Mildronate course of treatment intravenously. Mildronate: instructions for use. Pediatric use

Thanks

The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Names, forms of release, composition and dosage of Mildronate

The composition of all three dosage forms of Mildronate includes the same active substance - meldonium. This active ingredient is also called mildronate or trimethylhydrazinium propionate dihydrate. In some instructions for use attached to the drug, the name of the active substance (INN) is meldonium, in others - mildronate, and in the third - trimethylhydrazinium propionate dihydrate. However, in all cases we are talking about the same chemical substance, which is referred to by different names.

Mildronate capsules contain gelatin, titanium dioxide, silicon dioxide, calcium stearate and potato starch as excipients. The solution for injection does not contain any excipients, since it contains only meldonium and purified water. Mildronate syrup contains the following excipients:

• Methyl parahydroxybenzoate;
• Propyl parahydroxybenzoate;
• propylene glycol;
• Glycerol;
• Citric acid monohydrate;
• cherry essence;
• Allura Red dye (E129);
• Dye Brilliant Black BN (E151);

Mildronate capsules are often called pills. However, since the drug does not have such a dosage form, the term "tablets" means a variety of Mildronate for oral administration, and these are capsules. Therefore, in this case, capsules = tablets. To indicate the required dosage of capsules, usually use short names, such as Mildronate 250 And Mildronate 500, where the number corresponds to the dose of the active substance. To refer to a solution for injection in everyday life, short forms of names are often used, such as Mildronate injections And Mildronate ampoules.

Therapeutic action of Mildronate

• Cardioprotective action – protection of heart cells from negative influences and improvement of their viability;
• Antianginal action - a decrease in the oxygen demand of myocardial cells (due to this effect, even a small amount of oxygen supplied under ischemia is enough for myocardial cells, which reduces the severity of pain, reduces the frequency of angina attacks and increases the tolerance of physical and emotional stress);
• Antihypoxic action - reducing the negative impact of oxygen deficiency;
• Angioprotective action - protection and ensuring the integrity of the walls of blood vessels;
• Tonic action.

Mildronate injection solution is available in one concentration of 100 ml / ml and is intended for intravenous, intramuscular or parabulbar administration. That is, the same solution is used for any type of injection.

Ampoules with a solution should be opened immediately before the injection. Do not store open solution either outdoors or in the refrigerator. If the ampoule with the solution was opened in advance and stood for more than 20 minutes, then such a drug cannot be used, it should be discarded and a new ampoule opened.

Before opening the ampoule, carefully inspect the solution for cloudiness, flakes and other inclusions. If there are any, then the solution cannot be used. For injection, only a clear and completely transparent solution can be used.

Injections must be done in the morning, since Mildronate has a stimulating effect. If you need to make several injections per day, then the last of them should be made at least 4 to 5 hours before going to bed.

Intramuscular injections can be done independently at home, and intravenous and parabulbar injections can only be done in a clinic or hospital. Intravenous injections at home can only be given by a qualified nurse.

Dosages and rules for the introduction of Mildronate intramuscularly and intravenously

So, if you need the drug to act quickly and the effect occurs within a short period of time, then the solution is administered intravenously. This is usually necessary in acute conditions. If it is necessary to ensure a long-term effect of the drug with a not very rapid development of the clinical effect, then the solution is administered intramuscularly. This is usually justified in the treatment chronic conditions. Thus, it can be briefly summarized that intravenous injections used in acute conditions, and intramuscular - in the treatment of chronic diseases. Parabulbar injections are used only in the treatment of eye diseases.

The standard dosage of solutions for intravenous and intramuscular injections is 500 mg per day (5 ml of solution), and for parabulbar ones - 50 mg per day (0.5 ml). However, these dosages may vary depending on the severity of the person's condition and the type of disease for which the drug is used. Consider the dosage, frequency and duration of intravenous and intramuscular injections of Mildronate for various diseases and conditions.

For unstable angina or myocardial infarction Mildronate should be administered intravenously at 500-1000 mg (5-10 ml of solution) per day. This dosage can be administered at one time or divided into two. That is, if a person does not tolerate injections well, then it is better to administer the entire daily dosage of 500-1000 mg at once. If a person normally tolerates intravenous injections, then it is better to divide the daily dosage equally into 2 parts and inject a solution of 250-500 mg twice a day.

Injections are required only for one day, after which the person can be transferred to receive Mildronate in the form of tablets or syrup. However, if for some reason a person cannot take pills or syrup, or their effectiveness will be low due to diseases of the digestive tract, then the further course of treatment is continued with intramuscular injections. In this case, within 4-6 weeks, 500-1000 mg per day is already administered intramuscularly every 3 days. The daily dose can also be administered at one time or divided into two.

With chronic heart failure Mildronate is administered intravenously at 500-1000 mg (5-10 ml of solution) 1 time per day or intramuscularly at 500 mg (5 ml of solution) 2 times per day for 10-14 days. After completing the course of intravenous or intramuscular injections, they switch to taking Mildronate in the form of tablets or syrup for another 3 to 4 weeks.

In the acute period of cerebrovascular accident Mildronate is administered intravenously at 500 mg (5 ml) once a day for 10 days. After that, the person is transferred to taking the drug in the form of tablets or syrup, or on intramuscular injections. Intramuscular injections are made at 500 mg (5 ml of solution) once a day for 2 to 3 weeks.

