Preductal od

Trimetazidine prevents a decrease in intracellular adenosine triphosphate (ATP) concentration by maintaining the energy metabolism of cells in a state of hypoxia. Thus, the drug ensures the normal functioning of membrane ion channels, transmembrane transport of potassium and sodium ions and the preservation of cellular homeostasis.

Trimetazidine inhibits the oxidation of fatty acids due to the selective inhibition of the enzyme 3-ketoacyl-CoA thiolase (3-CAT) of the mitochondrial long-chain isoform of fatty acids, which leads to increased oxidation of glucose and acceleration of glycolysis with oxidation of glucose, which determines the protection of the myocardium from ischemia. The switch of energy metabolism from fatty acid oxidation to glucose oxidation underlies the pharmacological properties of trimetazidine.

Pharmacodynamic properties

— supports the energy metabolism of the heart and neurosensory tissues during ischemia;

— reduces the severity of intracellular acidosis and changes in the transmembrane ion flow that occur during ischemia;

- reduces the level of migration and infiltration of polynuclear neutrophils in ischemic and reperfused heart tissues;

- reduces the size of myocardial damage;

- does not have a direct effect on hemodynamic parameters.

In patients with angina pectoris, trimetazidine increases coronary reserve, thereby slowing the onset of exercise-induced ischemia, starting from the 15th day of therapy; limits fluctuations in blood pressure caused by physical activity without significant changes in heart rate; significantly reduces the frequency of angina attacks and the need for short-acting nitroglycerin; improves contractile function of the left ventricle in patients with ischemic dysfunction.

The results of clinical studies have confirmed the effectiveness and safety of trimetazidine in patients with stable angina, both in monotherapy and as part of combination therapy when the effect of other antianginal drugs is insufficient.

In a study of 426 patients with stable angina, the addition of trimetazidine (60 mg/day) to metoprolol 100 mg/day (50 mg twice daily) for 12 weeks statistically significantly improved exercise test scores and clinical symptoms compared with placebo: total duration of stress tests was +20.1 s, p=0.023, total time of exercise +0.54 METs, p=0.001, time to development of ST segment depression by 1 mm +33.4 s, p=0.003, time to development of angina attack + 33.9 s, p<0.001, number of angina attacks per week -0.73, p=0.014 and consumption of short-acting nitrates per week -0.63, p=0.032, without hemodynamic changes.

In a study of 223 patients with stable angina, the addition of trimetazidine 35 mg twice daily to atenolol 50 mg once daily for 8 weeks increased the time to development of ischemic ST-segment depression by 1 mm (+34.4 s, p = 0.03) during stress tests in a subgroup of patients (n = 173), compared with placebo, 12 hours after taking the drug. This difference was also shown for the time of development of angina attacks (p=0.049). There were no significant differences between groups for other secondary endpoints (total exercise test duration, total exercise time, and clinical endpoints).

In a study of 1962 patients with stable angina, trimetazidine at two doses (70 mg/day and 140 mg/day) was added to atenolol 50 mg/day versus placebo. In the general population, including patients with both asymptomatic and symptomatic angina, trimetazidine did not demonstrate benefit on ergometric (total duration of exercise tests, time to ischemic ST-segment depression of 1 mm, and time to onset of angina) and clinical endpoints. . However, in a post-hoc analysis of a subgroup of patients with symptomatic angina (n=1574), trimetazidine (140 mg) significantly improved total exercise test time (+23.8 s versus +13.1 s for placebo; p=0.001) and time to angina onset (+46.3 s versus +32.5 for placebo; p=0.005).

Pharmacokinetics

Suction

Trimetazidine has a linear pharmacokinetic profile and reaches Cmax in plasma approximately 14 hours after administration. In the intervals between doses of the drug (i.e., within 24 hours), the concentration of trimetazidine in the blood plasma for 15 hours after taking the drug remains at a level of at least 75% of Cmax. An equilibrium state is achieved after taking the 3rd dose (after 3 days). Food intake does not affect the bioavailability of trimetazidine when taking Preductal® OD 80 mg.

Distribution

Vd is 4.8 l/kg, which indicates good distribution of trimetazidine in tissues (the degree of binding to plasma proteins is quite low, about 16% in vitro).

