Mildronate for injection can be used orally. Mildronate injections: instructions for use

It is also prescribed to treat some 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 you need to quickly achieve therapeutic effect or if the patient cannot take the 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 reduces rehabilitation period. For angina pectoris, the drug reduces the number of attacks of anginal pain, increases cardiac output. Thanks to it, the stimulation of neurons increases, activation occurs motor sphere and physical endurance. It also has an anti-stress effect.

Meldonium improves the course of the rehabilitation period in patients who have suffered vascular, inflammatory diseases brain or had a CNS injury. 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 addiction, 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 disease heart disease, angina pectoris, myocardial infarction, chronic heart failure;
• dishormonal 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.

At cardiovascular pathology Mildronate injections are part of complex therapy of these diseases and cannot replace constant treatment with basic drugs

Among the indications for the use of Mildronate, they also found their niche sports training 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 fast action 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 specific disease and is selected individually by the doctor:

• 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 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 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 others medicines, can cause both desirable and dangerous reactions 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;
• allergy or the presence of individual hypersensitivity to meldonium.

Side effects and drug overdose

Usually there is a high degree of tolerability of the drug among patients, but sometimes there are cases adverse reactions for Mildronate:

• skin allergic manifestations in the form of rash, urticaria, rarely - angioedema Quincke;
• 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 Vehicle and working with mechanisms, since the drug does not slow down 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 rapid 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 high efficiency use of medication 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.

Is it possible to inject Mildronate intramuscularly and intravenously?

Mildronate is a metabolic medicine designed to restore the balance of oxygen inside cells and quickly restore energy reserves. To the question - can Mildronate be injected intramuscularly, the instructions supplied with the drug give the answer. In it, the manufacturer claims that the medication solution is intended for intravenous, intramuscular and parabulbar administration.

Indications

Mildronate is administered intravenously for:

• chronic heart failure;
• cardiomyopathy;
• retinal thrombosis;
• cerebrovascular insufficiency;
• retinopathy.

The drug is indicated to increase performance and maintain the body during severe physical and mental stress. The active components of this medication may be of interest to all heart patients and post-stroke patients. The medicine contains meldonium, which supports the functioning of the heart and brain in the body. Thanks to its effects, the patient’s performance improves and the neurological functions of the body improve.

How does the medicine work?

After entering the blood and tissues, the components of the drug reach their maximum concentration in the blood plasma. The medication increases heart contractions, supports myocardial function, and improves cerebral circulation. Mildronate can be injected intramuscularly to redistribute blood masses during ischemia. As a result of treatment, the concentration of carnitine stabilizes and the formation of necrotic areas slows down.

From the bloodstream, the active substances of the product are distributed throughout the cellular structures of the tissue.

• improve the functionality of the central nervous system;
• relieve paresis;
• improve the body's reflexes.

Mildronate, when administered intramuscularly, has a beneficial effect on the entire nervous system.

Mildronate injections intramuscularly reduce the body's rehabilitation for various heart diseases several times. The active substances of the drug enhance the synthesis of butyrobetaine, which has a vasodilating effect. The drug improves the functioning of brain structures, blood supply to the brain, and increases physical performance.

The drug eliminates functional disorders in chronic alcoholism, eliminate attacks of angina pectoris. As a result of treatment, heart function stabilizes. The medication is advisable to use in the treatment of stroke and heart disease.

Methods of drug administration

Intravenously

Injection of Mildronate solution when administered intravenously does not cause adverse reactions. The medicine is well tolerated by the body. However, when administered intramuscularly, the active substances of the drug are absorbed more slowly. This feature should definitely be taken into account if Mildronate is injected intramuscularly.

Parabulbar method of administration

The parabulbar method of administering the solution is that the injection is made into the lower eyelid. This method of drug administration is used in ophthalmic practice. The needle is directed into the eyeball located near the fiber. The injection is quite painful. The medicinal solution must be administered very carefully.

Intramuscularly

Intramuscular administration of the drug can be replaced by taking capsules and tablets. One tablet of the product contains 250 mg of meldonium dihydrate. The active substance has a metabolic effect. You need to take the drug per day at a dose of 500 mg - that’s two capsules per day. The daily dose is divided into two doses or taken once if necessary.

The drug Mildronate is administered intramuscularly to many patients suffering from heart failure. The price of medication, on average, varies between 665 rubles.

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Can mildronate be administered intramuscularly?

Mildronate can be called a kind of universal fighter: this drug is prescribed for a variety of ailments. Its active substance, meldonium, accelerates intercellular metabolism, helping the body cope with many ailments and recover from serious stress.

The instructions for use say: the drug can be taken orally - in the form of capsules, or, if injections are not scary, it can be injected intravenously - then ask pharmacists for it in ampoules. But is it permissible to administer mildronate intramuscularly?

Mildronate: one answer to a thousand troubles

The scope of action of this medicine is indeed wide.

The instructions for use of mildronate state that it is necessary for:

• speedy recovery after heavy physical and mental stress;
• oxygen saturation of cells;
• creating a barrier to toxins that accumulate in cells;
• toning the whole body;
• increasing the frequency of myocardial contractions;
• improving blood circulation;
• elimination of nervous system disorders, especially with long-term alcoholism;
• strengthening muscles.

That is why there are a lot of diagnoses for which doctors prescribe mildronate:

• chronic heart failure;
• acute ischemia;
• angina pectoris, myocardial infarction;
• circulatory disorders.

It is also often offered for reduced performance, rapid fatigue, and constant mental and physical stress.

It is noteworthy that the active ingredient of the drug, meldonium, has the same structure as the substance with complex name gamma-butyrobeta in, which can be found in every cell of our body. If there is a shortage of it, it is recommended to administer mildronate. According to the instructions for use, any analogue of mildronate has similar properties, of which, by the way, there are many in pharmacies: melfor, vasomag, medatern, idrinol...

Why do bodybuilders need mildronate?

What is metabolism?

The properties of the drug, which play into the hands of athletes, are really useful. Mildronate:

• ensures oxygen delivery to all cells;
• prevents the accumulation of saturated substances in cells fatty acids;
• helps to better nourish muscles;
• relieves tension, accumulated fatigue, increases performance;
• serves as a guarantee of training effectiveness;
• protects the heart from increased stress.

It is also interesting that thanks to the drug, you can restore the body in a much shorter time, make it stronger, and therefore get much better results.

Dosage of the drug

Mildronate is produced in capsules or ampoules. Swallowing or injecting is a personal choice, and yet, according to some studies, if the drug is injected intravenously, its effectiveness increases by about 2 times. That is why the instructions for use devote a lot of space to indicating the dosage of the medicine: it varies not only with various diseases, but also when using different forms release.

For example, athletes take 0.5–1 gram of medication orally twice a day. The course of admission is 3 weeks during preparation for competitions and 10–14 days during the active period of sports achievements and achievements.