With chronic disorders of cerebral circulation Mildronate can be taken in the form of tablets or administered intramuscularly. In such cases, the choice of method of administration of the drug (taking pills or intramuscular injections) is determined by the personal preferences of the person, as well as his objective condition and the body's ability to absorb drugs when taken orally. For example, if a person cannot swallow tablets, or they are poorly absorbed due to diseases of the digestive tract, then he should prefer intramuscular injections. If there are no obstacles to taking the pills, then it is better to choose this particular method of using the drug.

So, in case of chronic disorders of cerebral circulation, it is necessary to inject 500 mg (5 ml of solution) of Mildronate intramuscularly 1 time per day for 2 to 3 weeks. The course of therapy can be repeated 2-3 times a year.

With pain in the heart against the background of dyshormonal myocardial dystrophy Mildronate is administered intravenously at 500 - 1000 mg (5 - 10 ml of solution) 1 time per day, or intramuscularly at 500 mg (5 ml of solution) 2 times a day for 10 - 14 days. With incomplete disappearance of pain after the completion of the course of injections of Mildronate, the drug is prescribed in tablets for another 12 days.

With mental and physical overload or to speed up rehabilitation after surgery Mildronate can be administered intravenously, intramuscularly, or taken as tablets. The choice of method of administration is based on the same criteria as for chronic cerebrovascular accidents. Intravenously or intramuscularly, Mildronate is administered at 500 mg (5 ml of solution) 1-2 times a day for 10-14 days. If necessary, the course of therapy is repeated after 2 to 3 weeks.

With chronic alcoholism Mildronate is administered intravenously for severe lesions nervous system. In this case, 500 mg (5 ml of solution) is administered 2 times a day for 7 to 10 days.

With pathology of the vessels of the fundus or retinal dystrophy Mildronate is administered parabulbarno 500 mg (5 ml of solution) once a day for 10 days. In the presence of inflammatory process in the eyes, Mildronate is combined with intravenous or also parabulbar administration of corticosteroid hormones (Prednisolone, Dexamethasone, Betamethasone, etc.). And with retinal dystrophy, it is rational to combine Mildronate with the use of drugs that improve microcirculation.

special instructions

People suffering from chronic diseases of the liver and kidneys, with prolonged use of Mildronate, should periodically monitor the functioning of these organs.

In myocardial infarction, Mildronate is not a first-line drug, the use of which is mandatory for effective treatment acute condition.

The inclusion of Mildronate in the composition complex therapy patients suffering from chronic heart failure, increases their tolerance of physical and emotional stress.

In clinical studies, it was found that Mildronate reduces the concentration of atherogenic lipid fractions ("bad cholesterol") in the blood.

Since there are no scientifically confirmed data on the safety of Mildronate for children, it is recommended to refrain from using this drug in children under 12 years of age.

Influence on the ability to control mechanisms

Overdose

• decline blood pressure;
• Tachycardia (palpitations);
• General weakness.

Interaction with other drugs

Mildronate is well combined and improves the severity of the clinical effect of the following drugs:

• Antianginal agents (Sustak, Nitrong, Betalok, Kordanum, Trental, Dipyridamole, Riboxin, etc.);
• Anticoagulants (Warfarin, Thrombostop, etc.);
• Antiplatelet agents (Prostacycline, Aspirin Cardio);
• Antiarrhythmic drugs (Adenokor, Amiodarone, Bretilat, Difenin, Kordaron, Moratsizin, Propanorm, Ritalmex, Rhythmiodarone, etc.);
• Diuretic drugs (Veroshpiron, Diakarb, Furosemide, etc.);
• Bronchodilators (Ventolin, Berotek, etc.).

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

Meldonium - analogues

Synonyms of Mildronate are the following drugs:

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

• Angiosil retard tablets;
• Antisten and Antisten MB tablets;
• Biosint lyophilisate for solution for injection;
• Bravadin tablets;
• Valeocor-Q10 tablets;
• Vero-Trimetazidine tablets;
• Gistochrome solution for injections;
• Deprenorm MB tablets;
• Dibikor tablets;
• Dinaton solution for injection;
• Doppelherz Cardiovital tablets;
• Ezafosfin lyophilizate and ready solution;
• Inosie-F and Inosin-Eskom solution for injection;
• Carditrim tablets;
• Koraksan tablets;
• corona pellets;
• Kudevita capsules;
• Kudesan drops;
• Medarum 20 and Medarum MB tablets;
• Mexicor capsules and injection;
• Metaguard tablets;
• Sodium adenosine triphosphate (ATP) solution for injection;
• Neoton lyophilisate for solution for injection;
• Orocamag capsules;
• Pedea solution for injection;
• Predizin tablets;
• Preductal and Preductal MB tablets;
• precard tablets;
• Ranex tablets;
• Riboxin capsules, tablets and injection;
• Rimecor and Rimecor MV tablets;
• Taufon tablets;
• Triducard tablets;
• Trimectal capsules;
• Trimectal MB tablets;
• Trimet tablets;
• Trimetazid tablets and capsules;
• Trimetazidine and Trimetazidine MB tablets;
• Trimitard MV tablets;
• Ubinon capsules;
• Firazir solution for injection;
• Fosfaden tablets and solution for injection;
• Ethoxydol tablets.

Mildronate - reviews

Yes, in positive feedback Regarding the use of the drug in severe diseases, people indicate that they have taken or periodically take Mildronate for vegetative-vascular dystonia, hypertension, heart failure or angina pectoris. With vegetative-vascular dystonia, Mildronate for 3-5 months completely normalized the condition of a person who practically forgot about his disease for this period. When the symptoms of dystonia reappear, people take a course of Mildronate and are satisfied with the result.