Removal

Trimetazidine is excreted mainly by the kidneys, mainly unchanged. T1/2 in young healthy volunteers is about 7 hours, in patients over 65 years old - about 12 hours.

Renal clearance of trimetazidine directly correlates with creatinine clearance; hepatic clearance decreases with patient age.

Instructions for use PREDUCTAL® MR (PREDUCTAL MR)

An antianginal drug that improves myocardial metabolism in ischemic conditions. By preserving energy metabolism in cells exposed to hypoxia or ischemia, trimetazidine prevents a decrease in intracellular ATP levels, thereby ensuring the proper functioning of ion pumps and transmembrane Na+-K+ flux while maintaining cellular homeostasis.

Trimetazidine inhibits fatty acid β-oxidation by inhibiting long-chain 3-ketoacyl CoA thiolase (3-CAT), which increases glucose oxidation. In ischemic cells, energy requirements are met by glucose oxidation, which requires less oxygen consumption than β-oxidation. Enhanced glucose oxidation optimizes cellular energy processes, and thereby maintains proper energy metabolism during ischemia.

In patients with coronary artery disease, trimetazidine acts as a metabolic agent that preserves the intracellular level of high-energy phosphates in cardiomyocytes. The anti-ischemic effect is not accompanied by an effect on hemodynamics.

Clinical efficacy and safety

Clinical studies have shown the effectiveness and safety of trimetazidine in patients with angina pectoris, both in monotherapy and in combination when other antianginal drugs are insufficiently effective.

In a randomized, double-blind, placebo-controlled trial involving 426 patients (TRIMPOL-II), trimetazidine (60 mg/day) plus metoprolol 100 mg/day (50 mg twice a day) for 12 weeks statistically significantly improved parameters. stress tests and clinical symptoms compared with placebo:

the total duration of the stress tests was +20.1 s, p=0.023, the total load performed was +0.54 MET, p=0.001, the time until the development of ST segment depression by 1 mm was +33.4 s, p=0.003, the time until the onset of an angina attack was +33.9 s, p<0.001, number of angina attacks per week -0.73, p=0.014 and consumption of short-acting nitrates per week -0.63, p=0.032, without hemodynamic changes.

In a randomized, double-blind, placebo-controlled study of 223 patients (Sellier), the addition of trimetazidine 35 mg (1 modified-release tablet) twice daily to atenolol 50 mg (once daily) for 8 weeks significantly increased the time before the development of ST segment depression by 1 mm (+34.4 s, p = 0.03) during stress tests in a subgroup of patients (n = 173), compared with placebo, 12 hours after taking the drug. A significant difference was also proven for the time of onset of angina attacks (p=0.049). There was no significant difference between groups for other secondary endpoints (total exercise test duration, total exercise capacity, and clinical endpoints).

In a three-month, randomized, double-blind study of 1962 patients (the Vasco study), two doses of trimetazidine (70 mg/day and 140 mg/day) given in addition to atenolol 50 mg/day were studied in comparison with placebo. In the general population, including patients with or without clinical symptoms, no benefit was observed for trimetazidine on ergometric (total duration of stress tests, time to 1 mm ST segment depression, time to onset of angina) and clinical endpoints. However, in a post-hoc analysis of a subgroup of symptomatic patients (n=1574), trimetazidine (140 mg) significantly improved total exercise test time (+23.8 sec versus +13.1 sec placebo; p=0.001) and time to onset of angina (+46.3 sec versus +32.5 with placebo; p=0.005).

Note!

Description of the drug Preductal OD 80 mg caps. prol. d-via 80 mg No. 30 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Cardiovascular drugs Preductal MR - reviews

Oleg P
https://facey.ru/drug/heart/preduktal.html#i-17

I have chronic ischemia, my heart often hurts, my rhythm is disturbed. The doctor prescribed Binelol (for the heart), Suprilex (for blood circulation), Ritmonorm (for rhythm), Preductal or Mildronate (Mildrocard). Of the latest products to choose from, I purchased Preductal (based on reviews from other people). I have been undergoing treatment according to the indicated regimens for 1.5 weeks. I am very pleased with my condition. The pain and pressure in the heart went away, strength appeared, there was no shortness of breath or palpitations.

