other drugs that have a coronary effect; antihypertensive drugs, as well as drugs whose action is aimed at dilating peripheral blood vessels.

Due to the possible development of moderate tachycardia and a decrease in blood pressure, the above drugs should be used in combination with Mildronate with caution.

Terms of sale

Mildronate belongs to the category of prescription drugs.

Storage conditions

Mildronate should be stored in a dry place. Keep away from children. The optimal temperature is not higher than 25°C.

Best before date

special instructions

Due to the fact that the drug can provoke a stimulating effect, it is recommended to use it in the first half of the day.

There are no data regarding the ability of Mildronate to change the reaction rate and influence transport control.

The drug is prescribed with caution to people with liver and/or kidney pathologies.

Experience in treating patients with myocardial infarction and unstable angina shows that the active substance Mildronate is not a first-line drug for ACS.

Analogues of Mildronate

The price of drug analogues starts from 170 Russian rubles.

Riboxin or Mildronate - which is better?

Riboxin is a natural compound found also in the human body.

Being a precursor of adenosine triphosphate, it helps to increase the energy balance of the heart muscle, improve coronary circulation, reduce the severity of the consequences of intraoperative ischemic kidney damage, stimulate the production of nucleotides and the activity of individual enzymes of the citrate cycle.

The drug has a positive effect on metabolic processes in the heart muscle, increases the force of its contractions and stimulates its more complete relaxation in diastole, which in turn leads to an increase in stroke volume (stroke volume of blood).

Mildronate has a similar effect, but is not itself involved in the synthesis of other substances. At the same time, the drug regulates the activity and biosynthesis of enzymes involved in energy production, and thus normalizes metabolism.

The conclusion is this: Mildronate is a drug whose action is aimed at correcting metabolic processes, while Riboxin takes part in biochemical reactions and is a means of metabolic action.

To obtain the expected effect from the use of Riboxin, it should be administered in quantities that are comparable to its consumption in the body. And since Riboxin is used by the body in various reactions, it is required in very large quantities.

Mildronate, on the contrary, is not consumed in metabolic reactions, its effect lasts for a longer period of time, and its body requires much less than Riboxin.

Therefore, the use of Mildronate also improves the body’s use of Riboxin. Thus, the combined use of these drugs will potentiate each other's effects.

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 500 mg/5 ml injection solution.

Prescription of Mildronate for children

Since today there is insufficient data on the safety of Mildronate in pediatric practice, the drug should not be used to treat children.

Alcohol compatibility

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 a cardiovascular disease or a cerebral circulatory disorder, the patient is still advised to stop drinking alcohol.

This is due to the fact that taking the drug in combination with alcohol can negate all the positive results that have been achieved in treating the disease.

Taking Mildronate with alcohol can provoke:

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 this reason, alcohol should be excluded for the entire period of treatment with the drug.

Use of Mildronate during pregnancy and lactation

The safety of Mildronate for the treatment of pregnant women has not been proven. To exclude the possibility of its adverse effects on fetal development, the drug is not prescribed during pregnancy.

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.

From this medical article you can familiarize yourself with the drug Mildronate. The instructions for use will explain in what cases the medicine can be taken, what it helps with, what are the indications for use, contraindications and side effects. The annotation presents the forms of release of the drug and its composition.

In the article, doctors and consumers can leave only real reviews about Mildronate, from which one can find out whether the medicine helped in the treatment of strokes, heart attacks and acceleration of metabolic processes in tissues in adult patients and children. The instructions list analogues of Mildronate, prices of the drug in pharmacies, as well as its use during pregnancy.

Mildronate is a synthetic drug that helps improve energy supply and tissue metabolism.

Release forms and composition

Mildronate is produced in the form of:

1. capsules 250 mg or 500 mg;
2. tablets Mildronate Gx 500 mg (slightly sour taste);
3. solution for intravenous injection (injections in ampoules). A solution for intramuscular administration does not exist in nature, only an intravenous method of administering the drug;
4. syrup.

One hard gelatin capsule of Mildronate contains 250 or 500 mg of Meldonium in the form of dihydrate as an active component and excipients.

One milliliter of Mildronate injection solution contains 100 mg of Meldonium and water for injection as an auxiliary component.