With hypertension, angina pectoris and heart failure, Mildronate is taken as part of complex therapy. In the reviews, people who took Mildronate for these diseases noted that the drug relieves fatigue, eliminates shortness of breath, a feeling of weakness, hopelessness and apathy, reduces the frequency of angina attacks, increases the overall endurance of the body and the tolerance of physical and emotional stress.

People who took Mildronate for functional disorders of the cardiovascular system (for example, low blood pressure, pain in the heart due to stress or high loads, darkening before the eyes when moving from a sitting to standing position, etc.), note in the reviews, that the drug quickly and completely eliminated their problem, instead of weakness and fatigue, lightness, energy, vigor, clarity in the head and a desire to live appeared.

Many reviews note that Mildronate helped to cope with high mental and physical stress, increasing efficiency and speeding up recovery after work. Athletes note that when using Mildronate, it becomes much easier to breathe during aerobic training and endurance increases significantly.

Negative reviews about Mildronate are literally single and they are usually associated with the development of a side effect that was poorly tolerated by a person, and therefore forced to stop using the drug.

Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Mildronate in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Mildronate in the presence of existing structural analogues. Use to treat heart attacks and strokes and improve tissue metabolism in adults, children, and during pregnancy and lactation.

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

Under conditions of increased stress, Mildronate restores the balance between the delivery and demand 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 the load and quickly restore energy reserves. Due to these properties, Mildronate is used to treat various violations activity of the cardiovascular system, blood supply to the brain, as well as increasing physical and mental performance.

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

In heart failure, the drug increases myocardial contractility, increases tolerance to physical activity reduces the frequency of angina attacks.

In acute and chronic ischemic disorders of cerebral circulation, it improves blood circulation in the focus of ischemia, promotes the redistribution of blood in favor of the ischemic area.

Effective in vascular and dystrophic pathology of the fundus.

The drug eliminates functional disorders nervous system, developing against the background of long-term alcohol intake in patients with chronic alcoholism with withdrawal syndrome.

After oral administration, the drug is rapidly absorbed from the gastrointestinal tract. It is metabolized in the body with the formation of two main metabolites, which are excreted by the kidneys.

• as part of the complex therapy of IHD (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy;
• as part of the complex therapy of acute and chronic disorders of cerebral circulation (strokes and cerebrovascular insufficiency);
• reduced performance;
• physical overstrain (including athletes);
• withdrawal syndrome in chronic alcoholism (in combination with specific alcoholism therapy);
• hemophthalmos, retinal hemorrhages of various etiologies;
• thrombosis of the central retinal vein and its branches;
• retinopathy of various etiologies (diabetic, hypertensive).

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

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

Instructions for use and dosing regimen

In connection with the possibility of developing an exciting effect, the drug is recommended to be used in the morning.

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

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

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

In chronic disorders of cerebral circulation, the drug is taken orally at 0.5-1 g per day. General course of therapy weeks. Repeated courses are prescribed individually 2-3 times a year.

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

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

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

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

In case of vascular pathology and degenerative diseases of the retina, Mildronate is administered parabulbarno at 0.5 ml of injection with a concentration of 500 mg / 5 ml for 10 days.

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

In chronic alcoholism, the drug is prescribed in / in 500 mg 2 times a day. Course of treatment days.

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

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

Use during pregnancy and lactation

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

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

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

Years of experience in treatment acute infarction myocardial infarction and unstable angina in cardiology departments shows that Mildronate is not a first-line drug in acute coronary syndrome.

Pediatric use

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

Influence on the ability to drive vehicles and control mechanisms

Data on the adverse effects of Mildronate on the speed of the psychomotor reaction are not available.

At joint application Mildronate enhances the effect of antianginal drugs, some antihypertensive drugs, cardiac glycosides.

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

When combined with Mildronate nitroglycerin, nifedipine, alpha-blockers, antihypertensives and peripheral vasodilators, moderate tachycardia may develop, arterial hypotension(Caution should be exercised when using this combination).

Analogues of the drug Mildronate

Structural analogues for the active substance:

• 3-(2,2,2-Trimethylhydrazinium) propionate dihydrate;
• Vazomag;
• Idrinol;
• Cardionate;
• Meditern;
• Meldonium;
• Meldonium-Eskom;
• Meldonium dihydrate;
• Melfor;
• Midolat;
• Trimethylhydrazinium propionate dihydrate.

News edited by: admin017, 00:15

Mildronate injections

Mildronate is a drug with metabolic activity, which improves the energy supply of cells and tissues. The positive effect of this remedy on metabolism and the elimination of energy deficiency made it possible to use Mildronate in many chronic diseases of the cardiovascular, respiratory, and nervous systems. It is also prescribed for the treatment of certain ophthalmic 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 the symptoms, the patient's condition, or his personal preferences. Usually, doctors prescribe Mildronate injections in cases where you need to quickly achieve a therapeutic effect or if the patient cannot take the pills. Usually, in the future, the course of administration can be continued, switching from the injectable to the oral form of the drug.

Description of the active ingredient

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 that are under hypoxic conditions.

The drug protects cells from the aggressive effects of catabolism products and toxins, accelerating the elimination of these agents from the body. With ischemia of tissues and organs (for example, myocardium, brain, retina of the organ of vision), meldonium changes the ratio of blood flow 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 to slow down the formation of necrotic damage and shortens the rehabilitation period. With angina pectoris, the drug reduces the number of attacks of anginal pain, increases cardiac output. Thanks to him, the stimulation of neurons increases, the activation of the motor sphere and physical endurance occurs. It also has an anti-stress effect.