(Anna22.04) Anna
https://www.imho24.ru/recommendation/57119/#review77354

Advantages:

There is a good effect.

Flaws:

Not identified.

Review:

My grandmother took this drug, because in addition to hypertension, she has coronary heart disease. She complained a lot about constant dizziness, tinnitus, and when she came to the doctor with these problems, he prescribed her this medicine, which was supposed to solve all the problems that were bothering my grandmother. My grandmother started taking it, but the dizziness and tinnitus did not go away. But there were noticeable improvements in coronary artery disease, the heart began to work much better, shortness of breath decreased, and vigor appeared. This drug had virtually no effect on blood pressure, but my grandmother took other antihypertensive drugs on an ongoing basis. Since this drug did not solve the problems associated with dizziness and tinnitus, the doctor discontinued it and prescribed another remedy, and explained that perhaps this medicine specifically affects the grandmother differently. But nevertheless, the grandmother’s general condition has improved and she takes this drug in courses, since it still has a positive effect on the cardiovascular system. Since this drug has a number of serious contraindications, it should be taken only after consultation with a doctor.

(Kareliya) Karelia
https://www.imho24.ru/recommendation/57119/#review77327

Advantages:

Excellent support for the heart muscle.

Flaws:

Not detected.

Review:

I am a hypothyroid patient with decent experience. I have been taking a hormonal drug for many years, for which I am very grateful. However, not everything is so smooth! Due to hormonal therapy, my heart muscle is suffering. And although my ECG does not show anything critical, there are some deviations from the norm. To put it in simple language, I have a “tired” heart muscle. What does this mean? Attacks of tachycardia without physical activity, shortness of breath and, what especially alarmed me, “overflow” in the heart. I also call them “squishies.” Everything was fine, and then, as if a faucet was turned on, a portion of blood was drained. I haven’t seen a doctor yet and haven’t had an examination, I’ve been imagining so many things for myself. But it turned out that my heart was fed up with thyroxine. But I can’t categorically cancel it and I can’t even lower the dosage. What should I do? Here Preductal MR came to my aid. Manufacturer: Servier (France). Main active ingredient: trimetazidine dihydrochloride. And MR means that this substance has a prolonged effect. The main indications for the use of this drug are:

ischemia (
this is when the blood supply to the heart muscle decreases);
hypoxia
(oxygen content in the heart muscle decreases).

This drug is good for such conditions because it is able to stabilize energy metabolism. In general, in cases of stable angina, this drug is what you need! Cardiologists love him very much!

I was prescribed to take it 2 times a day, 1 tablet with meals. My course lasted a month. And my doctor recommended drinking it every six months. Within two weeks I felt relief. Shortness of breath and tachycardia practically did not make themselves felt, and “overflow” in the heart began to happen less and less often. And after a month they practically disappeared. Now such “overflows” only happen if I get scared or overexcited. In the instructions you can read about various side effects and contraindications, depending on age categories and concomitant diseases. But I tolerate the drug very well. Now my heart beats evenly and confidently. I intend to continue to repeat the course of this drug every six months, because the heart is not to be trifled with! Of course, you should not prescribe this drug yourself, without consulting a specialist. However, if you are prescribed it, know that it really works! Be healthy!

Kira
https://lekotzyvy.com/review.php?id=6490

After taking the hormonal drug for many years, my heart muscle began to suffer. Most of all I was alarmed by unexpected attacks of tachycardia, shortness of breath and some kind of flapping in my heart. The doctor prescribed Preductal MP twice a day with meals for a month. The drug is cumulative, and therefore even after the first week of taking it I did not notice any changes, but after the second I felt improvements. The first thing I noticed was that the flapping in my heart became less frequent, shortness of breath and tachycardia practically forgot about me and did not bother me. In order for the condition to always remain stable, the doctor recommended taking Preductal MP in a course every six months.