During mental and physical stress, you can administer 250 mg of the medicine as much as 4 times a day! Injecting veins so often, especially since the course of treatment lasts 12 days, you must admit, it’s still a test. Therefore, it is better to take it in capsule form.

But for cardiovascular diseases, you will need to administer mildronate intravenously - 1 gram each active substance twice a day. You will have to be patient: the course of treatment lasts 4–6 weeks.

Can the drug be administered intramuscularly? The instructions for use compiled by the manufacturer do not provide for this method of use. And doctors themselves are wary of this idea. Firstly, the effectiveness of the drug is significantly reduced. In addition, many manufacturers warn that medicine administered intramuscularly can cause allergies, and such an injection itself can be called very painful. Therefore, it is better to abandon the idea of ​​​​doing an intramuscular injection: the game is not worth the candle.

Contraindications and side effects

Despite its tempting properties, injections of mildronate must be done with great caution: it is known to cause side effects. Among them are muscle agitation, rapid heartbeat, itching, rash and redness on the skin, swelling at the injection site. If at least one of the side effects manifests itself, this serious reason stop taking the drug and consult a doctor.

In addition, it has many contraindications.

• increased intracranial pressure;
• chronic kidney and liver diseases;
• age under 18 years;
• period of pregnancy and breastfeeding.

In a separate line, manufacturers warn against taking the medicine while drinking alcohol. Remember: mildronate and alcohol are completely incompatible!

Mildronate (Meldonium - tablets, capsules, syrup, injections) – indications, instructions for use, analogues, reviews, price

Names, release forms, composition and dosages of Mildronate

1. Capsules for oral administration;

2. Syrup for oral administration;

3. Solution for injection (intramuscular, intravenous and parabulbar).

• Methyl parahydroxybenzoate;
• Propyl parahydroxybenzoate;
• Propylene glycol;
• Sorbitol;
• Glycerol;
• Citric acid monohydrate;
• Cherry essence;
• Allura Red dye (E129);
• DyeBrilliant Black BN (E151);
• Purified water.

Capsules are available in two dosages - 250 mg and 500 mg of meldonium. The syrup contains 250 mg of meldonium per 5 ml, that is, it has a concentration of 50 mg/ml. And the injection solution contains 100 mg of meldonium in 1 ml (100 mg/ml).

Therapeutic effect of Mildronate

• Cardioprotective effect– protecting heart cells from negative influences and improving their viability;
• Antianginal action– reduction in the oxygen needs of myocardial cells (due to this effect, myocardial cells have enough of even a small amount of oxygen supplied under ischemic conditions, which reduces the severity of pain, reduces the frequency of angina attacks and increases the tolerance of physical and emotional stress);
• Antihypoxic effect- decrease negative influence oxygen deficiency;
• Angioprotective effect– protection and ensuring the integrity of the walls of blood vessels;
• Tonic effect.

In addition, Mildronate dilates blood vessels and normalizes cellular immunity, which increases the body's resistance to viral infections.

Mildronate - indications for use

• Coronary heart disease (as part of complex treatment);
• Angina pectoris (as part of complex treatment);
• Myocardial infarction (as part of complex treatment);
• Chronic heart failure;
• Pain in the heart due to myocardial dystrophy;
• Dyshormonal cardiomyopathy (myocardial dystrophy);
• Functional disorders of the cardiovascular system in adolescents;
• Myocardial dystrophy in adolescents;
• Neurocirculatory dystonia in adolescents;
• Acute and chronic cerebral circulatory disorders (stroke, cerebrovascular insufficiency);
• Poor blood circulation in the retina;
• Hemophthalmos (injection solution only);
• Hemorrhages in the retina (injection solution only);
• Thrombosis of the central retinal vein or its branches (injection solution only);
• Diabetic and hypertensive retinopathy (injection solution only);
• Bronchial asthma (as part of complex therapy);
• Chronical bronchitis(as part of complex therapy);
• Alcohol withdrawal (as part of complex treatment);
• Chronic alcoholism (as part of complex treatment);
• Low mental and physical performance;
• Physical stress and fatigue;
• Postoperative period after any surgical intervention.

• For quick recovery after high loads in training and competitions;
• Overtraining;
• Low performance.

Mildronate - instructions for use

Mildronate tablets (Mildronat 250, Mildronate 500) and syrup

• A teaspoon contains 5 ml of liquid;
• A dessert spoon contains 10 ml of liquid;
• A tablespoon contains 15 ml of liquid.

That is, you can just take a spoon that holds required quantity syrup and pour it into it.

250 mg in 5 ml (this is the concentration declared by the manufacturer);

X = 312.5 * 5/250 = 6.25 ml.

Mildronate injections - instructions for use

Dosages and rules for administering Mildronate intramuscularly and intravenously

special instructions

Impact on the ability to operate machinery

Overdose

Treatment of an overdose of Mildronate is only symptomatic, aimed at relieving painful manifestations and maintaining normal functioning vital organs.

Interaction with other drugs

• Antianginal agents (Sustak, Nitrong, Betalok, Cordanum, Trental, Dipyridamole, Riboxin, etc.);
• Anticoagulants (Warfarin, Thrombostop, etc.);
• Antiplatelet agents (Prostacyclin, Aspirin Cardio);
• Antiarrhythmic drugs (Adenokor, Amiodarone, Bretilate, Difenin, Cordarone, Moratsizin, Propanorm, Ritalmex, Rhythmiodarone, etc.);
• Diuretics (Veroshpiron, Diakarb, Furosemide, etc.);
• Bronchodilators (Ventolin, Berotek, etc.).

Mildronate should be combined with caution with Nitroglycerin, Nifedipine, alpha-blockers (Doxazosin, Setegis, Tulazin, etc.), antihypertensive drugs and peripheral vasodilators (Traklir, Naniprus, Cormagnesin, etc.), since there is a high risk of developing tachycardia and a sharp decrease in blood pressure.

Side effects

Contraindications for use

• Increased intracranial pressure (due to impaired venous outflow or in the presence of intracranial tumors);
• Pregnancy and breastfeeding (due to unproven complete safety);
• Hypersensitivity or allergic reactions to the components of the tablets, syrup or solution;
• Age under 12 years.

Some instructions for use indicate that Mildronate is contraindicated for children under 18 years of age, however, such terms are reinsurance on the part of the drug manufacturer.

Meldonium - analogues

• Angiocardil solution for injection;
• Vasomag capsules and solution for injection;
• Idrinol injection solution;
• Cardionate capsules and solution for injection;
• Meldonium capsules and solution for injection;
• Midolate capsules;
• Mildracor solution for injection (only in Ukraine);
• Mildrocard capsules (only in Belarus);
• Melfor capsules;
• Medatern capsules.