Meldonium improves the course of the rehabilitation period in patients who have undergone vascular, inflammatory diseases brain or have had CNS injury. It reduces movement disorders (paresis), improves coordination, reduces the severity of vegetative manifestations. The use of the drug improves the condition of patients with alcohol addiction, reduces manifestations of an abstinence syndrome.

Pharmacokinetics

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

Attention! The drug penetrates partially through the hematoplacental barrier, and its entry into breast milk was also detected.

Metabolism of Mildronate occurs in the liver

The drug and its metabolites are excreted mainly 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: 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;
• recovery postoperative period;
• bronchial asthma and chronic obstructive pulmonary disease as a component complex treatment;
• eye diseases various genesis: hemorrhage in the retina and vitreous body eyes, 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! In diseases of the organ of vision, the use of injections of the drug Mildronate is indicated only parabulbarno.

In cardiovascular pathology, Mildronate injections are part of the complex therapy of these diseases and cannot replace permanent treatment basic preparations

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 sports.

How to take the drug?

Mildronate solution has a concentration of 10% meldonium. It is produced in ampoules of 5 ml. Accordingly, in 1 ml of solution - 100 mg of meldonium, and in one ampoule - 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 (approx. eyeball).

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

The drug in the form of a solution can not be diluted before administration

Mildronate solution is produced in 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, in saline. If Mildronate is still diluted, then the absolute amount of the active substance will not change, only its concentration will decrease, which may affect the speed of the onset of the drug.

In cases where rapid action is not required, Mildronate can be diluted. Only for this purpose it is better to use a 0.9% sodium chloride solution (saline solution). Mixing with other solvents may affect the properties of the drug, which is highly 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 is possible. The daily dose can be taken as a single injection or divided into two doses.

Dosage for different pathologies

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

• Not stable angina and myocardial infarction. In such cases, intravenous administration of the drug is indicated, since these conditions are acute and require immediate intervention. Enter 5-10 ml of Mildronat intravenously. In case of poor tolerability of injections, the entire dose is administered once; in other cases, it is shown to divide it into two injections. The duration of parenteral administration of drugs is from 1 to 10 days. Later on you can switch to oral forms Mildronate and take it in a general course lasting up to 4-6 weeks.
• Chronic circulatory failure. It is used 5-10 ml intravenously once a day or 5 ml twice a day intramuscularly. The course lasts up to 2 weeks with the transition to syrup or tablets.
• Ophthalmic pathology. In this case, Mildronate is applied parabulbarno at 0.5 ml per day (50 mg of meldonium) for 10 days.
• Stroke of the brain in the acute phase. To achieve a quick effect from the use of the drug, it is administered intravenously at 5 ml per day for 10 days. You can also inject it intramuscularly at 500 mg once a day for 2-3 weeks.
• Chronic cerebrovascular insufficiency. With this pathology, the drug is administered either intramuscularly or in tablet form. Enter 5 ml of the solution / m 1 time for 14 days. Reception is extended if necessary up to 4 weeks.
• Dishormonal 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 with continued oral administration, it is recommended to take Mildronate for another 2 weeks.
• Chronic alcoholism. Patients receive Mildronate intravenously in a jet of 5 ml 2 times a day for the relief of neurological symptoms. Continue therapy for up to one week.
• Fatigue during periods of high physical and mental stress. There is no urgent need for parenteral administration of Mildronate for such indications, but it all depends on which method is more acceptable for the patient and how fast 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 dosing 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 accident, there are swallowing disorders or digestive problems, the parenteral route of administration of Mildronate should be chosen.

Interaction

Mildronate interacting with others medicines, can cause both desirable and dangerous reactions of 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 action of beta-blockers and cardiac glycosides. With extreme caution, you should combine the reception of Mildronate with such drugs:

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

The combined use of these drugs 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 such cases:

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

Side effects and overdose of the drug

Typically, patients have high degree tolerability of the drug, but sometimes there are cases adverse reactions on Mildronate:

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

special instructions

In patients who have serious kidney and liver diseases with insufficiency of the functions of these organs, blood biochemical parameters should be monitored. If it is necessary to take meldonium for a long time, a 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 work with mechanisms, since the drug does not cause a slowdown in reactions. Elderly patients should reduce the therapeutically effective daily dose.

Application in sports

Due to the ability of Mildronate to increase the uptake of oxygen by tissues, it can be recommended to increase exercise tolerance. It improves the nutrition of the myocardium and peripheral muscles. This helps to reduce fatigue and speed up recovery after workouts.

Until recently, meldonium was not considered doping, and 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. The refrigerator is also not suitable for this purpose. After 20 minutes or more after a leak, the ampoule should be discarded.

Reviews about Mildronate

Patient reviews about this drug are mostly positive. The opinions of doctors about Mildronate are somewhat different.

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

Since the evidence base for the drug Mildronate is almost absent, its effect is equated to the placebo effect.

I took Mildronate to improve performance during exams at the institute. I can only say good things: the drug greatly helps to overcome fatigue and improve the memorization of the material. I could not sleep for a long time, while feeling relatively cheerful. In its action, it resembles an energy drink, only without side effects.

Valentina, 58 years old

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

Irina, 42 years old, cardiologist

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

I was prescribed droppers of mildronate along with panangin, but after two droppers I started to have a nightmare, the pressure rose and fell sharply and diarrhea appeared, who will tell me whether to continue with droppers or not.