One Mildronate Gx tablet contains 500 mg of Meldonium in the form of phosphate and additional substances.

Pharmacological properties

The active ingredient Mildronate improves metabolism, promotes the removal of accumulated toxins from cells, has a tonic effect and protects cells from damage. As a result of using the drug, the ability to withstand stress and quickly recover from it increases.

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.

For heart failure, Mildronate, instructions for use confirms this fact, increases myocardial contractility, reduces the frequency of angina attacks, while increasing tolerance to physical activity.

For ischemic cerebrovascular accidents, the drug is used to improve blood circulation in the ischemic area, which promotes blood redistribution. The drug is also effective for disorders of the nervous system during withdrawal syndrome and fundus pathology.

What does Mildronate help with?

Indications for use include:

• physical overexertion (including among athletes);
• retinopathy of various etiologies (diabetic, hypertensive);
• thrombosis of the central retinal vein and its branches;
• reduced performance;
• complex treatment of acute and chronic cerebrovascular accidents (stroke and cerebrovascular insufficiency);
• withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism);
• hemophthalmos, retinal hemorrhages of various etiologies;
• complex therapy of coronary artery disease (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy.

Instructions for use

Mildronate capsules and tablets

Due to the possibility of developing an stimulating effect, the drug is recommended to be used in the first half of the day.

• For cardiovascular diseases, as part of complex therapy, the drug is prescribed orally at a dose of 0.5-1 g per day, frequency of use is 1-2. The course of treatment is 4-6 weeks.
• For cardialgia against the background of dyshormonal myocardial dystrophy, Mildronate is prescribed orally at a dose of 250 mg 2 times a day. The course of treatment is 12 days.
• For chronic alcoholism, the drug is prescribed orally at 500 mg 4 times a day. The course of treatment is 7-10 days.
• In case of cerebrovascular accident in the acute phase, the drug is prescribed intravenously (in the appropriate dosage form - 500 mg once a day for 10 days), then the drug is taken orally at 0.5-1 g per day. The general course of therapy is 4-6 weeks.
• For mental and physical stress, 250 mg is prescribed orally 4 times a day. The course of treatment is 10-14 days. If necessary, therapy is repeated after 2-3 weeks.
• For chronic cerebrovascular accidents, the drug is taken orally at 0.5-1 g per day. The general course of therapy is 4-6 weeks. Repeated courses are prescribed individually 2-3 times a year.
• Athletes are recommended to use 0.5-1 g 2 times a day before training. The duration of the course during the preparatory period is 14-21 days, during the competition period - 10-14 days.

Injections

• For mental and physical stress, 500 mg is prescribed intravenously once a day. The course of treatment is 10-14 days. If necessary, therapy is repeated after 2-3 weeks.
• For chronic alcoholism, the drug is prescribed intravenously at 500 mg 2 times a day. The course of treatment is 7-10 days.
• For vascular pathology and dystrophic diseases of the retina, Mildronate is administered parabulbarly in 0.5 ml of injection solution with a concentration of 500 mg/5 ml for 10 days.
• For cardiovascular diseases, as part of complex therapy, the drug is prescribed at a dose of 0.5-1 g per day intravenously (5-10 ml of injection solution with a concentration of 500 mg/5 ml), frequency of use 1-2 times a day. The course of treatment is 4-6 weeks.
• In case of cerebrovascular accident in the acute phase, the drug is prescribed intravenously at 500 mg once a day for 10 days, then the drug is taken orally (in the appropriate dosage form - 0.5-1 g per day). The general course of therapy is 4-6 weeks.

Side effects

Negative reactions occur quite often. Typically they are expressed as:

• 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;
• decreased blood pressure;
• tachycardia;
• allergic reactions (redness, skin rashes, itching and swelling).

Contraindications

According to the instructions, Mildronate should not be taken in the following situations:

• increased intracranial pressure;
• individual intolerance to the drug Mildronate, from which these tablets and injections can cause allergies;
• intracranial tumors;
• pregnancy and breastfeeding;
• violation of venous outflow;
• children under 18 years of age.

With extreme caution, Mildronate injection solution and tablets are prescribed to persons suffering from kidney and liver diseases.