The following drugs are analogues of Mildronate:

• Angiosil retard tablets;
• Antisten and Antisten MV tablets;
• Biosynth lyophilisate for the preparation of solution for injection;
• Bravadin tablets;
• Valeocor-Q10 tablets;
• Vero-Trimetazidine tablets;
• Histochrome solution for injection;
• Deprenorm MV tablets;
• Dibicor tablets;
• Dynaton solution for injection;
• Doppelhertz Cardiovital tablets;
• Ezaphosphine lyophilisate and ready solution;
• Inosie-F and Inosine-Eskom solution for injection;
• Carditrim tablets;
• Coraxan tablets;
• Coronatera pellets;
• Kudevita capsules;
• Kudesan drops;
• Medarum 20 and Medarum MV tablets;
• Mexicor capsules and solution for injection;
• Metagard tablets;
• Sodium adenosine triphosphate (ATP) solution for injection;
• Neoton lyophilisate for the preparation of solution for injection;
• Orocamag capsules;
• Pedea solution for injection;
• Predisin tablets;
• Preductal and Preductal MV tablets;
• Precard tablets;
• Ranexa tablets;
• Riboxin capsules, tablets and solution for injection;
• Rimecor and Rimecor MV tablets;
• Taufon tablets;
• Triducard tablets;
• Trimectal capsules;
• Trimectal MV tablets;
• Trimet tablets;
• Trimetazide tablets and capsules;
• Trimetazidine and Trimetazidine MB tablets;
• Trimitard MV tablets;
• Ubinon capsules;
• Firazir solution for injection;
• Phosphaden tablets and solution for injection;
• Ethoxidol tablets.

Mildronate - reviews

Reviews from cardiologists

Results of clinical studies of the drug Mildronate, comments from experts - video

What is better than Mildronate?

Mildronate (tablets, ampoules) – price

• Capsules 250 mg, 40 pieces – 243 – 308 rubles;
• Capsules 500 mg, 60 pieces – 561 – 712 rubles;
• Solution 10%, 10 ampoules of 5 ml – 303 – 391 rubles.

Mildronate for injection - official instructions for use

By medical use drug

Registration number:

Trade name of the drug

International nonproprietary name

Dosage form

Compound

active ingredient - meldonium dihydrate 100 mg;

excipient - water for injection.

Transparent colorless liquid.

Pharmacotherapeutic group

Pharmacological properties

Meldonium (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 to 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 myocardium Mildronate ® slows down the formation of the necrotic zone and shortens the rehabilitation period. In heart failure, it increases myocardial contractility, increases exercise tolerance, and reduces the frequency of angina attacks. In acute and chronic ischemic disorders of cerebral circulation, Mildronate ® improves blood circulation in the ischemic area and promotes blood redistribution in favor of the ischemic area.

The drug eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.

The bioavailability of the drug after intravenous administration is 100%. The maximum concentration in blood plasma is achieved immediately after its administration. Metabolized in the body to form two main metabolites, which are excreted by the kidneys. The half-life (T 1/2) is 3-6 hours.

Indications for use

Reduced performance; mental and physical overload (including among athletes).

Withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism).

Contraindications

For liver and/or kidney diseases.

Use during pregnancy and breastfeeding

Directions for use and doses

The method of administration, dose and duration of treatment are determined individually, depending on the indications, severity of the condition, etc.

As part of complex therapy:

coronary heart disease (myocardial infarction) intravenously in a stream of 0.5-1.0 g per day (5-10 ml of the drug Mildronate ®), applying the entire dose at once or dividing it into 2 administrations;

coronary heart disease (stable angina); chronic heart failure and dishormonal cardiomyopathy intravenously in a stream of 0.5-1.0 g per day (5-10 ml of the drug Mildronate ®), applying the entire dose at once or dividing it into 2 injections, or intramuscularly at 0.5 g 1-2 times a day, a course of treatment of days, followed by transition to oral administration.

The general course of treatment is 4-6 weeks.

2. Cerebrovascular accident

As part of complex therapy in the acute phase, 0.5 g (5 ml of the drug Mildronate ®) 1 time per day intravenously for 10 days, switching to 0.5-1 g orally. The general course of treatment is weeks. For chronic cerebral circulatory failure (dyscirculatory encephalopathy), 0.5 g (5 ml of Mildronate ®) IM or IV once a day for 10 days, then 0.5 g orally. The general course of treatment is 4-6 weeks.

Repeated courses (usually 2-3 times a year) are possible after consultation with a doctor.

3. Ophthalmopathology (hemophthalmos and retinal hemorrhages of various etiologies, thrombosis of the central retinal vein and its branches, retinopathy of various etiologies (diabetic, hypertensive)).

0.05 g (0.5 ml of the drug Mildronate ®) parabulbarly for 10 days. It is also used as part of combination therapy.

4. Mental and physical overload

0.5 g (5 ml of Mildronate ®) IM or IV 1 time per day. Course of treatment days. If necessary, treatment is repeated after 2-3 weeks.

0.5 g (5 ml of Mildronate ®) IM or IV 2 times a day. Course of treatment days.

Side effect

Overdose

Mildronate ® is low-toxic and does not cause side effects dangerous to the health of patients.

Interaction with other drugs

Can be combined with antianginal agents, anticoagulants, antiplatelet agents, antiarrhythmic drugs, diuretics, bronchodilators. Enhances the effect of cardiac glycosides.

In view of possible development moderate tachycardia and arterial hypotension, caution should be exercised when combined with nitroglycerin, nifedipine, alpha-blockers, other antihypertensive drugs and peripheral vasodilators, since Mildronate ® enhances their effect.

special instructions

Impact on the ability to drive vehicles and machinery

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

Release form

5 ml in a clear glass ampoule with a line or break point.

5 ampoules in a cell package made of polyvinyl chloride film or uncoated polyethylene terephthalate film (pallet).

Two cell packaging (pallets) along with instructions for use in a cardboard pack.

Storage conditions

Keep out of the reach of children.

Best before date

Do not use after the expiration date stated on the package.

Conditions for dispensing from pharmacies

Registration Certificate Holder

JSC "Grindeks" St. Krustpils 53, Riga, LV-1057, Latvia.

Manufacturer(s)

Elfa Pharmaceutical Company S.A. St. Vincentego Polya 21, Jelenia Gora, Poland

PJSC "Pharmstandard-UfaVITA", Russia., Republic of Bashkortostan, Ufa, st. Khudayberdina, 28;

Organizations accepting complaints

Representative office in Moscow (in the production of the drug JSC Sanitas, Lithuania; Elfa Pharmaceutical Company S.A., Poland; HBM Pharma sr.o., Slovakia).

117556, Moscow, Varshavskoe highway, 74, bldg. 3rd, 5th floor,

PJSC "Pharmstandard-UfaVITA", Russia (in the production of the drug PJSC "Pharmstandard-UfaVITA", Russia)., Republic of Bashkortostan, Ufa, st. Khudayberdina, 28.