Mildronate

The description is current as of 09.03.2016

• Latin name: Mildronate
• ATH code: C01EB
• Active ingredient: Meldonium (Meldonium)
• Producer: JSC "Grindeks", Latvia

Composition

The composition of one hard gelatin capsule of Mildronate includes 250 or 500 mg of Meldonium in the form of a dihydrate as an active ingredient and excipients: Amylum solani (potato starch), Silicii dioxydum colloidal (colloidal silicon dioxide), Calcium stearate (calcium stearate).

For the manufacture of the gelatin shell, Gelatinum (gelatin) and Titanium dioxyde (titanium dioxide) are used.

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

One tablet of Mildronate 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 of:

• clear colorless solution for injection;
• hard gelatin capsules No. 1 and No. 2 filled with hygroscopic white crystalline powder. The powder contained in the capsules has a slightly pronounced characteristic odor and a sweetish taste (the capsule itself has a neutral taste);
• tablets Mildronate Gx 500 mg (the taste of the tablet is slightly sour).

The solution goes on sale in 5 ml ampoules (500 mg/5 ml). One carton contains: 2 blister packs with 5 ampoules of Mildronate each and instructions for using the drug.

Capsules are packed in blisters of 10 pieces each. One cardboard pack contains 4 blisters and instructions for the use of the drug.

pharmachologic effect

Meldonium is a synthetic drug that has a similar effect with γ-butyrobetaine (GBB; a substance that is a precursor of hydroxytrimethylaminobutyric acid, a natural vitamin-like substance related to B vitamins).

According to Wikipedia, meldonium is characterized by the ability to improve the metabolism and energy supply of cells and is used as:

The mechanism of action of Meldonium determines a wide range of its pharmacotherapeutic properties. Taking this drug helps to increase efficiency, reduces the severity of manifestations of mental, intellectual and physical overstrain, 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 exertion.

In acute myocardial injuries, the use of Meldonium slows down the formation of necrotic zones, shortens the rehabilitation period, normalizes blood circulation in the focus of ischemic damage and redistributes blood in favor of the ischemic area.

Under conditions of increased stress, meldonium helps to restore the balance between the transport of oxygen into cells and the need for cells in it, prevents the accumulation of cellular metabolic products and toxic substances in cells, protects cells and cellular structures from damage, ensures that the body quickly compensates for its energy reserves and maintains the highest speed metabolic processes.

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

In addition, the substance has a beneficial effect on the state of dystrophically altered retinal vessels, which makes it possible to use it for the treatment of vascular and dystrophic pathologies of the fundus.

Pharmacodynamics and pharmacokinetics

The action of the active substance of the drug is aimed at inhibiting the enzymatic activity of γ-butyrobetaine hydroxylase, which is the last enzyme in the chain reaction of L-Carnitine synthesis.

Meldonium helps to reduce the concentration of free carnitine, prevents the transport of long chain fatty acids through cell membranes, and prevents the accumulation in cells of activated forms of unoxidized fatty acids, which are derivatives of acylcarnitine and acylcoenzyme.

In ischemic tissues, it restores the balance between oxygen transport and its absorption by cells, prevents the disruption of adenosine triphosphate transport, simultaneously activating glycolysis, which occurs without additional oxygen consumption.

The result of a decrease in the concentration of carnitine is an enhanced synthesis of the vasodilator γ-butyrobetaine.

After taking per os tablets Mildronate, the meldonium contained in it is rapidly absorbed in the digestive tract. The drug is characterized by a fairly high bioavailability. The latter is approximately 78%.

The concentration of Meldonium in the blood plasma reaches its maximum values ​​in an hour or two after administration. In the body, meldonium is metabolized to non-toxic products - glucose, succinate, 3-hydroxypropionic acid.

Excretion of metabolites is carried out by the kidneys. The half-life (T½), depending on the characteristics of a particular organism and the dose taken, can be 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 the administration of the drug. The half-life (T½), depending on the characteristics of a particular organism and the dose taken, can be from three to six hours.

The result of the metabolization of Meldonium 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: from what tablets Mildronate, from what medicine in the form of injections

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

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

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

Additional indications for the use of injections of the drug:

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

The 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 at the same time 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 shown as a prophylactic that prevents overwork (including the heart muscle) and overtraining.

In addition, by facilitating faster removal of decay products from cells and accelerating the recovery of cell energy resources, Mildronate improves metabolism at the cellular level and accelerates the recovery of athletes' muscles after physical exertion. Moreover, the latter applies to both power 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 does not allow fatty acids to penetrate into the cell and thus prevents the accumulation of fats in the liver. In addition, by burning mainly sugars, the body spends more of the feedstock, which is precisely fats, for each molecule of adenosine triphosphate produced (that is, for energy production).

Meldonium did not belong to the class of doping 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) in early 2016, a number of athletes, mainly from Russia and the countries of the former CIS, were convicted of using this drug. Mildronate also became the subject of a huge scandal when Maria Sharapova admitted to using this doping on March 7, 2016.

Mildronate: contraindications for use

Contraindications to the appointment of Mildronate (for all forms of release 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 impaired venous outflow.

Side effects

Side effects caused by taking Mildronate occur quite often. As a rule, they are expressed as:

• allergic reactions (redness, skin rashes, itching and swelling);
• dyspeptic symptoms, manifested by belching, bouts 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 Mildronate

Often you can meet the questions “Is it possible to administer Mildronate intramuscularly?” or “Can I inject the drug intramuscularly?”.

In the instructions for medical use it is indicated that the drug in injectable 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 as a whole, without chewing, crushing or spilling the contents of the capsules.

