Trimetazidine dihydrochloride 35 mg. Excipients: mannitol - 13.5 mg, microcrystalline cellulose - 21 mg, mountain glycolic wax (montan wax) - 39 mg, methyl methacrylate copolymer, trimethylammonioethyl methacrylate chloride and ethyl acrylate [1: 2: 0.1] (Eudragit RS PO) - 40 mg, magnesium magnesium - 1.5 mg. Shell composition: 8 mg (FD & C aluminum lacquer blue No2 - 0.07%, FD & C aluminum lacquer No6 yellow - 0.77%, macrogol (polyethylene glycol) - 20.2%, polyvinyl alcohol - 40%, aluminum lacquer Ponso 4R - 0.24%, talc - 14.8 %, titanium dioxide - 23.92%).
It has an antihypoxic effect. Normalizes the energy metabolism of cells subjected to hypoxia or ischemia. Directly affecting the cardiomyocytes and neurons of the brain, optimizes their metabolism and function. The cytoprotective effect is due to increased energy potential, activation of oxidative decarboxylation and rationalization of oxygen consumption (increased aerobic glycolysis and slowed oxidation of fatty acids due to the selective inhibition of long-chain 3-ketoacyl-CoA-thiolase). Trimetazidine maintains myocardial contractility, prevents a decrease in the intracellular content of adenosine triphosphate (ATP) and creatine phosphate. Under conditions of acidosis, it normalizes the functioning of the ion channels of the membranes, prevents the accumulation of calcium and sodium ions in cardiomyocytes, and normalizes the intracellular concentration of potassium ions. Reduces intracellular acidosis and elevated phosphate levels due to myocardial ischemia and reperfusion. Interferes with the damaging effects of free radicals, preserves the integrity of cell membranes, prevents activation of neutrophils in the ischemic zone, increases the duration of electrical potential, reduces the release of creatine phosphokinase from cells and the severity of ischemic myocardial damage. When angina reduces the frequency of attacks, reduces the need for taking nitrates, after 2 weeks of treatment increases exercise tolerance, reduced sharp fluctuations in blood pressure. Reduces dizziness and tinnitus of ischemic etiology. When vascular pathology of the eye restores the functional activity of the retina.
After ingestion, trimetazidine is rapidly and almost completely absorbed in the gastrointestinal tract. Eating does not affect the pharmacokinetic properties of the drug. Bioavailability - 90%. The time to reach the maximum plasma concentration is 3-5 hours. During the day, the concentration in the blood plasma remains at a level exceeding 75% of the concentration determined 11 hours after taking one tablet of the drug. Equilibrium plasma concentration is reached after about 60 hours from the start of treatment. The volume of distribution is 4.8 l / kg, the bond with plasma proteins is 16%. Easily penetrates histohematogenous barriers. It is excreted unchanged, mainly by the kidneys (about 60%). The elimination half-life is about 7 hours, in patients over 65 years old it is about 12 hours. The renal clearance of trimetazidine directly correlates with the creatinine clearance (CK), the hepatic clearance decreases with age.
Cardiology: ischemic heart disease - prevention of attacks of stable angina (as part of combination therapy). Otorhinolaryngology: treatment of cochleo-vestibular disorders of ischemic nature (such as dizziness, tinnitus, hearing loss). Ophthalmology: chorioretinal vascular disorders with ischemic component.
- hypersensitivity to the components of the drug - severe renal failure (creatinine clearance less than 15 ml / min) - pronounced liver dysfunction - pregnancy - lactation period - up to 18 years old (efficacy and safety have not been established).
Dosage and administration
Inside, during the meal. Rimecor MB is used 1 tablet 2 times a day (morning and evening). When skipping one dose, the second dose should not double the dose of the drug. The course of treatment is recommended by the doctor.