Mildronate

Description current as of 03/09/2016

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

Compound

Composed of one solid gelatin capsule Mildronate includes 250 or 500 mg of Meldonium in the form of dihydrate as active component and excipients: Аmylum 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:

• transparent 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 wide range 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 need of cells 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 most high 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 beneficial influence 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 chain reaction synthesis of L-Carnitine.

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 contained in it is quickly absorbed into the digestive tract. The drug is characterized sufficiently high rate bioavailability. 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. Half-life (T½) depending on the characteristics of a particular organism and 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);
• illnesses peripheral arteries;
• 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 retina eyes;
• 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 growth aid 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, promoting faster removal of breakdown products from cells and accelerating recovery energy resources cells, 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 IV administration is carried out in finished form. Mildronate should be administered intravenously separately from other drugs, diluted aqueous solution sodium chloride is not required (however, in some cases it is allowed).

When injected into a muscle, the injection solution has irritant effect and can provoke local painful sensations 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.

Patients with cerebral circulatory disorders in acute stage the solution is injected into a vein once a day at a dose of 500 mg. The duration of the therapeutic course is 10 days. Further treatment carried out using dosage forms for oral administration.

For patients with chronic cerebral circulatory disorders, it is indicated intramuscular injection Mildronate 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 elimination acute disorders The use of the drug is indicated 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. Optimal temperature regime- no 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, reduces the severity of the consequences of intraoperative ischemic kidney damage, stimulates 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 provides similar action, but is not itself involved in the processes of 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 ruin everything 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 increased risk various kinds complications and the likelihood of 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.

Mildronate is considered a drug that has a positive effect on metabolism and performance. This drug was previously often prescribed to athletes to increase endurance and strengthen the body, but recently it has been added to the list of doping drugs. Now “Mildronat” is in demand mainly in cardiology, and it is also used for disorders of the blood supply to the brain. Not everyone knows whether such a medicine is allowed for children and what it can be replaced with if necessary.

Release form and composition

"Mildronat" is presented in the pharmacy in two forms:

• Capsules. They are white in color and have a dense gelatinous shell. These capsules are available in two different dosages and are sold in 20, 40 or 60 pieces per pack.
• Ampoules with solution for intravenous administration. It is colorless and transparent, bottled in each ampoule of 5 ml. This medicine is also administered parabulbarly. One box contains 10 ampoules.

Each form of Mildronate contains a substance called meldonium as an active ingredient. It is presented in the form of a dihydrate, in 1 ml of injectable medicine with a dosage of 100 mg (one ampoule contains 500 mg), and one capsule can contain either 250 or 500 mg. Additionally, the ampoules contain only sterile water, and the capsules include Ca stearate, silica, gelatin, titanium dioxide and potato starch.

Operating principle

Meldonium provides many positive effects. This connection:

• Increases heart cell viability and ensures their protection from adverse effects.
• Reduces the oxygen needs of heart cells and reduces the negative impact of oxygen deficiency on tissues.
• Protects and maintains vascular integrity, and also contributes to their expansion.
• Has a tonic effect on the body.
• Supports cellular immunity , helping the body resist viral attacks.
• Helps eliminate retinal ischemia, myocardium or brain, improving blood supply to these organs.
• Stimulates the removal of toxic compounds from cells, protecting them from damage.
• Helps with physical activity and quickly restore your own reserves.
• Helps relieve symptoms mental stress.

Indications

"Mildronat" is used:

• For heart failure, myocardial dystrophy, functional disorders of the heart, myocardial infarction, angina pectoris and other problems with the cardiovascular system.
• For chronic bronchitis or bronchial asthma.
• For circulatory disorders in the retina or brain.
• When overtired, severe physical exertion, decreased performance, and also after surgical treatment.

Is it prescribed for children?

As noted in the annotation for Mildronate ampoules and capsules, these drugs are not used in the treatment of patients under 18 years of age. The main reason is an insufficient amount information about the effect of meldonium on children's body. If a doctor prescribes this medication in adolescence, he takes responsibility for himself, selecting the dosage and regimen of use individually.

Mildronate is contraindicated for children under 12 years of age.

Contraindications

Side effects

Judging by the reviews, Mildronate extremely rarely provokes any negative reactions. However, in some patients, its use may lead to psychomotor agitation, severe weakness, tachycardia, allergic reaction, dyspepsia and other symptoms. If they occur, you should immediately consult a doctor.

Instructions for use

Suitable shape medications, single dose and duration of Mildronate therapy are determined individually. For example, during physical overload, the injection solution is injected into a vein once a day - 1 ampoule (for 10-14 days). For adolescents, the dosage of the drug is calculated based on their weight, multiplying their body weight in kilograms by 12.5-25 mg of meldonium.

More detailed instructions You can learn how to use Mildronate in the following video.

Terms of sale and storage

To purchase Mildronate in ampoules or capsules, you need a prescription from a doctor. average price 40 capsules cost 300 rubles, and 10 ampoules cost approximately 400 rubles. The shelf life of both forms is 4 years. The medication should be stored at home at temperatures up to +25 degrees.

Mildronate, what does this drug help with? The medicine improves metabolism and energy supply to tissues. Mildronate instructions for use prescribe to take it for ischemia, heart failure, physical overexertion, and alcoholism.

Composition and release form

The medicine is produced in the form of an injection solution, gelatin-coated capsules, and Mildronate Gx 500 mg tablets. The injections are sold in ampoules of 5 ml, which contain 500 mg of the active substance. The active element of the drug Mildronate, which helps with heart problems, is meldonium.

Pharmacological properties

The active component of the drug "Mildronat", which improves metabolic processes and removes toxins, tones and protects cells from destruction. After taking the medication, the body acquires the ability to withstand increased loads, and the person regains strength faster.

The action of the drug is aimed at improving the oxygen supply to the brain and treating various pathologies of the heart and blood vessels. After its use, performance increases. Why is Mildronate still popular?

Tablets and injections increase the contractility of the heart muscle, reduce the frequency of angina attacks, and increase resistance to physical stress. The medicine improves blood microcirculation in the brain, which promotes its redistribution. The drug is used for withdrawal symptoms, abnormalities in the functioning of the nervous system, and fundus abnormalities.

Medicine "Mildronat": what helps

Indications for use include the following diseases:

• stroke;
• heart failure;
• ischemia, including angina and heart attack;
• dishormonal cardiomyopathy;
• cerebrovascular insufficiency;
• physical overload, low performance;
• hemophthalmos;
• retinal hemorrhage;
• retinal vascular thrombosis;
• withdrawal symptoms;
• retinopathy.

Why is Mildronate used in sports?