Mildronate in / in the introduction is produced in finished form. Mildronate intravenously should be administered separately from other medicines, dilution aqueous solution sodium chloride is not required (however, in some cases it is allowed).

When injected into a muscle, the injection solution has an irritating effect and can provoke local pain and allergic reactions of a local nature. For this reason, the drug Mildronate is usually injected into a vein.

Mildronate injections: instructions for use, what is prescribed and how the injection solution is dosed

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

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

For patients with vascular pathologies of the fundus, the drug is administered retrobulbar (behind the eyeball) or subconjunctival (under the outer shell of the eyeball) 0.5 ml for 10 days.

For patients with cerebral circulatory disorders in the acute stage, the solution is 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.

Patients with circulatory disorders of the brain in a chronic form are shown 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 pomg 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.

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

Patients with cerebral circulatory disorders after the elimination of acute disorders are shown to use the drug at a dose equal to mg per day. Take it at one time or divided into two doses.

Patients with cerebrovascular accidents in a chronic form are recommended to take Mildronate 500 mg per day.

The duration of the course of treatment varies from 4 to 6 weeks. By decision of the attending physician, the patient may be assigned to repeat 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) mg, which should be divided into two doses.

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

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

With alcohol withdrawal in patients suffering from chronic alcoholism, Mildronate should be taken four times a day, 500 mg. Course duration - from 7 to 10 days.

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

Overdose

Cases of overdose have not been recorded. The drug Mildronate is characterized as low toxicity and does not provoke side effects that could threaten the patient's health.

Interaction

It is allowed to combine Mildronate with antianginal, antiarrhythmic, anticoagulant, antiplatelet and diuretic drugs, cardiac glycosides, bronchodilators, etc. drugs.

Mildronate has the ability to potentiate the action of Nitroglycerin, β-adrenergic blockers; nifedepine and other drugs with coronary action; antihypertensive drugs, as well as drugs whose action is aimed at expanding peripheral vessels.

Due to the possible development of moderately severe 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- not higher than 25°C.

Best before date

special instructions

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

Data on the ability of Mildronate to change the reaction rate and influence the management of transport are not available.

The drug is prescribed with caution to people with pathologies of the liver and / or kidneys.

Experience in the treatment of 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 analogues of the drug starts from 170 Russian rubles.

Riboxin or Mildronate - which is better?

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

Being a precursor of adenosine triphosphate, it improves the energy balance of the heart muscle, improves coronary circulation, reduces the severity of the effects 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 the metabolic processes in the heart muscle, increases the strength of its contractions and stimulates its more complete relaxation in diastole, which in turn leads to an increase in SVK (stroke volume).

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

The conclusion is as follows: 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 effects.

To obtain the expected effect from the use of Riboxin, it should be administered in amounts 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 itself consumed in metabolic reactions, its action persists for a longer period of time, and its body needs much less than Riboxin.

Therefore, the use of Mildronate improves the use of Riboxin by the body. Thus, the combined use of these drugs will potentiate the action of each other.

Cardionate or Mildronate - which is better?

Cardionate and Mildronate are synonymous drugs. They are based on the same active substance, so both drugs have a similar mechanism of action.

Their only difference is that, unlike Mildronate, Cardionat is available only in the form of 250 mg capsules and a 500 mg / 5 ml injection solution.

Appointment of Mildronate to children

Since there are currently no sufficient 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 in 12 hours, therefore, after this time, the risk of interaction of the drug with another active substance extremely low or non-existent.

In general, drinking alcohol during treatment with Mildronate is not prohibited; however, if this drug is used for the treatment of cardiovascular disease or in violation of the blood circulation of the brain, the patient is still advised to stop drinking alcohol.

This is due to the fact that taking the drug in combination with alcohol, you can cross out all positive results achieved in the treatment of the disease.

Taking Mildronate with alcohol can provoke:

The poor compatibility of Mildronate with alcohol is due to an increased risk of various complications and the likelihood of a relapse of the disease. For this reason, alcohol should be excluded for the entire period of drug treatment.

The 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 the development of the fetus, the drug is not prescribed during pregnancy.

It has not been established whether meldonium can be excreted into 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 a drug with metabolic activity, which improves the energy supply of cells and tissues. The positive effect of this remedy on metabolism and the elimination of energy deficiency made it possible to use Mildronate in many chronic diseases of the cardiovascular, respiratory, and nervous systems. It is also prescribed for the treatment of certain ophthalmic 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 the symptoms, the patient's condition, or his personal preferences. Usually, doctors prescribe Mildronate injections in cases where you need to quickly achieve a therapeutic effect or if the patient cannot take the pills. Usually, in the future, the course of administration can be continued, switching from the injectable to the oral form of the drug.

Description of the active ingredient

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 that are under hypoxic conditions.

Attention! With an increase in physical activity, Mildronate helps to maintain a balance between the need for oxygen in tissues and cells of the body with its direct delivery.

The drug protects cells from the aggressive effects of catabolism products and toxins, accelerating the elimination of these agents from the body. With ischemia of tissues and organs (for example, myocardium, brain, retina of the organ of vision), meldonium changes the ratio of blood flow 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 to slow down the formation of necrotic damage and shortens the rehabilitation period. With angina pectoris, the drug reduces the number of attacks of anginal pain, increases cardiac output. Thanks to him, the stimulation of neurons increases, the activation of the motor sphere and physical endurance occurs. 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 CNS injuries. It reduces movement disorders (paresis), improves coordination, reduces the severity of vegetative manifestations. The use of the drug improves the condition of patients with alcohol dependence, reduces the manifestations of the withdrawal syndrome.

