"Trimectal", the basic basis of which is the active substance trimetazidine, belongs to the group of drugs with an antihypoxic nature of action and is used mainly in cardiology to stabilize the cardiovascular system. The drug, as a rule, is prescribed as a maintenance / corrective agent in complex therapy and, by stimulating the process of cellular metabolism, contributes to the overall improvement of the patient's condition.
Form and composition
There are several forms of production of the drug "Trimectal". The instructions for use indicate that these can be either hard gelatin capsules (blisters of 10/20 units or polymer cans with a capacity of 60 units), and tablets with a film shell that slows down the release of reagents (blisters of 10/20/30 pcs. or plastic packages for 60/100/120 pcs.). The main component in both cases is trimetazidine dihydrochloride. However, the form of the drug, which is characterized by a reduced rate of absorption and metabolism, has a different trade name - "TrimectalMV.”
Pharmacological action
Being an antihypoxic drug, "Trimectal" (instructions for use in this regard gives a clear classification of the drug and at the same time emphasizes the importance of its antioxidant properties) has a direct "invigorating" effect on cardiomyocytes and brain neurons. Thus, the drug increases the coefficient of their functionality. Achieving a cytoprotective effect is a natural result of an increase in the energy potential of cells against the background of a complete optimization of the oxygen consumption regime.
The active substance does not allow asynchronous myocardial contraction by "preserving" the required minimum of phosphocreatine. In violation of the acid-base balance, "Trimectal" controls the concentration of calcium and sodium, that is, it prevents the excessive accumulation of derivatives of these elements in cardiomyocytes and along the way normalizes the balance of potassium ions in the cells. In the fight against angina pectoris, the drug manifests itself as a neutralizer of the root cause: a decrease in nitrate intake leads to the fact that after 14 days of therapy, patients experience progress in exercise tolerance (the magnitude of blood pressure drops markedly decreases).
Absorption and metabolism
The instructions for use describe the pharmacological kinetics of the drug "Trimectal", taking into account the form of its release. So, in particular, the contents of the capsules, getting inside the body, are absorbed very quickly (and almost in full) in the segment of the gastrointestinal tract. Two hours after takingthe maximum concentration of reagents in the blood plasma is noted. A single dose of 20mg sets this at 55ng/mL.
As for the degree of distribution of active components, the binding to plasma proteins, as a rule, does not exceed 16%. At the same time, histohematic barriers are overcome by trimetazidine quite easily. About 60% of the dose taken is excreted unchanged in the urine, with the first 50% within 4-5 hours.
In turn, "Trimectal MV" (tablet form of production), due to the presence of a special shell, provides the maximum concentration of reagents in the blood plasma after three hours. The elimination half-life, depending on the age of the patients, can vary from 7 to 12 hours.
Indications for prescription
Cases of prescription medication "Trimectal" instructions for use defines the following:
- prevention of angina pectoris (as part of complex therapeutic measures);
- disturbances in the work of chorioretinal vessels;
- dizziness caused by functional imbalances of the cardiovascular system;
- hearing impairment (the result of ischemic processes in the vestibular apparatus).
In addition, the attending physician may decide on the advisability of prolonged use of the medication in the elimination of focal erosions of the retina.
Use and recommended dosage
The drug is taken orally, directly with meals. The duration of the course is set by the doctor (based on the results of a detailed medical examination and diagnosis).
For the capsule form, the average rate is 40-60 mg / day (you need to use it 2-3 times).
In the case of the drug "Trimectal MB" (instructions for use in this respect are somewhat different from the above recommendation), it is usually prescribed one tablet in the morning and evening.
Side effects
Along with the healing effect, side effects of the active ingredients are sometimes manifested. Regarding probable allergic reactions to the use of Trimectal capsules, the instructions for use, the price of which is the he alth of the patient, reads:
- Some patients may experience local skin irritation;
- with prolonged use of the drug, disorders of the food system (nausea, vomiting) are extremely rare;
- sometimes the negative effects of regular use are expressed in headaches and migraines;
- blood lines and the heart muscle are sometimes subjected to excessive stress, indicating the need to reduce the dosage.
Regarding the drug "Trimectal MV" instructions for use says:
- development of orthostatic hypotension and the formation of "blush" on the face is unlikely (less than one conditional patient per thousand people);
- imbalance in workdigestive tract (pain in the abdomen, diarrhea, vomiting, etc.) - quite often (more than one individual case per hundred doses of the drug).
In addition, scenarios are not ruled out when the use of tablets with modified release of reagents can be the root cause of reversible asthenia, tremor, akinesia and urticaria.
Contraindications for prescribing
We are considering the antihypoxic drug "Trimectal". Instructions for use, the price of the drug, the names of substitute drugs, as well as various opinions of specialists are presented in this review in order to familiarize the interested audience. This drug has a number of contraindications that are equally relevant for all forms of release (capsules / tablets).
Medicine is not prescribed if:
- diagnosed with renal failure (assuming CC<15 ml/min);
- patient has symptoms of liver dysfunction;
- the patient has not reached the age of eighteen;
- Severe allergic reactions to drug components are traced.
Other contraindications include pregnancy and lactation.
Special instructions and drug interaction mechanism
"Trimectal", the price of which varies widely (depending on the form of release and the country of manufacture - 300-1100 rubles), has not been subjected to any serious clinical studies for interaction with other medicines. By thisTherefore, it is possible to talk about the mechanism of a complex combination of effects only on the basis of the conclusions obtained as a result of laboratory work with trimetazidine, the main component of the described drug. It is noted that trimetazidine plays the role of an enhancer of anti-ischemic activity, which is a consequence of taking other antianginal drugs. Contacts of a different type with the participation of Trimectal reagents were not observed.
Special instructions for prescribing the drug:
- cannot be used in the first days of hospitalization of a patient who has been diagnosed with unstable angina (or has a pre-infarction condition);
- The relationship between taking Trimectal capsules (tablets) and the course of Parkinson's disease, which is expressed in an increase / decrease in tremor, necessitates additional monitoring of the patient's condition (we are talking about periodic examinations by a neurologist);
- for patients over 75 years of age, the therapeutic course is fraught with complications in the work of the kidneys, so the final decision is up to the doctor;
- disturbance of psychomotor reactions provoked by trimetazidine is a reason to think about the advisability of using the drug in cases where the patient is outside the hospital, and his professional activity is associated with the threat of industrial injuries.
Overview of analogues
The most common substitutes for the drug "Trimectal" (analogues, the active substance of which is also trimetazidine):
- Trimetazidin-Biocom MV, Russia;
- Trimetazid, Poland;
- Trimet, India;
- Antisten, Russia;
- Medarum 20, Russia;
- Preductal MV, France;
- Rimecore MV, Ukraine.
Despite the general chemical formula, the effect of generics on the body may be slightly different than the original. Therefore, the choice of a specific drug is the prerogative of the doctor.
Trimectal medicine: opinions and comments
He alth problems related to the issue of arterial arrhythmias are often targeted by thematic discussions. Those who want to hear the opinions of patients and people with medical education regarding the drug "Trimectal" (reviews, as a rule, have a positive emotional connotation) have no difficulty in finding information. However, even a superficial analysis of opinions shows that the specificity of the appointment affects the objectivity of points of view. After all, the mentioned medicine in the vast majority of cases is prescribed “in combination”, that is, together with other medicines.
For example, a very large group of patients, and part-time patients who have undergone a therapeutic course on the basis of "Trimectal", agree in their evaluation conclusions that significant changes in curbing such ailments as chronic hypertension and coronary artery disease heart, the drug did not provide.
