To improve or maintain metabolism, as well as energy supply to all organs of the human body, experts prescribe Mildronate.
The good effect, as well as the few side effects of Mildronate, determine its popularity among almost all categories of the population.
Like any other drug, Mildronate should be prescribed by a doctor even in the absence of visible symptoms of the disease.
The active ingredient of the drug is meldonium, which leads to:
- to improve the body's performance;
- increasing humoral and tissue immunity;
- increasing human resistance to negative psychological and physiological factors;
- normalization of cardiac activity.
In addition, the product protects cells from destruction, removes toxic products and waste from cellular metabolism, and also helps to increase their stability. As a result, the increased metabolic rate leads to faster recovery of the body.
The drug's ability to optimize blood flow allows it to redirect blood flow to oxygen-starved areas of the heart, brain and eye. As a result, blood supply is normalized, the organ receives a sufficient amount of oxygen and necessary nutrients. This property of Mildronate is of particular relevance in ischemia.
The use of Mildronate leads to vasodilation and normalization of cellular immunity, as a result of which immunity in general improves.
The tonic effect on the somatic and autonomic nervous system leads to the elimination of physical and psychological disorders due to prolonged use of alcoholic beverages. Allows you to eliminate alcohol withdrawal, manifested in the form of tremors, memory loss, and obsessive states.
Among the most common indications for the use of Mildronate are:
- ischemia of the heart and brain;
- angina pectoris;
- heart attack;
- chronic heart failure;
- pain syndrome in the heart due to pathologies of the organ;
- dishormonal cardiomyopathy;
- impaired functioning of the cardiovascular system and neurocirculatory dystonia during puberty;
- pathological changes in the eyes;
- chronic obstructive pulmonary pathologies;
- psychological and physical consequences of long-term alcohol use;
- low performance;
- overstrain and fatigue.
Only a doctor can determine the need to use the drug
Composition and release form
The drug is produced by several manufacturers, and its composition depends on the form of release. It is presented on the pharmaceutical market in two forms:
- solution for injection, 1 ml contains 100 mg of meldonium dihydrate;
- capsules with a dosage of the main active ingredient of 250 or 500 mg.
The capsules contain excipients - magnesium stearate, potato starch, silicon dioxide and microcrystalline cellulose. Contents: hygroscopic white powder. In pharmacies it is sold in cardboard boxes of 30, 40, 60 pieces.
The solution is a slightly yellowish or transparent substance, containing water for injection as an excipient. Sold in 5 ml ampoules of 10 pieces, packed in cardboard boxes.
The solution for injection into a vein or muscle has the fastest absorption (immediately after administration), but it is more convenient to take capsules at home.
Effect of the drug
Meldonium improves metabolic processes in the heart muscle and provides energy to the myocardium, as well as:
- improves blood circulation in the brain;
- normalizes the inflow and outflow of blood in areas with insufficient blood supply;
- slows down the formation of a zone of tissue death;
- brings myocardial performance indicators back to normal;
- provides brain and heart cells with oxygen;
- removes toxins;
- normalizes the functioning of the nervous system;
- shortens the rehabilitation period after heart surgery or stroke;
- helps in the treatment of alcoholism.
History of creation
The trade name of the substance is mildronate . It was discovered in the Soviet Union in the mid-seventies of the last century by Professor Ivars Kalvins. While working on his dissertation, he was able to synthesize meldonium for the first time. The scientist was looking for a substance in the body whose capabilities are reduced by constant overload. This is how gamma-butyrobetaine was discovered. During its transformation, meldonium was obtained for convenient storage and use.
The initial scope of application of the invention was the army. Soldiers needed a stimulant that could increase their nervous and physical endurance during military operations. After some time, researchers found that the drug has a beneficial effect on the development of plants and animals. Only almost ten years later, after clinical trials, when mildronate was already patented in the USA, did it begin to be used in medicine.
Indications for use
Meldonium is prescribed as an additional therapy for serious diagnoses and certain conditions:
- cardiac ischemia;
- myocardial dysfunction;
- disruption of blood supply to the brain as a result of a stroke;
- rehabilitation period after surgical interventions;
- heavy physical activity;
- low performance, weakness and chronic fatigue;
- withdrawal syndrome in chronic alcoholism;
- dishormonal cardiomyopathy.
The drug is administered by injection through the skin of the lower eyelid for hemorrhages, circulatory disorders or thrombosis of the veins in the retina, pathologies of the fundus vessels, as well as for diabetic or hypertensive retinopathy.
Meldonium: methods of application and doses
Depending on the dosage form used, the drug is prescribed orally, intravenously, intramuscularly or by eye injection.
The method, duration of therapy and dose are determined based on the indications and severity of the condition individually.
Instructions for use of Meldonium provide for several capsule administration regimens:
- for heart disease - 500-1000 mg per day, once or in two doses, with a course of treatment of 1-1.5 months;
- in case of impaired cerebral circulation - 500-1000 mg per day for 1-1.5 months;
- for chronic alcohol intoxication, the dose reaches 500 mg in 4 doses per day, the course is up to 10 days;
- with systematic heavy physical activity, during the rehabilitation period after surgery - 250 mg 4 times a day for two weeks.