The popularity of the drug among athletes is due to its properties to increase the body’s tolerance to physical and mental stress. The medicine improves nutrition of the myocardium and other organs, reduces fatigue. This allows you to increase the effectiveness of the training process.

Mildronate tablets are not intended to increase muscle mass, as many mistakenly believe, but to prevent fatigue and overtraining in athletes. The product allows you to quickly restore the energy reserves of cells and muscles after physical exertion.

The drug is actively used in bodybuilding and other sports. Until 2016, the meldonium contained in the drug, which made it legally used for training, was not classified as a doping drug. Currently, its use in sports is prohibited.

Contraindications

The instructions for use do not recommend using Mildronate tablets and injections for:

• intracranial tumors;
• violation of venous outflow;
• individual failure to take Mildronate, which can cause an allergy;
• increased intracranial pressure;
• children under 18 years of age;
• pregnant and nursing mothers.

Caution during treatment must be observed in patients with liver and kidney pathologies.

Drug: "Mildronat": instructions for use

Many patients ask: “Can Mildronate be administered intramuscularly?” The annotation states that the injections are intended for intravenous administration only. The solution is usually used ready-made, although dilution is allowed physiological composition. And yet, is it possible to inject the drug intramuscularly? Such use of the product is painful and can cause allergies. However, in exceptional cases it is permissible.

Tablets and capsules should be taken orally with water. They cannot be bitten or chewed; they must be consumed whole.

Instructions for using injections

Mildronate in ampoules for coronary syndrome is injected into a vein once a day. The dosage is 0.5-1 g. Treatment is continued with capsules or tablets. For vascular anomalies of the fundus, the medication is administered behind the eyeball or under its outer shell for a decade. Dosage – 0.5 ml.

Patients with cerebrovascular accidents acute form give intravenous injections once a day, injecting 0.5 g of solution. Treatment is continued for 10 days. After this they switch to tablets.

The chronic form of this disease is treated intramuscular injections medicine "Mildronat". The procedure is performed 1-3 times a day before lunch. The dosage is 0.5 g. The duration of therapy takes 14-28 days.

Use of tablets and capsules

The instructions recommend taking Mildronate in tablet form for diseases of the heart and blood vessels in combination with other therapeutic measures. The daily volume of the drug is 0.5-1 g. You can take the medicine twice. Therapy lasts 1-1.5 months.

Treatment of cardialgia is carried out by prescribing 0.5 g once a day. In case of impaired cerebral circulation, which occurs in an acute form, drink 0.5-1 g once a day. For chronic illness, 0.5 g per day is indicated. The course of treatment is 30-42 days. Treatment can be repeated 2-3 times a year.

For excessive mental and physical stress, Mildronate tablets are taken 1-2 times a day. The daily dose is 1 g. The course of treatment is 10-14 days. After a 2-3 week break, taking the capsules can be repeated. Athletes before training are shown a similar treatment regimen.

For chronic alcoholism, Mildronate is given 0.5 g 4 times a day to break out of binge drinking. The maximum daily volume of the drug is 2 g. Treatment is carried out for 7-10 days.

Side effects

The drug "Mildronat", reviews and instructions confirm this, does not cause reactions dangerous to human health. In rare cases, the following were observed:

• pressure changes;
• signs of dyspepsia;
• tachycardia;
• skin itching;
• rash; psychomotor agitation;
• swelling.

Analogues

Mildronate can be replaced with the following medications:

1. Methonate;
2. Meldonium;
3. Metamax;
4. Idrinol;
5. Vazonat;
6. Cardionate;
7. Mildracore;
8. Vasopro;
9. Riboxil;
10. Trizipine;
11. Melfort;
12. Mildrocard.

Many patients ask: “Riboxin” or “Mildronate” - which is better? Doctors answer that the analogue is natural component which enters the human body. The medicine is used for similar indications, but to achieve positive effect its dosage must be very high.

The drug "Mildronate" ensures the occurrence of metabolic reactions in the body, while it itself is not consumed in them, which cannot be said about the drug "Riboxin", which is consumed in these processes. A good therapeutic effect can be achieved by combining these medications. "Mildronat" promotes better absorption riboxin organism.

“Cardionat” or “Mildronat” - which is better?

These analogues include meldonium as an active substance. There is no difference in the mechanism of action. The analogue "Cardionat" is available only in capsules of 0.25 g and a solution of 0.5 g in ampoules of 5 ml.

Price, where to buy

In Russia, Mildronate injections can be bought for 370, tablets for 309-690 rubles. The price in Ukraine is 360 and 180-370 hryvnia, respectively. In Kazakhstan, you will have to pay 4,430 tenge for capsules, in Belarus they cost 7-34, injections - 16-22 Bel. rubles

Opinions of patients and doctors

On the forums about the drug Mildronate, reviews are mostly positive. Much is said about its tonic effect, increasing efficiency, and solving problems with the heart and blood vessels. Athletes, patients and doctors indicate that after using the product, memory, endurance, and agility improve.

Cardiologists confirm that the drug can reduce the likelihood of recurrent myocardial infarction. Negative reviews are due to side effect, which is observed when deviating from the correct therapy regimen and self-medication.

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Mildronate injections: instructions for use

Active substance

Meldonium (3-(2,2,2-trimethylhydrazinium) propionate) dihydrate

Pharmacological group

Drugs that improve metabolism and energy supply to tissues

Release form

Colorless solution for injection, 5 ml ampoules, blister, cardboard pack.

Compound

Actively active ingredient:

3-(2,2,2-trimethylhydrazinium) propionate dihydrate, 100 mg

Excipients:

Sterile water for injection

pharmachologic effect

Angioprotective, cardioprotective, antihypoxic, antianginal

Pharmacodynamics

The active component of the drug, meldonium dihydrate, helps improve metabolism and enhances energy supply to tissues. Being a synthetic analogue of gamma-butyrobetaine (a component that is part of every cell of the human body), this drug helps to activate tissue and humoral immunity, increases performance, reduces symptoms of physical and mental stress, and has a cardioprotective effect.

By inhibiting gamma-butyrobetaine hydrooxinase, 3-(2,2,2-trimethylhydrazinium) propionate dihydrate prevents the accumulation of acyl-coenzyme A derivatives and acylcarnitine (activated forms of unoxidized fatty acids) in cells, reduces the synthesis of carnitine, slows down the transfer through cell membrane long-chain fatty acids, restores the balance between the processes of oxygen delivery and consumption, enhances glucose catabolism, normalizes/prevents disruption of active ATP transport. Under the influence of the drug, due to a decrease in the concentration of carnitine, the production of gamma-butyrobetaine (a substance with vasodilating (vasodilating) properties) increases.

3-(2,2,2-trimethylhydrazinium) propionate dihydrate, characterized by a cardioprotective effect, normalizes metabolic processes occurring in the myocardium, reduces the frequency of angina attacks, and increases the body's resistance to physical stress.