Jevgenia
https://www.medkrug.ru/community/show_thread/1885?thread=73839

I take it from time to time. I don’t know if it’s a coincidence or not, but it helped me when I wasn’t feeling well. Several times in a course of two months

Lilechka
https://irecommend.ru/content/esli-khochesh-zhit-preduktal-pomozhet-glavnoe-vyderzhat-kurs-lecheniya-i-ne-brosit-inache-ne

Preductal MV tablets should be taken only as prescribed by a doctor; this drug is not one of those that you can simply read on the Internet or buy on the advice of friends. He's very serious. It was prescribed to me for heart pain three years ago.

I had pain in the heart area, shortness of breath, weakness, and my heart pounded when I inhaled and exhaled.

Diagnosis: tachycardia, grade 1 MVP.

At first I treated her with the usual means of panangin, riboxin, carboxylase injections, but all this did not help. And only the preduct was saved. For two years my heart didn't bother me.

The drug is very good for diseases of the cardiovascular system. But you need to drink it with caution, there are side effects. The main thing is to endure and not quit. Because the effect will then be positive. I had side effects after taking the pill, after 20 minutes the shaking began, the feeling that everything was pounding and it was difficult to breathe, but this attack passed quickly. Honestly, I wanted to quit, but the doctor said that this happens and advised me to be patient. After two weeks it was already better, there were no such attacks. A month of treatment – a healthy heart!

Now I have started having heart problems again. Shortness of breath, lack of air, pain, dizziness, weakness. I drank panangin, but it helps for a short time, then it all comes back again. It's time to drink the preductal again. I didn't want to take it because of the side effects. If you want to live, you will endure it!

Three years ago they cost 1 thousand rubles. Now I bought it for 700 rubles. Expensive drug but they are worth it.

Main

And if you have heart problems and the doctor prescribes these pills for you, don’t be afraid, buy them and undergo a course of treatment. They're worth it.

Now the package even comes with a calendar, so you don’t forget to take the pill and see whether you took it or not.

Take morning and evening, with meals.

I recommend other drugs, they are very good.

If you have a fungus

Runny nose

GrainOl
https://irecommend.ru/content/chto-prinimat-ot-serdtsa

I will say right away that I do not recommend self-medication and in every possible way I ask you not to treat my review as a secret to treating the heart and blood vessels. I will just tell you about my own experience of taking the drug that my cardiologist prescribed to me.

This drug is Preductal. It is not in short supply; it is available in pharmacies. It is released without a doctor's prescription.

The tablets are easy to swallow and the patient does not feel the taste of the drug.

The main component of Preductal is Trimetazidine. I will not write clever words about how the drug works. Find the Preductal instructions and everything is written there in professional language.

It was prescribed to me because a problem arose and became acute. I took it as written in the instructions and as the doctor said - 2 times a day, with meals. Be sure to drink it with water and not tea, as some people sometimes do.

The drug did not cause me any allergies or other side effects.

How did Preductal help me? The dizziness became less, the nausea disappeared completely (apparently it was due to dizziness), and my health improved. The pulse returned to normal, otherwise there were surges. Breathing became easier and freer.

There are 60 tablets in a package.

ZaraMira
https://irecommend.ru/content/dela-serdechnye

My endocrinologist prescribed this drug to me. I have suffered from hypothyroidism for many years and take L-thyroxine. Lately my heart has started to worry me a lot. Tachycardia, shortness of breath, overflow in the heart area. I did an ECG, tested TSH and free T-4 to check if I was going too far in replacement therapy. But with 150 mg of L-thyroxine, my results are just normal, there is no overdose, but the ECG showed fatigue of the heart muscle. So, along with other drugs, I was prescribed Preductal. And my doctor said that I should drink it periodically for 1 month every six months. After 2 weeks from the start of taking it, I felt relief. The tachycardia practically ceased to appear, I began to climb stairs freely, but lately this had been a problem and I felt like an old grandmother. The drug is great for hypoxia and ischemia. If your doctor prescribes this drug to you, I highly recommend that you follow the recommendations. The drug is what you need. Be healthy!

Becamehorning
https://otzyv.expert/realnaya-pomosh-serdcu-podverzhennomu-ishemii-1973405

Advantages:

Effective drug

Flaws:

Price, constant reception

Details:

Many people have probably heard about the drug Preductal. It is prescribed to those patients who have heart problems, namely coronary artery disease. This phenomenon is very common among older people, although there are also middle-aged patients. Ischemia is a local decrease in blood supply, hence all the troubles.