Use during pregnancy and lactation

The safety of Mildronate during pregnancy has not been proven. To avoid possible adverse effects on the fetus, the drug should not be prescribed during pregnancy. It is not known whether the drug is excreted in breast milk. If it is necessary to use Mildronate during lactation, breastfeeding should be discontinued.

special instructions

Due to the fact that the drug can provoke a stimulating effect, it is recommended to use it in the first half of the day. There are no data regarding the ability of Mildronate to change the reaction rate and influence transport control.

The drug is prescribed with caution to people with liver and/or kidney pathologies. Experience in treating patients with myocardial infarction and unstable angina shows that the active substance Mildronate is not a first-line drug for ACS.

Drug interactions

When used together, Mildronate enhances the effect of antianginal drugs, some antihypertensive drugs, and cardiac glycosides. The drug can be combined with antianginal agents, anticoagulants and antiplatelet agents, antiarrhythmic agents, diuretics, and bronchodilators.

According to the instructions, when used together with Mildronate, nitroglycerin, nifedipine, alpha-blockers, antihypertensive drugs and peripheral vasodilators may develop moderate tachycardia and arterial hypotension (care should be taken when using this combination).

Analogues of the drug Mildronate

Complete analogues for the active substance:

1. Vasomag;
2. Idrinol;
3. Cardionate;
4. Melfort;
5. Midolat;
6. Meldonium;
7. Meldonium-Eskom;
8. Meldonium dihydrate;
9. Medatern;
10. Trimethylhydrazinium propionate dihydrate.
11. 3-(2,2,2-Trimethylhydrazinium) propionate dihydrate.

Price

In pharmacies, the price for Mildronate capsules (Moscow) is 324 rubles for 40 tablets of 250 mg. For 10 injections of Mildronate 10% in 5 ml ampoules you need to pay 395 rubles.

Mildronate (international nonproprietary name - meldonium) is a very interesting drug, synthesized in the 70s of the last century by scientists of the Academy of Sciences of Latvia, which has firmly established itself on Russian pharmacy counters. It has a whole range of pharmacological effects: antianginal (directed against angina attacks), cardioprotective, antihypoxic (increasing resistance to oxygen starvation) and angioprotective (beneficially affecting the vascular wall and microcirculation). To be fair, it should be noted that mildronate has not yet earned recognition either in Europe or in the USA. However, its effectiveness was confirmed according to all the rules of evidence-based medicine in two double-blind randomized clinical trials conducted in Riga and Tomsk. And it is unlikely that mildronate would have managed to gain such popularity among domestic specialists, patients and even athletes if it had been a useless “dummy”.

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, and has a tonic effect. 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, cerebral circulatory disorders, and increasing mental and physical performance.

The vasodilating properties of mildronate are due to its ability to reduce the concentration of carnitine while increasing the synthesis of gamma-butyrobetaine. In acute ischemia of the heart muscle, the drug slows down the necrotic degeneration of myocytes and accelerates the rehabilitation process. In case of heart failure, mildronate helps the myocardium to contract better and withstand physical activity. In acute and chronic cerebral ischemia, the drug improves cerebral circulation and optimizes microcirculation in favor of the tissue area most affected by ischemia. In ophthalmology, mildronate is used in cases of vascular and dystrophic pathology of the fundus. 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.

The Latvian pharmaceutical industry has mastered the production of three dosage forms of mildronate: capsules, solution for intravenous and parabulbar (in the lower eyelid) administration, and syrup. Specific dosages of the drug depending on the disease and age of the patient can be found in the package inserts, although, given the prescription order for dispensing mildronate (including syrup), this is not necessary, because The last (and even the first) word in any case remains with the doctor.

Pharmacology

A drug that improves metabolism and energy supply to tissues. Meldonium dihydrate is a synthetic analogue of gamma-butyrobetaine, a substance that is found in every cell of the human body.

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.

Inhibits gamma-butyrobetaine hydrooxinase, reduces the synthesis of carnitine and the transport of long-chain fatty acids through cell membranes, prevents the accumulation in cells of activated forms of unoxidized fatty acids - derivatives of acylcarnitine and acyl coenzyme A. Under ischemic conditions, meldonium restores the balance between 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.