For acute and chronic forms ischemic disorders of cerebral circulation, this drug helps improve blood circulation in the ischemic focus.

It has a positive therapeutic effect in vascular and dystrophic pathologies of the fundus structures, eliminates functional disorders of the ANS during withdrawal syndrome in patients suffering from chronic alcoholism, and eliminates functional disorders of the central nervous system.

Pharmacokinetics

After intravenous administration, the bioavailability of Mildronate is 100%. Reaches maximum concentration in blood plasma immediately after intravenous administration. Metabolized primarily in the liver, with the formation of two metabolites. Excreted by the kidneys, along with urine. Half-life is 3-6 hours.

Indications for use

• Physical and mental stress (including among athletes);
• Decrease in mental and physical performance;
• Subacute and chronic cerebrovascular accidents (cerebrovascular insufficiency, stroke);
• Complex treatment of coronary artery disease (myocardial infarction, angina pectoris);
• Cardialgia occurring against the background of myocardial dystrophy;
• Chronic heart failure;
• Hemothalmos, retinal hemorrhage;
• Retinopathy;
• Thrombosis of the central retinal vein;
• Chronic bronchitis and bronchial asthma (as an immunomodulator in complex treatment);
• Postoperative period (in order to speed up rehabilitation);
• Chronic alcoholism (withdrawal syndrome).
• Intracranial tumors.
• Dyspeptic symptoms;
• Tachycardia;
• Psychomotor agitation;
• General weakness (rare);
• Eosinophilia (very rare).

Contraindications

• Hypersensitivity to individual components of the drug;
• Pregnancy and period breastfeeding;
• Age under 18 years (due to lack of data on use);
• Organic lesions of the central nervous system;
• Increased intracranial pressure;
• Violation of intracranial venous outflow;
• Intracranial tumors.

Directions for use and doses

Midronate has an stimulating effect, and therefore it is recommended to use it in the first half of the day.

For pathologies of the cardiovascular system, the drug is used as part of complex therapy 1-2 times a day, 5-10 ml of solution (concentration 100 mg/1 ml). The duration of treatment is 4-6 weeks.

In case of cerebrovascular accident in acute period diseases LDS is used intravenously for 10 days, 5 ml per day (500 mg/5 ml). Next, the patient is transferred to taking the drug in capsules. The course of treatment is 4-6 weeks.

With increased mental and physical stress, Mildronate is administered intravenously for 10-14 days, 5 ml, 1 time per day. If necessary, treatment can be repeated after 2-3 weeks.

For dystrophic diseases of the retina and vascular pathologies, the drug is administered parabularly (into the periocular area), 0.5 ml of a 10% solution for injection.

Patients suffering from chronic alcoholism are prescribed 5 ml of the drug 2 times a day for 7-10 days.

Drug interactions

Mildronate enhances the pharmacological effect of cardiac glycosides, antihypertensive drugs and coronary dilators.

This drug can be used in combination with prolonged forms of nitrates, arrhythmic drugs, antiplatelet agents, anticoagulants, diuretics, bronchodilators and antianginal drugs.

When taking Mildronate in combination with nitroglycerin and antihypertensive drugs (short-acting forms of nifedipine and alpha-blockers), arterial hypotension and tachycardia may develop.

Side effects

• In rare cases, the manifestation of allergic reactions (hyperemia, skin itching, rashes, urticaria, angioedema);
• Dyspeptic symptoms;
• Decreased or increased blood pressure;
• Tachycardia;
• Psychomotor agitation;
• General weakness (rare);
• Eosinophilia (very rare).

Overdose

In case of an overdose of the drug, a decrease in blood pressure, tachycardia, dizziness, headaches, and general weakness are observed. There is no antidote to the drug; the patient is prescribed symptomatic treatment.

special instructions

During pregnancy and breastfeeding, due to the lack of clinical data on the effect on fetal development and the health of the child, Mildronate is not prescribed.

The drug should be used with extreme caution when chronic diseases kidneys and liver.

For patients with myocardial infarction, Mildronate is not a first-line drug.

No data have been identified on the effect of injection drugs on the ability to drive vehicles or perform work that requires increased concentration and speed of psychomotor reactions.

Vacation conditions

The drug is a prescription drug.

Storage conditions

Store in a dry place, protected from light, out of reach of children, at a temperature not exceeding 25 C. Do not freeze! Shelf life 4 years. After the expiration date, the drug is not suitable for use.

Manufacturer

PJSC "Grindex", Latvia.

Analogues of Mildronate injections

• Meldonium organic (solution for injection);
• Cardionate (solution for injection);
• Midolat (solution for injection);
• Idrinol (injection solution).

Mildronate ampoules price

Mildronate solution for injection 100 mg/ml 5 ml - 380-430 rub.

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What does Mildronate help with?

Mildronate is an effective drug that improves metabolism and energy supply to tissues. What does this remedy help with? Mildronate instructions for use recommend using it for ischemia and heart failure, stroke, to improve performance.

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;
• 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.

Compound

The composition of one hard gelatin capsule of Mildronate, on which the action of the product depends, includes 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). Capsules are packaged in blisters of 10 pieces each. One cardboard box contains 4 blisters and instructions for use of the drug.

pharmachologic effect

The active ingredient Meldonium, which improves metabolism, helps remove accumulated toxins from cells, has a tonic effect and protects cells from damage. As a result of the use of Mildronate, 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.

In case of heart failure, Mildronate, according to the instructions, increases myocardial contractility, reduces the frequency of angina attacks, while increasing tolerance to physical activity. Mildronate is used, which helps with ischemic disorders of cerebral circulation, to improve blood circulation in the area of ​​ischemia, which promotes blood redistribution. Also, according to reviews, Mildronate is effective for disorders of the nervous system with withdrawal syndrome and pathology of the fundus.

Medicine Mildronate: what helps

The main indications for Mildronate are:

• heart failure;
• dishormonal cardiomyopathy;
• coronary heart disease (angina pectoris and myocardial infarction as well);
• cerebrovascular insufficiency;
• strokes.

In addition, Mildronate is indicated for: physical overexertion; low performance; thrombosis of the central retinal vein; retinal hemorrhage of various origins; hemophthalmia; withdrawal syndrome; retinopathy of various etiologies (including hypertensive and 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.

Contraindications

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

• individual intolerance to the drug;
• violation of venous outflow;
• intracranial tumors;
• children under 18 years of age;
• pregnancy and breastfeeding period.

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

Instructions for use of Mildronate

The dose and route of administration of Mildronate depend on the disease. For cardialgia developing against the background of dyshormonal myocardial dystrophy, Mildronate is taken twice a day for 12 days, 250 mg. At cardiovascular diseases Mildronate is indicated as part of complex therapy, up to 2 times a day, 0.5-1 g. Treatment is usually carried out from a month to 6 weeks.