It manifests itself as attacks of pain in the heart - angina pectoris (angina pectoris), shortness of breath during physical exertion. Moreover, it can happen to everyone to varying degrees. Someone begins to choke after climbing to the 4th-5th floor, and someone after walking 10 meters on a flat surface. It's all sad and hard. Therefore, this type of therapy is provided. Preductal is not a new drug, widely known, although not the only one of its kind. The active ingredient of the drug is trimetazidine, there are a number of drugs that are analogues of Preductal, but do not rush to run to the pharmacy in search of something cheaper. After all, we are talking about your heart, or the heart of a loved one. Of course, the price is not small, about 700 rubles for a month, but if you buy an analogue for 100 rubles, do not expect a good effect. Although I know one worthy analogue, I will write about it later. Preductal improves myocardial metabolism. That is, the patient. whoever takes it will suffer less from shortness of breath and will be less likely to experience pain in the heart. And the longer Preductal is taken, the better the effect becomes. Therefore, according to indications, I prescribe Preductal (or its analogue, which I will talk about later) for regular use. You should drink 1 tablet 2 times a day. Package of 60 tablets, designed for a month. I definitely recommend this treatment to anyone who suffers from IHD.

Laggle
https://otzyv.expert/uluchshaet-rabotu-serdca-1655193

Advantages:

improves well-being

Flaws:

expensive drug

Details:

I was forced to get acquainted with the drug “Preductal” by necessity after receiving a not very good ECG result. Before this, I heard a lot of advice and reviews about this drug. The doctor said that there was nothing terrible or fatal on the ECG, but you need to support your heart by taking this drug.

Much has been written in the instructions about the action of Preductal, but the main thing is that it improves the metabolic processes occurring in the heart muscle and stops the development of ischemia. And this is very good for the prevention of myocardial infarction. Moreover, my heredity is heavily burdened in this regard.

Doctors' opinions about the duration of taking the drug vary greatly. One doctor told me that the drug should be taken for 3 months and the course repeated at least once a year. Another doctor assured that you can take it almost for life. The only problem is the price of the drug. If you take it twice a day, the package will only last for a month. This means you need to spend about 800 rubles per month on Preductal alone. Quite expensive. The only thing that makes me happy so far is that I only take it once a day. And a package lasts me two months. Therefore, I have been taking it for the third month and so far I am very pleased.

The instructions for the drug describe contraindications (there are few of them) and side effects in the form of abdominal pain, diarrhea, asthenia, dizziness, headache, tremor, insomnia, drowsiness. From the cardiovascular system there may be tachycardia, palpitations, decreased blood pressure, and rushes of blood to the scalp and neck. But fortunately for me, I do not observe any side effects of the drug. I feel good, my heart doesn’t bother me much. But whether I’m better or not - the ECG will show.

Bogdan
https://www.otzyvua.net/preduktal/review-171434

This drug was recommended to me by my cardiologist for cardiac ischemia. I took this medicine during complex treatment along with other drugs. I felt better after just a week of treatment. Shortness of breath and pressing pain in the chest went away. Moreover, it became much easier to climb stairs. Once every seven to eight months I repeat the course of treatment using Preductal. I highly recommend that anyone who suffers from ischemia try this drug. Of course, before using this medicine, be sure to consult a cardiologist.

Daria
https://www.otzyvua.net/preduktal/review-633644

Mom takes preductal OD, these are capsules to improve the supply of the heart muscle. I began to feel better, there was no shortness of breath, I began to walk more and faster. She says she's younger

djessi1985
https://otzovik.com/review_2553959.html

Advantages:

Effective drug

Flaws:

Price

Greetings my friends and site guests! I would like to dedicate today’s review to the drug Preductal, which I bought on the recommendation of a general practitioner. I would like to note that at the time I went to the doctor, I did not have any serious heart problems, sometimes I felt tachycardia, and my blood pressure periodically dropped. The price of the drug was a little shocking, 750 rubles, and I was prescribed to take it for 6 months, one package is just enough for one month. After taking the drug, I did not notice any side effects, and my condition improved significantly, but not immediately, but after about a month. The blood pressure normalized, the heartbeat stopped being felt, and the general condition improved.