Pharmacokinetics

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

Attention! The drug penetrates partially through the hematoplacental barrier, and its entry into breast milk was also detected.

Metabolism of Mildronate occurs in the liver

The drug and its metabolites are excreted mainly 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 such pathological conditions:

• cardiovascular pathology: chronic ischemic heart disease, angina pectoris, myocardial infarction, chronic heart failure;
• vegetative-vascular dystonia;
• chronic circulatory disorders in the brain;
• cerebral stroke;
• pathology of peripheral arterial vessels;
• recovery postoperative 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! In diseases of the organ of vision, the use of injections of the drug Mildronate is indicated only parabulbarno.

In cardiovascular pathology, Mildronate injections are part of the complex therapy of these diseases and cannot replace permanent 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 sports.

How to take the drug?

Mildronate solution has a concentration of 10% meldonium. It is produced in ampoules of 5 ml. Accordingly, in 1 ml of solution - 100 mg of meldonium, and in one ampoule - 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;
• parabulbarno (near the eyeball).

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

The drug in the form of a solution can not be diluted before administration

Mildronate solution is produced in 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, in saline. If Mildronate is still diluted, then the absolute amount of the active substance will not change, only its concentration will decrease, which may affect the speed of the onset of the drug.

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

Mildronate is administered intramuscularly when there are 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 is possible. The daily dose can be taken as a single injection or divided into two doses.

Dosage for different pathologies

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

• Unstable angina and myocardial infarction. In such cases, intravenous administration of the drug is indicated, since these conditions are acute and require immediate intervention. Enter 5-10 ml of Mildronat intravenously. In case of poor tolerability of injections, the entire dose is administered once; in other cases, it is shown to divide it into two injections. The duration of parenteral administration of drugs is 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. It is used 5-10 ml intravenously once a day or 5 ml twice a day intramuscularly. The course lasts up to 2 weeks with the transition to syrup or tablets.
• Ophthalmic pathology. In this case, Mildronate is applied parabulbarno at 0.5 ml per day (50 mg of meldonium) for 10 days.
• Stroke of the brain in the acute phase. To achieve a quick effect from the use of the drug, it is administered intravenously at 5 ml per day for 10 days. You can also inject it intramuscularly at 500 mg once a day for 2-3 weeks.
• Chronic cerebrovascular insufficiency. With this pathology, the drug is administered either intramuscularly or in tablet form. Enter 5 ml of the solution / m 1 time for 14 days. Reception is extended if necessary up to 4 weeks.
• Dishormonal 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 with continued oral administration, it is recommended to take Mildronate for another 2 weeks.
• Chronic alcoholism. Patients receive Mildronate intravenously in a jet of 5 ml 2 times a day for the relief of 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 for the patient and how fast 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 dosing 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 accident, there are swallowing disorders or digestive problems, the parenteral route of administration of Mildronate should be chosen.

Interaction

Mildronate, interacting with other drugs, can cause both desirable and dangerous reactions of 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 action of beta-blockers and cardiac glycosides. With extreme caution, you should combine the reception of Mildronate with such drugs:

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

The combined use of these drugs 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 such cases:

• pregnancy;
• lactation period;
• children's age up to 12 years;
• 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 childbearing or lactation. However, in practice, it can be used during pregnancy with impaired feto-placental blood flow.

Side effects and overdose of the drug

Usually among patients there is 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 a rash, urticaria, rarely - angioedema angioedema;
• dyspepsia;
• fluctuations in blood pressure;
• increased heart rate;
• insomnia and psychomotor agitation;
• weakness;
• change in the blood formula (increased levels of eosinophils).

There have been no recorded cases of overdose with Mildronate. With a strong excess of the recommended doses, it is possible a sharp decline blood pressure, weakness, dizziness, headache. Therapy for signs of overdose is exclusively symptomatic.

special instructions

In patients who have serious kidney and liver diseases with insufficiency of the functions of these organs, blood biochemical parameters should be monitored. If it is necessary to take meldonium for a long time, a 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 work with mechanisms, since the drug does not cause a slowdown in reactions. Elderly patients should reduce the therapeutically effective daily dose.

Application in sports

Due to the ability of Mildronate to increase the uptake of oxygen by tissues, it can be recommended to increase exercise tolerance. It improves the nutrition of the myocardium and peripheral muscles. This helps to reduce fatigue and speed up recovery after workouts.

Until recently, meldonium was not considered doping, and 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. The refrigerator is also not suitable for this purpose. After 20 minutes or more after a leak, the ampoule should be discarded.

Trade name of the drug

International non-proprietary name

chemical name
3-(2,2,2-trimethylhydrazinium)propionate dihydrate.

Dosage form

Composition

Description
Transparent colorless liquid.

Pharmacotherapeutic group

ATC code: C01EB.

Pharmacological properties

Indications for use

Contraindications

Carefully
With diseases of the liver and / or kidneys.

Use during pregnancy and during breastfeeding

Dosage and administration

Mildronate is a drug that improves the metabolism and energy supply of tissues.

Release form and composition

Mildronate is produced in the following dosage forms:

• Capsules: white, hard gelatin, size No. 1 (250 mg each) or No. 00 (500 mg each); the contents of the capsules are a hygroscopic crystalline white powder with a slight odor (in blisters of 10 pcs., 2, 4 or 6 blisters in a cardboard box);
• Solution for injection: colorless, transparent (in ampoules of 5 ml, 5 ampoules in blister packs, 2 packs in a carton box).