It has a cardioprotective effect and normalizes myocardial metabolism. In case of acute ischemic damage to the myocardium, meldonium slows down the formation of the necrotic zone and shortens the rehabilitation period. In heart failure, the drug 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 somatic and autonomic nervous system in patients with chronic alcoholism with abstinence syndrome.

Pharmacokinetics

Suction

After oral administration, meldonium dihydrate is rapidly absorbed from the gastrointestinal tract. Bioavailability is 78%. Cmax in blood plasma is achieved 1-2 hours after oral administration.

Metabolism and excretion

Metabolized mainly in the liver with the formation of two main metabolites, which are excreted by the kidneys. T1/2 when taken orally is 3-6 hours and depends on the dose.

Release form

Hard gelatin capsules, size No. 1, white; the contents of the capsules are white crystalline powder with a slight odor, hygroscopic.

Excipients: potato starch - 13.6 mg, colloidal silicon dioxide - 5.4 mg, calcium stearate - 2.7 mg.

Composition of the capsule shell: titanium dioxide (E171) - 2%, gelatin - up to 100%.

10 pieces. - contour cell packaging (4) - cardboard packs.

Dosage

Due to the possibility of developing an stimulating effect, the drug is recommended to be used in the first half of the day and no later than 17.00 (if taken several times a day).

For ischemic heart disease (angina pectoris, myocardial infarction), chronic heart failure, as part of complex therapy, the drug is prescribed orally at a dose of 0.5-1 g/day, frequency of use 1-2 times/day. The course of treatment is 4-6 weeks.

For dishormonal cardiomyopathy, Mildronate ® as part of complex therapy is prescribed orally at a dose of 500 mg/day. The course of treatment is 12 days.

In case of subacute cerebrovascular accidents (stroke and cerebrovascular insufficiency), after completing the course of injection therapy with Mildronate ®, continue to be taken orally as part of complex therapy at 0.5-1 g/day, using the entire dose once or dividing it into 2 doses. The course of treatment is 4-6 weeks.

For chronic cerebrovascular accidents, the drug is taken orally as part of complex therapy at a dose of 0.5 g/day. The general course of therapy is 4-6 weeks. Repeated courses are possible after consultation with a doctor (usually 2-3 times a year).

In case of reduced performance, mental and physical stress (including in athletes), 500 mg is prescribed orally 2 times a day. The course of treatment is 10-14 days. If necessary, therapy is repeated after 2-3 weeks.

For withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism), the drug is prescribed orally at 500 mg 4 times a day. The course of treatment is 7-10 days.

Overdose

Symptoms: decreased blood pressure, accompanied by headache, tachycardia, dizziness and general weakness.

Treatment: symptomatic therapy.

Interaction

Mildronate ® enhances the effect of coronary dilatants, some antihypertensive drugs, and cardiac glycosides.

Mildronate ® can be combined with prolonged forms of nitrates, other antianginal drugs, anticoagulants and antiplatelet agents, antiarrhythmic drugs, diuretics and bronchodilators.

Due to the possible development of tachycardia and arterial hypotension, caution should be exercised when combined with nitroglycerin (for sublingual use) and antihypertensive drugs (especially alpha-blockers and short-acting forms of nifedipine).

Side effects

Rarely - allergic reactions (redness and itching of the skin, skin rash, urticaria, angioedema), as well as dyspeptic symptoms, tachycardia, decreased or increased blood pressure, increased excitability.

Very rarely - eosinophilia, general weakness.

Indications

• as part of complex therapy for coronary artery disease (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy;
• as part of complex therapy for subacute and chronic cerebrovascular accidents (stroke and cerebrovascular insufficiency);
• reduced performance;
• mental and physical stress (including among athletes);
• withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism).

Contraindications

• increased intracranial pressure (including in case of impaired venous outflow, intracranial tumors);
• age under 18 years (efficacy and safety have not been established);
• pregnancy;
• lactation period (breastfeeding);
• hypersensitivity to the active substance and other components of the drug.

The drug should be used with caution in case of liver and/or kidney diseases.