mazurka
https://otzovik.com/review_1854260.html

Advantages:

An original drug that works well as a prevention and treatment of cardiovascular diseases

Flaws:

Not everyone can afford it

Preductal MV is the original trimetazidine, a drug that is widely used in therapy and cardiology. In my practice, I use this drug very often, as it has proven itself to be excellent. Of course, you shouldn’t expect any special results with monotherapy; there will be more prevention of coronary artery disease and replenishment of the heart. But in the complex treatment of angina pectoris, myocardial infarction, chronic heart failure and other problems associated with the cardiovascular system, Preductal MV is simply irreplaceable. I will not list the indications and contraindications for its use; if you are reading the review, you have most likely already studied the annotation for this medicine. I can only give advice from a practicing doctor: there are a lot of trimetazidines on the domestic market now, but not a single generic has conducted as many studies on its drugs as on preductal. By prescribing it and making sure that the patient takes this medicine according to the right regimen and in the right combination, you can be sure that you are prolonging the person’s life.

lushenika
https://otzovik.com/review_3034361.html

Advantages:

efficiency

Flaws:

price

I would like to share the results of taking the cardiac drug Preductal MR. This, of course, is a medicine that should be prescribed by a doctor. But perhaps the information will be useful to someone. My mother took the drug; she is already over seventy. She suffers from coronary heart disease, and recently angina attacks have become more frequent. Her friend shared the positive results of using the preductal with her. Mom consulted with a doctor and prescribed a dosage regimen. For a year she took the drug in certain courses. The result is visible, angina attacks have decreased to a minimum, and my health has improved. Preductal was in addition to her regular heart medications and support. The drug turned out to be effective.

Elena-kolibry
https://otzovik.com/review_3659943.html

Advantages:

Helps.

Flaws:

Expensive.

Symptoms of IHD are varied and unpleasant. It is clear that such a common thing as angina pectoris, ischemia and other heart diseases are permanent until the end of life and cannot be cured. But still, by supporting your heart with a complex of treatments, you can prevent crisis situations. More than once I drew the attention of my doctor to the fact that the tonometer readings indicate a rapid heartbeat, about 90-100 beats. This, of course, does not cause any pain, but shortness of breath, fatigue, and excessive sweating in the summer are a constant phenomenon. Finally, the doctor prescribed Preductal tablets from Servier Industry Laboratories, France. The package contains two blasters of 30 tablets each. It was prescribed to take 1 tablet 2 times a day.

While studying information on the Internet regarding this medicine, I learned that experts consider Preductal an innovation in the field of cardiology and strongly recommend it for use. My daily heartbeat measurements showed a slight decrease in heart rate after just one day; after 5 days, my heart rate confidently remained at 75 beats. Well, my health has improved noticeably accordingly - so far I can only see this when I’m short of breath, in any case, I can climb to the fourth floor without much effort (but slowly). There were no side effects identified for this drug, except for one - it is expensive.

Compound

Active ingredient: trimetazidine;

Preductal® ED 40 mg

1 sustained-release hard capsule contains 40 mg trimetazidine dihydrochloride;

Excipients: spherical sugar*, hypromellose, ethylcellulose, acetyltributyl citrate, talc, magnesium stearate;

Capsule shell: titanium dioxide (E 171), gelatin; ink: shellac (E 904), propylene glycol (E 1520), concentrated ammonia solution (E 527), potassium hydroxide (E 525), titanium dioxide (E 171), black iron oxide (E172)

Preductal® ED 80 mg

1 extended-release hard capsule contains 80 mg trimetazidine dihydrochloride;

Excipients: spherical sugar*, hypromellose, ethylcellulose, acetyltributyl citrate, talc, magnesium stearate;

Capsule shell: titanium dioxide (E 171), gelatin, red iron oxide (E172) ink: shellac glaze-45% (20% esterified) in ethanol, titanium dioxide (E 171), simethicone, propylene glycol (E 1520), ammonium hydroxide 28% (E 527).

* Spherical sugar (710-850 microns) contains sucrose and corn starch