The composition of 1 capsule includes:

• Active substance: meldonium dihydrate - 250 or 500 mg;
• Auxiliary components: potato starch - 13.6 / 27.2 mg; colloidal silicon dioxide - 5.4 / 10.8 mg; calcium stearate - 2.7 / 5.4 mg.

The composition of the capsule shell: E171 (titanium dioxide) - 2%; gelatin - up to 100%.

The composition of 1 ml of solution includes:

• Active substance: meldonium - 100 mg (as trimethylhydrazinium propionate);
• Auxiliary component: water for injections.

Indications for use

• Reduced performance, physical overstrain (including athletes);
• Withdrawal syndrome in chronic alcoholism (simultaneously with specific therapy for alcoholism);
• Ischemic heart disease (myocardial infarction, angina pectoris), chronic heart failure (as part of complex treatment);
• Sharp and chronic disorders cerebral circulation, including strokes and cerebrovascular insufficiency (as part of complex treatment).

Additionally for Mildronate in the form of a solution for injection:

• Thrombosis of the central retinal vein and its branches;
• Hemophthalmos, retinal hemorrhages of various etiologies;
• Retinopathy of various etiologies (hypertensive, diabetic).

Contraindications

• Increased intracranial pressure (including with intracranial tumors, impaired venous outflow);
• Hypersensitivity to the components of the drug.

It is not recommended to prescribe the drug to children under 18 years of age, as well as to lactating and pregnant women due to the lack of clinical data confirming the safety and efficacy of Mildronate in these groups of patients.

Mildronate should be used with caution in patients with kidney and / or liver disease (especially for a long time).

Method of application and dosage

Due to the possible development of an exciting effect, Mildronate is recommended to be used in the first half of the day, when taken several times a day - no later than 17.00.

Inside Mildronate in the form of capsules is usually prescribed as follows:

• Ischemic heart disease (myocardial infarction, angina pectoris), chronic heart failure: daily dose- 500-1000 mg; frequency of reception - 1-2 times a day. The duration of the therapeutic course is 1-1.5 months (simultaneously with other drugs);
• Dishormonal cardiomyopathy: daily dose - 500 mg. The duration of the therapeutic course is 12 days (simultaneously with other drugs);
• Subacute disorders of cerebral circulation (cerebrovascular insufficiency and stroke): daily dose - 500-1000 mg; frequency of reception - 1-2 times a day. The duration of the therapeutic course is 1-1.5 months (the drug is taken orally simultaneously with other drugs after the end of the course injection therapy Mildronate);
• Chronic disorders of cerebral circulation: daily dose - 500 mg. The duration of the therapeutic course is 1-1.5 months (simultaneously with other drugs). It is possible to conduct repeated courses (usually 2-3 times a year) after a medical consultation;
• Reduced performance, mental and physical overstrain (including athletes): daily dose - 1000 mg; frequency of reception - 2 times a day. The duration of the therapeutic course is 10-14 days. After 2-3 weeks, a second course is possible;
• Withdrawal syndrome in chronic alcoholism: daily dose - 2000 mg; multiplicity of reception - 4 times a day. The duration of the therapeutic course is 7-10 days (simultaneously with the specific treatment of alcoholism).

Mildronate in the form of a solution for injection is administered intravenously and parabulbarno.

As a rule, intravenous drug is prescribed:

• Cardiovascular diseases: daily dose - 500-1000 mg (5-10 ml of injection solution, concentration - 500 mg / 5 ml); frequency of use 1-2 times a day. The duration of the treatment course is 1-1.5 months (simultaneously with other drugs);
• Violations of cerebral circulation (acute phase): daily dose - 500 mg; frequency of use - 1 time per day. The solution is administered for 10 days, after which they switch to taking Mildronate inside (500-1000 mg per day). The total duration of the treatment course is 1-1.5 months;
• Physical and mental stress: daily dose - 500 mg; frequency of use - 1 time per day. The duration of the treatment course is 10-14 days. After 2-3 weeks, a second course is possible;
• Chronic alcoholism: daily dose - 1000 mg; frequency of use - 2 times a day. The duration of the treatment course is 10-14 days.

In case of vascular pathologies and degenerative diseases of the retina, Mildronate should be administered parabulbarno at a dose of 0.5 ml of an injection with a concentration of 500 mg / 5 ml for 10 days.

Side effects

In rare cases, when using Mildronate in all dosage forms, such side effects like: allergic reactions (itching, redness and skin, urticaria, skin rash, angioedema), dyspeptic symptoms, tachycardia, increase or decrease in blood pressure, irritability.

In very rare cases, eosinophilia and general weakness may develop.

special instructions

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

drug interaction

With the simultaneous use of Mildronate with certain drugs, the following undesirable effects may occur:

• Coronary dilating agents, some antihypertensive drugs, cardiac glycosides: enhancing their action;
• Nitroglycerin, nifedipine, alpha-blockers, antihypertensive drugs and peripheral vasodilators: the development of arterial hypotension, moderate tachycardia (when using such combinations, care must be taken).

Mildronate can be administered simultaneously with prolonged forms of nitrates, other antianginal drugs, antiplatelet agents and anticoagulants, antiarrhythmic, bronchodilator and diuretic drugs.

Terms and conditions of storage

Store in a dry place out of the reach of children at temperatures up to 25 ° C (do not freeze the injection solution).

Shelf life - 4 years.

Found a mistake in the text? Select it and press Ctrl + Enter.