Features of application

Use during pregnancy and breastfeeding

The safety of the drug during pregnancy has not been established. To avoid possible adverse effects on the fetus, Mildronate ® should not be prescribed during pregnancy.

It is not known whether meldonium dihydrate is excreted in breast milk. If it is necessary to use the drug Mildronate ® during lactation, breastfeeding should be discontinued.

Use for liver dysfunction

Use for renal impairment

Use in children

special instructions

Patients with chronic liver and kidney diseases should be careful with long-term use of the drug.

Use in pediatrics

There is insufficient data on the use of Mildronate ® in children and adolescents under 18 years of age.

Impact on the ability to drive vehicles and operate machinery

There is no data on the adverse effects of the drug Mildronate ® on the ability to drive vehicles and machines.

Until recently, the drug Mildronate, familiar to many, was considered a simple medicine, widely used in our country for the treatment of diseases such as ischemia (IHD), angina pectoris, myocardial infarction and strokes. However, for a number of reasons, in sports circles it was included in the anti-doping list, which is why ordinary people began to wonder whether this drug was harmful and whether it was worth taking it?

Pharmacology of the drug

The instructions for use of Mildronate say that its active substance is meldonium, which was synthesized in the seventies by Latvian scientists. Initially, the drug was developed for the military, but due to some reasons it became available to a wider audience for the treatment of cardiovascular diseases. Meldonium is a substance that is an analogue of gamma-butyrobetaine contained in the cells of our body, which protects them from damage due to coronary artery disease, heart failure, and cerebral circulatory disorders.

In addition to protection, Mildronate nourishes the body's cells with the necessary amount of oxygen and cleanses them of toxins that are the result of metabolic processes. It also strengthens the walls of blood vessels, ensuring their integrity. The drug is an excellent prophylactic for varicose veins.

With long-term use of Mildronate, our body is able to withstand enormous physical stress and restore energy balance in a short time, which allows it to be used as a medicinal and prophylactic agent for disorders of the blood supply to the brain and diseases of the heart and blood vessels.

Often, it is prescribed to patients with decreased performance and to increase mental activity. In case of ischemic heart disease, meldonium slows down necrotic processes and accelerates the recovery period.

Indications

The drug is a panacea for many diseases. Its scope is quite wide. Indications for the use of Mildronate:

• Coronary heart disease in complex therapy;
• Various cardiovascular pathologies - angina pectoris, myocardial infarction, myocardial dystrophy, heart failure;
• Acute cerebrovascular accidents (stroke), and chronic form;
• Disorders of the heart muscle in adolescence;
• Bronchial asthma and chronic bronchitis;
• Poor blood circulation in the retina of the eyes due to hypertension and diabetes mellitus;
• Chronic fatigue, physical overstrain and decreased performance;
• Postoperative period for a speedy recovery of the body.

Treatment with the drug is carried out strictly under the supervision of a doctor.

Forms of release of the drug, composition

Mildronate is produced in several forms, these are:

• Capsules for oral use in a gelatin shell containing white powder 250 and 500 mg (40 and 60 pieces per package);
• Syrup for oral administration;
• Ampoules 5 ml, 10 pieces per package.

Mildronate tablets

One of the forms of release of the product is capsules, often called tablets. In accordance with the leaflet on the use of tablets, they include:

• Active component meldonium - 250 or 500 mg;
• Potato starch - 13.6 or 27.2 mg;
• Colloidal silicon dioxide - 5.4 or 10.8 mg;
• Calcium stearate - 2.7 or 5.4 mg;
• Shell - gelatin (98%) and titanium dioxide (2%).

Sold in a cardboard box of 40 or 60 pieces.

Ampoules for intravenous and intramuscular injections, according to the instructions for use, 5 ml contain:

• Meldonium - 500 mg;
• Water for injections.

Ampoules are produced in a cardboard box of 10 pieces with a dosage of 5 ml.

The substance in the ampoules must be absolutely transparent. If there is any sediment in it, then this medicine cannot be used.

Syrup

Mildronate is also produced in the form of a dark syrup of 100 and 250 ml, which contains 250 mg of meldonium per 5 ml of medication. In addition to the active component, the syrup contains auxiliary substances - cherry essence, purified water, glycerin, dyes, propylene glycol.