For chronic cerebrovascular accidents, take 1-2 tablets of Mildronate (500 mg each) per day for a course of 4 to 6 weeks. According to indications, treatment can be performed several times a year. In the acute phase of cerebrovascular accident, Mildronate is administered intravenously for 10 days, 500 mg once a day, according to instructions. After this, you can switch to taking Mildronate tablets, 0.5-1 g per day. The general course of therapy is usually up to 6 weeks.

For increased mental or physical stress, take 1 tablet of Mildronate 250 mg, up to 4 times a day for two weeks. Repeat course can be completed no earlier than in 2 weeks. Athletes are recommended to use Mildronate before training, twice a day, 0.5-1 g. During the preparatory period, the drug - from two to three weeks, during competitions - 2 weeks.

For disorders caused by chronic alcoholism, usually take 1 tablet of Mildronate (500 mg) 4 times a day for 10 days. Mildronate is indicated for use in the first half of the day due to the possibility of developing an stimulating effect.

Side effects

The use of Mildronate (according to patient reviews) does not lead to life-threatening complications. In rare situations, this drug may cause unwanted reactions such as:

• psychomotor agitation;
• tachycardia;
• changes in blood pressure;
• dyspeptic symptoms.

In addition, reviews of Mildronate indicate that this medicine sometimes causes allergic reactions - skin itching, rashes, redness and angioedema.

Analogues and price

Analogs of Mildronate: Vasopro, Vazonat, Metamax, Metonat, Trizipine, Mildrakor, Mildrocard, Cardionat, Riboxil. The price of drug analogues starts from 180 Russian rubles. You can buy 250 mg capsules in pharmacies for an average of 260-290 rubles, 500 mg capsules for 570-660 rubles. The price of Mildronate for intravenous administration is 330-390 rubles. Price Mildronate Gx 500 mg - 720-730 rubles.

Patient opinions

Reviews about Mildronate on forums are mostly positive. The unique mechanism of action of this drug allows it to be widely used to eliminate problems with the cardiovascular system, as well as as a means of increasing performance in healthy people who are subject to frequent physical and intellectual overload.

Both patients in cardiology departments, doctors, and athletes note the fact that Mildronate provokes a tonic effect. Its use significantly improves memory function, accelerates thought processes, increases dexterity, endurance and the degree of body resistance to adverse factors.

Reviews from cardiologists confirm the data of numerous studies that have shown that the use of Mildronate in capsules and in the form of a solution for injections can reduce the incidence of recurrent myocardial infarction by more than nine times. Reviews from patients about Mildronate allow us to conclude that the drug is simply necessary for people whose activities are associated with increased stress on the body, as well as during the recovery period after long-term abuse alcohol, for pain and burning in the heart area, VSD and other pathologies of the cardiovascular system.

Sometimes you come across negative reviews about Mildronate. It is important to remember that, like any other drug, Mildronate gives a good result only if its dose and concomitant treatment(if necessary).

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Mildronate injections

Mildronate is a drug with metabolic activity, which improves the energy supply of cells and tissues. Positive influence This means for metabolism and elimination of energy deficiency made it possible to use Mildronate for many chronic diseases of the cardiovascular, respiratory, and nervous systems. 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.

Attention! When increasing physical activity Mildronate helps maintain a balance between the need for oxygen in the tissues and cells of the body with its direct delivery.

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.

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;
• dishormonal 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 is administered intramuscularly when there is no acute conditions. This route of administration is indicated for chronic cardiovascular and cerebrovascular diseases.

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.

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.

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.

Reference! Due to the lack of controlled studies, meldonium is not recommended during pregnancy or lactation. However, in practice, it can be used during pregnancy with impaired feto-placental blood flow.

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).

There have been no recorded cases of Mildronate overdose. If the recommended doses are greatly exceeded, it is possible a sharp decline blood pressure, weakness, dizziness, headache. Treatment of signs of overdose is exclusively symptomatic.

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.

Many patients are interested in: when is Mildronate prescribed, what does it help with, and in what cases is it most effective. The medicine is synthetic drug, which improves tissue metabolism and contributes to their energy supply. The active ingredient, meldonium, improves metabolism, allows the removal of accumulated toxins from cells, protects cells from damage and has a tonic effect on them. As a result of using the medication, a person’s ability to withstand stress and quickly recover from it increases. Thanks to these properties, the medicine is used to improve cerebral blood supply and therapy of various disorders of the cardiac and vascular system, as well as increasing performance.

According to the instructions, the drug "Mildronat" for heart failure reduces the number of angina attacks, increases myocardial contractility, while increasing the body's tolerance to physical activity. For ischemic pathologies of cerebral circulation, the drug is used to improve blood circulation in the area of ​​ischemia, which promotes its redistribution. Also, patient reviews indicate that the drug is effective in cases of fundus pathology and nervous system abnormalities as a result of the effects of abstinence syndrome.

Release form of the drug "Mildronat":

The medicine is produced in the form of gelatinous white capsules containing the active substance in the form of a crystalline powder with a slight odor. 500 or 250 mg of the active substance meldonium in a capsule, 10 pieces in a blister. And also in the form of a transparent colorless solution. 1 ml of the drug contains 100 mg of the active substance, ampoules - 5 ml.

The drug "Mildronat": what is it prescribed for?

The medication is indicated for use in complex therapy for cerebrovascular insufficiency and strokes, with ischemic pathology heart disease, including angina pectoris and myocardial infarction, as well as dyshormonal cardiomyopathy and heart failure. In addition, the medicine "Mildronat" is used for:

• Various etiologies of retinopathy, including hypertensive and diabetic;
• Withdrawal syndrome in chronic alcoholism, in combination with specific therapy;
• Reduced performance;
• Thrombosis of the central retinal vein and its branches;
• Physical overstrain;
• Hemophthalmia and retinal hemorrhages.

Contraindications

According to the instructions, the product is contraindicated for use in childhood up to 18 years old, with hypersensitivity to the drug, as well as with increased intracranial pressure, including impaired venous outflow and intracranial tumors. The drug is not recommended for use during pregnancy and lactation, since no reliable studies on the use of the drug have been conducted during these periods. The medicine is used with caution for liver or kidney diseases.

Instructions for use of the drug "Mildronat"

The dose and route of administration depend on the disease:

• For cardialgia developing against the background of dyshormonal myocardial dystrophy, the medicine is taken twice a day for 12 days, 250 mg; For cardiovascular diseases, the medication is indicated as part of complex therapy, up to 2 times a day, 0.5-1 g. Treatment is usually carried out from a month to 6 weeks;
• For chronic cerebrovascular accidents, take 1-2 tablets (500 mg) per day for a course of 4 to 6 weeks. According to indications, treatment can be performed several times a year;
• In the acute phase, in case of cerebrovascular accident, the medicine according to the instructions is administered intravenously for 10 days, 500 mg once a day. After this, you can switch to taking tablets, 0.5-1 g per day. The general course of therapy is usually up to 6 weeks;
• For increased mental or physical stress, take 1 tablet of 250 mg, up to 4 times a day for two weeks. A repeat course can be completed no earlier than 2 weeks later.

