"Trimectal", the basic basis of which is the active substance trimetazidine, belongs to the group of drugs with an antihypoxic nature of action and is used mainly in cardiology in order to stabilize the cardiovascular system. A medication, as a rule, is prescribed as a supportive / corrective agent in complex therapy and, by stimulating the process of cellular metabolism, contributes to the general improvement of the patient's condition.
Release form and composition
There are several forms of production of the drug "Trimektal." The instructions for use indicate that it can be either hard gelatin capsules (blisters for 10/20 units or polymer cans with a capacity of 60 units), or tablets with a film membrane that slows the release of reagents (blisters for 10/20/30 pcs. or plastic packaging for 60/100/120 pcs.). The main component in both cases is trimetazidine dihydrochloride. However, the form of the drug, which is characterized by a reduced rate of absorption and metabolism, has a different trade name - "Trimectal MV".
pharmachologic effect
Being an antihypoxic drug, Trimectal (the instructions for use in this regard give a clear classification of the medication and at the same time emphasize the importance of its antioxidant properties) has a direct “invigorating” effect on cardiomyocytes and brain neurons. Thus, the drug increases the coefficient of their functionality. The achievement of the cytoprotective effect is a natural result of the growth of the energy potential of cells against the background of a complete optimization of the oxygen consumption regimen.
The active substance does not allow asynchronous contraction of the myocardium by "preserving" the necessary minimum of phosphocreatine. In case of violation of the acid-base balance, Trimektal controls the concentration of calcium and sodium, that is, prevents the excessive accumulation of derivatives of these elements in cardiomyocytes and simultaneously normalizes the balance of potassium ions in the cells. In the fight against angina pectoris, the drug manifests itself as a neutralizer of the root cause: a decrease in nitrate intake leads to the fact that after 14 days of therapy, patients show progress in resistance to physical activity (the value of the blood pressure drops decreases significantly).
Absorption and metabolism
The pharmacological kinetics of the drug "Trimektal" describes the instructions for use, taking into account the form of its release. So, in particular, the contents of the capsules, getting inside the body, are absorbed very quickly (and almost in full) on the gastrointestinal tract. Two hours after administration, the maximum concentration of reagents in the blood plasma is noted. A single dose of 20 mg determines this indicator at the level of 55 ng / ml.
As for the degree of distribution of active components, the binding to plasma proteins, as a rule, does not exceed 16%. At the same time, histohematological barriers are overcome quite easily by trimetazidine. About 60% of the dose taken is excreted unchanged in the urine, with the first 50% within 4–5 hours.
In turn, “Trimektal MV” (tablet form of production), due to the presence of a special coating, ensures the maximum concentration of reagents in blood plasma after three hours. The half-life, depending on the age of the patients, can range from 7 to 12 hours.
Indications for appointment
Cases of prescription of the drug "Trimektal" instructions for use determines the following:
- angina prophylaxis (as an integral part of complex therapeutic measures);
- disturbances in the work of vessels of a chorioretinal nature;
- dizziness caused by functional imbalances of the cardiovascular system;
- hearing impairment (the result of ischemic processes in the vestibular apparatus).
In addition, the attending physician may decide on the advisability of prolonged use of the drug in the elimination of focal erosion of the retina.
Dosage and recommended dosage
The drug is taken orally, directly with meals. The duration of the course is set by the doctor (following a detailed medical examination and diagnosis).
For the capsule form, an average norm of 40-60 mg / day applies (you need to use it for 2-3 times).
In the case of the drug "Trimektal MV" (instructions for use in this regard are somewhat different from the above recommendation), usually one tablet is prescribed in the morning and evening.
Side effects
Along with the healing effect, side effects of active components are sometimes manifested. Regarding probable allergic reactions to the use of Trimectal capsules, the instructions for use, the price of which is the patient’s health, reads:
- in individual patients, local irritation of the skin may occur;
- with prolonged use of the medication, disorders of the food system (nausea, vomiting) are extremely rare;
- sometimes the negative consequences of regular use are expressed in headaches and migraines;
- the blood vessels and heart muscle are sometimes subjected to excessive loads, which indicates the need to reduce dosage.
Regarding the drug "Trimektal MV", the instructions for use report:
- the development of orthostatic hypotension and the formation of "blush" on the face is unlikely (less than one conditional patient per thousand people);
- imbalance in the digestive tract (pain in the abdomen, diarrhea, vomiting, etc.) - often enough (more than one individual case per hundred doses of the drug).
In addition, scenarios are not excluded when the use of tablets with a modified release of reagents can be the root cause of reversible asthenia, tremor, akinesia, and urticaria.
Contraindications
We are considering the antihypoxic drug Trimektal. Instructions for use, the price of the drug, the names of the backup drugs, as well as various opinions of specialists are presented in this review in order to familiarize the interested audience. This drug has a number of contraindications that are equally relevant for all forms of release (capsules / tablets).
A medication is not prescribed if:
- renal failure was diagnosed (provided that QC <15 ml / min);
- the patient has symptoms of functional liver disorders;
- the patient has not reached the age of eighteen;
- acute allergic reactions to the components of the drug are observed.
Among other contraindications are pregnancy and lactation.
Special instructions and mechanism of drug interaction
“Trimektal”, the price of which varies widely (depending on the form of release and the country of manufacture - 300-1100 rubles), has not undergone any serious clinical studies regarding its interaction with other medicines. For this reason, it is possible to talk about the mechanism of the complex combination of effects only on the basis of conclusions obtained as a result of laboratory work with trimetazidine, the main component of the described drug. It is noted that trimetazidine plays the role of an enhancer of anti-ischemic activity, which is a consequence of taking other antianginal drugs. Contacts of a different type with the participation of Trimectal reagents were not observed.
Special instructions for the appointment of the drug:
- can not be used in the early days of hospitalization if the patient is diagnosed with unstable angina (or preinfarction occurs);
- the relationship between the administration of Trimectal capsules (tablets) and the course of Parkinson's disease, which is expressed in strengthening / weakening tremor, necessitates additional monitoring of the patient's condition (we are talking about periodic examinations by a neurologist);
- for patients older than 75 years, the therapeutic course is fraught with complications in the work of the kidneys, so the final decision is up to the doctor;
- violation of psychomotor reactions provoked by trimetazidine is a reason to reflect on the advisability of using the medicine in cases where the patient is outside the hospital, and his professional activity is associated with the risk of industrial injuries.
Overview of analogues
The most common understudies of the drug "Trimektal" (analogues, the active substance of which is also trimetazidine):
- Trimetazidine-Biocom MV, Russia;
- Trimetazide, Poland;
- Trimet, India;
- Antisten, Russia;
- Medarum 20, Russia;
- "Preductal MV", France;
- Rimekor MV, Ukraine.
Despite the general chemical formula, the effect of generics on the body may be slightly different than the original. Therefore, the choice of a specific drug is the prerogative of the doctor.
The medicine "Trimektal": opinions and comments
Health problems related to arterial arrhythmias are often targeted by thematic discussions. Those who want to hear the opinions of patients and people with a medical education regarding the Trimektal preparation (reviews, as a rule, have a positive emotional connotation) do not have difficulty finding information. However, a superficial analysis of opinions shows that the specificity of the appointment affects the objectivity of the points of view. After all, the mentioned medicine in the vast majority of cases is prescribed "in complex", that is, together with other medicines.
For example, a very large group of patients, and concurrently, patients who underwent a therapeutic course on the basis of Trimectal, in their evaluative conclusions agree that the drug did not provide significant changes in curbing such ailments as chronic hypertension and coronary heart disease .