The syrup is sold in cardboard boxes; the kit includes a 5 ml measuring spoon.

How to take Mildronate

Typically, capsules are taken 30 minutes before meals. Due to the fact that the drug can increase performance, it is recommended to use it before 17.00 to avoid problems with sleep. Capsule dosage: 500 - 750 mg per day. The syrup is taken in a measuring spoon 2-4 times a day before meals or no earlier than 30 minutes after meals.

The standard dosage of injections is 500 mg or 1 g per day once or by dividing the dose into 2 parts. The drug is used in the first half of the day. In acute cases of the disease, Mildronate is recommended to be administered intravenously.

The dosage may vary depending on the type of disease and its severity.

The dose of the medicine is prescribed by the attending physician individually for each patient.

Contraindications

Every medication has some contraindications. Mildronate is no exception. It is not recommended for use in the following cases:

• With high levels of intracranial pressure;
• For brain tumors;
• Children under 12 years of age;
• The presence of individual intolerance;
• During pregnancy and breastfeeding.

Side effects and overdose

Mildronate is generally well tolerated by patients. Rarely, when using the medicine, various allergic manifestations (rashes, urticaria, swelling), dyspepsia, rapid heartbeat (tachycardia), sudden changes in blood pressure, excited states or general weakness may occur.

If such symptoms occur, you should stop using the medicine.

An overdose of the drug can cause a sharp decrease in blood pressure, headache, dizziness with loss of consciousness, weakness, and tachycardia.

Alcohol compatibility

The instructions for using Mildronate do not contain information about how it behaves when used with alcoholic beverages, but like many medications, it should not be used together with alcohol due to the fact that meldonium itself has a very active effect on blood circulation, and together with When taken with alcohol, it can cause sudden changes in blood pressure due to the dilation and constriction of blood vessels. This condition is extremely undesirable for patients.

Mildronate and sport

Despite the fact that meldonium increases the endurance of athletes and helps quickly recover after enormous physical exertion, it was banned from use in sports, being included in the list of doping substances.

The influence of Mildronate on those who play sports is simply irreplaceable

It is recommended for all sports without exception due to the fact that it helps to avoid overwork during long training sessions. It is most suitable for athletes and bodybuilders because it improves the nutrition of muscle tissue, protects the heart muscle from overload and enriches cells with oxygen, and also reduces fatigue, increasing the effectiveness of each workout.

How to lose weight with Mildronate

Meldonium is an active component of the drug L-carnitine (an analogue of Mildronate), which is successfully used by athletes for rapid weight loss. It lowers blood cholesterol and improves metabolic and fat processes. But the process of losing weight with the help of this product is possible only with intense physical activity and proper nutrition.

Analogues of Mildronate

In Russia, analogues of the Latvian drug Mildronate containing meldonium are produced, these are:

• Methadern;
• Idrinol;

The most popular product is Cardionat, produced in Moscow and Nizhny Novgorod.

Which is better, Mildronate or Cardionate? There is no clear answer to this question. Despite the fact that both drugs have the same active ingredient - meldonium, and the compositions are almost similar, and the only difference is in price, judging by the reviews of patients, the effect of Mildronate is more pronounced than the effect of Cardionate. The effect after using the Latvian remedy appears more clearly, and its manifestation occurs much faster.

The benefits and harms of the drug

Ordinary people, having heard about the scandalous story involving Mildronate in sports, began to increasingly wonder whether this drug was harmful to them? Cardiologists are in a hurry to reassure: those to whom the drug was prescribed by doctors for one reason or another can safely continue to take it, however, it is still not worth using it constantly, it is addictive, so it is recommended to use the drug for no more than two weeks, after which it is worth taking two week break.

Despite all the above advantages of the drug, it is also not recommended for ordinary people to use it for prophylaxis during sports; it should not interfere with the normal functioning of the heart. Absolutely healthy individuals do not need to use it.

Prices

The cost of capsules with a dosage of 250 mg in an amount of 40 pieces fluctuates around 300 rubles, and 60 pieces of 500 mg capsules cost a little more than 600 rubles.

The medicine in ampoules can be purchased in pharmacies for 400-450 rubles, and the syrup costs from 250 rubles per 250 ml bottle.