Athletes are recommended to use the medication before training, twice a day, 0.5-1 g. During the preparatory period, the drug - from two to three weeks, during the competition - 2 weeks. For disorders caused by chronic alcoholism, usually take 1 tablet (500 mg) 4 times a day for 10 days. The medicine is indicated for use in the first half of the day due to the possibility of an stimulating effect.

Side effects of Mildronate

According to reviews, the medicine is a low-toxic drug and does not cause side effects hazardous to health. Extremely rarely:

• Tachycardia;
• Psychomotor agitation;
• Changes in blood pressure;
• Dyspeptic symptoms.

Also, the drug "Mildronat" can cause allergic reactions in the form of rash, swelling, redness or itching of the skin. Care must be taken when simultaneous use with some antihypertensive and antianginal drugs, as well as cardiac glycosides, since. At joint use Antihypertensive drugs, alpha-blockers, peripheral vasodilators nitroglycerin, nifedipine may develop arterial hypotension and moderate tachycardia. The drug "Mildronate" can be combined with antiplatelet agents and anticoagulants, as well as antiarrhythmic and diuretic drugs.

In this article you can read the instructions for use of the drug Meldonium. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Meldonium 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 Meldonium in the presence of existing structural analogues. Use for treatment of ischemic heart disease, overwork, recovery of athletes in adults, children, as well as during pregnancy and lactation. Composition of the drug.

Meldonium- a drug that improves metabolism, an analogue of gamma-butyrobetaine. Suppresses gamma-butyrobetaine hydroxinase, inhibits the synthesis of carnitine and the transport of long-chain fatty acids through cell membranes, and prevents the accumulation in cells of activated forms of unoxidized fatty acids - derivatives of acylcarnitine and acyl coenzyme A.

Under conditions of ischemia, it restores the balance of the processes of oxygen delivery and its consumption in cells, prevents disruption of ATP transport; At the same time, 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. The mechanism of action determines its diversity pharmacological effects: increased performance, reduced symptoms of mental and physical stress, activation of tissue and humoral immunity, cardioprotective effect.

In case of acute ischemic damage to the myocardium, it slows down the formation of the necrotic zone and shortens the rehabilitation period. In heart failure, it increases myocardial contractility, increases exercise tolerance, and reduces the frequency of angina attacks. In acute and chronic ischemic disorders of cerebral circulation, it improves blood circulation in the ischemic 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 nervous system in patients with chronic alcoholism with withdrawal syndrome.

Compound

Meldonium dihydrate (trimethylhydrazinium propionate dihydrate) + excipients.

Pharmacokinetics

After oral administration, it is quickly absorbed from the gastrointestinal tract. Bioavailability is about 78%. Cmax in plasma is achieved 1-2 hours after administration. It is biotransformed in the body to form two main metabolites, which are excreted by the kidneys.

Indications

For oral or intravenous administration:

• 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);
• decreased performance;
• physical overexertion (including among athletes);
• postoperative period to speed up rehabilitation;
• withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism).

For parabulbar administration:

• acute circulatory disorder in the retina;
• hemophthalmos and retinal hemorrhages of various etiologies;
• thrombosis of the central retinal vein and its branches;
• retinopathy of various etiologies (including diabetic and hypertensive) - only for parabulbar administration.

Release forms

Capsules 250 mg and 500 mg (sometimes mistakenly called tablets).

Solution for parabulbar and intravenous administration (injections in injection ampoules).

Instructions for use and dosage

Due to the possibility of developing an stimulating effect, it is recommended to use it in the first half of the day. The dose is set individually depending on the indications and route of administration.

When taken orally, a single dose is 0.25-1 g, the frequency of administration and duration of treatment depend on the indications.

At intravenous administration the dose is 0.5-1 g 1 time per day, the duration of treatment depends on the indications.

0.5 ml of injection solution with a concentration of 500 mg/5 ml is administered parabulbarically for 10 days.

Athletes are prescribed for rehabilitation therapy according to special schemes in combination with other means. Officially recognized as doping.

Side effect

• tachycardia;
• changes in blood pressure (hypotension);
• psychomotor agitation;
• dyspeptic symptoms;
• skin itching;
• redness;
• rash;
• edema.

Contraindications

• increased intracranial pressure (including in case of impaired venous outflow, intracranial tumors);
• pregnancy;
• lactation period (breastfeeding);
• children's and adolescence up to 18 years old;
• hypersensitivity to meldonium.

Use during pregnancy and breastfeeding

During pregnancy and lactation (breastfeeding), the use of Meldonium is contraindicated.

Use in children

In children and adolescents under 18 years of age, the effectiveness and safety of meldonium have not been established.

Meldonium in capsule form is contraindicated for use in children and adolescents under 18 years of age; in syrup form - in children under 12 years of age.

special instructions

Use with caution in case of liver and/or kidney diseases, especially for a long time.

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

Drug interactions

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

With the simultaneous use of Meldonium with nitroglycerin, nifedipine, alpha-blockers, antihypertensive drugs and peripheral vasodilators, the development of moderate tachycardia and arterial hypotension is possible (with these combinations, caution is required).

Analogues of the drug Meldonium

Structural analogues according to active substance:

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

Analogues therapeutic effect(medicines for the treatment of physical, mental overload and rehabilitation):

• Additive with iron;
• Antioxycaps with iodine;
• Asvitol;
• Ascovit;
• Berocca Plus;
• Vasomag;
• Vasoton (L-arginine);
• Valeocor Q10;
• Vitamax;
• Vitaspectrum;
• Vitatress;
• Vitrum Plus;
• Galavit;
• Hepargin;
• Heptolexin;
• Dibikor;
• Jeriton;
• Duovit;
• Idrinol;
• Inosine;
• Beresh Plus drops;
• Cardionate;
• Carnitine;
• Korilip;
• Coenzyme compositum;
• Cropanol;
• Kudevita;
• Kudesan;
• Lamivit;
• Leriton Active;
• Mexidol;
• Mexico;
• Metaprot;
• Mildronate;
• Nagipol;
• Neotone;
• Oligovit;
• Pantogam;
• Pantocalcin;
• Pikovit;
• Pikovit forte;
• Riboxin;
• Ribonosine;
• Selmevit;
• Trekrezan;
• Triovit;
• Ubiquinone compositum;
• Falkamin;
• Centrum;
• Cytoflavin;
• Cigapan;
• Eleutherococcus extract;
• Eltacin;
• Elkar;
• Encephabol;
• Yantavit.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.