Athletes are prescribed capsules of 500-1000 mg twice a day before training and during competitions for 2-3 weeks.
When prescribing injections, the dose is 500-1000 mg per day.
For unstable angina, a condition after myocardial infarction, the solution is administered intravenously, 1-2 ampoules once a day for 4 days.
0.5 ml of the drug with a concentration of meldonium of 500 mg per 5 ml is injected into the retina of the eye, the course of treatment is 10 days.
Meldonium manufacturer: “There is just a lobby of competing drugs”
Drug production line.
Photo: REUTERS
— We are discussing a doping scandal, as a result of which six Russian athletes have already been burned. The problem is with the drug mildronate, which contains meldonium.
— In fact, mildronate is the trade name for the active substance meldonium. One of the names of meldonium is mildronate from one of the manufacturers. That is, in principle, the active substance is the same.
— I wanted to clarify with you which countries you supply this drug to, where it is sold and under what conditions - with a doctor’s prescription or in the public domain?
— In most cases, according to a doctor’s prescription. We sell to 11 countries: Ukraine, Latvia, Lithuania, Kazakhstan, Kyrgyzstan, Turkmenistan, Georgia, Albania, Kosovo, Moldova, Mongolia. These are our markets. But we are not the only producers of meldonium in the world. We don’t sell it in Russia, but we have our own manufacturers of this product.
— So you don’t supply the drug to Russia?
- No. We do not supply meldonium specifically to Russia. But we don’t know, if we talk specifically about the case with Sharapova, where it was bought.
— That is, Russia has its own manufacturers of this drug, do I understand correctly?
— As far as I know, the holder of the Mildronate trademark, to which Sharapova referred, is another Latvian. That is, whether they make the drug for the Russian market in Russia, in Latvia or somewhere else, I just don’t know.
— I wanted to ask about the drug. They call it doping. Is this really true or not?
— I’m not a doctor myself, but I probably wouldn’t call him a doping person. The essence of the drug is that in various complicated situations it helps cells, including muscle cells, to survive. The product is mainly used in cases of heart attacks and strokes. Slightly similar processes occur in athletes when they receive extreme loads. That is, this is a lack of oxygen in the body. In theory, the product helps to endure even very heavy loads, such as those experienced by professional athletes, without severe consequences. It can hardly be said that the drug somehow greatly improves physical capabilities. It protects the body more in situations of very high stress. In my opinion, there is no evidence that it helps you run faster or jump higher or anything like that.
— That is, it does not improve athletic performance, even if it is used in large dosages?
— Let’s just say that I don’t know of evidence or studies of this kind that have proven that meldonium in any quantity improves the physical and athletic performance of an athlete.
— In the West, this substance, meldonium, is prohibited.
- No. It is not registered because, for various reasons or due to the fact that this is a very complex and expensive procedure, the manufacturers decided not to do it. That is, it is not available to doctors there. But this is not the same as prohibited.
— That is, not registered, but not prohibited?
- Yes, it is not registered.
— Maybe there are some analogues that are used by doctors?
— In similar situations, as far as I know, in the West they use a product called Preductal, which is also available in the CIS countries, with a very similar effect. But this does not mean that Meldonium is prohibited. It’s just that manufacturers work in some of their markets. Let's just say that the classic Western countries - France, England, Germany and others like them - are not included in their zone of interests, they simply did not dare to register.
- That is, they found an easier way for themselves.
- Not necessary.
— Do you have any assumptions why there are now complaints about this drug? As I understand it, it was used for many years, and now for some reason there is a scandal, a ban, etc.
- This is a very good question actually. Because there are different versions here, even conspiracy theories. There are different medications that are used in similar cases, with very similar effects. According to the inventor Meldonius, academician Kalvins, there is a lobby of competing drugs that have a similar effect, but for some reason are not included in the doping list.
— So these analogues that you told me about earlier are trying to somehow promote themselves on the market?
- One of the versions is exactly like this.
AND AT THIS TIME
The State Duma is convening for an emergency meeting because of Sharapova
In one day, several of our athletes were blacklisted
The doping scandal continues to gain momentum. Seven Russian athletes from different sports have already been involved in its orbit.
The loudest self-exposure was made by tennis player Maria Sharapova, who could lose tens of millions of dollars and even end her career. (details)
BY THE WAY
Meldonium, invented in Latvia, was made “bad” by German scientists
"KP" talks about how a widely used drug became prohibited for athletes
Over the past couple of days, meldonium has become one of the most famous drugs in Russia. As of January 1, 2021, it is officially on the list of substances that are prohibited for use by the World Anti-Doping Agency. This drug is widely used in Eastern European countries and was first developed by the Latvian professor Ivars Kalvins, who, after a loud scandal, hastened to declare that meldonium does not help improve results, but only preserves the health of athletes (details)
Contraindications and side effects
The drug is contraindicated in:
- individual intolerance;
- hypersensitivity to components;
- increased intracranial pressure due to impaired venous outflow or brain tumors.
Negative effects are rare and may include:
- tachycardia;
- increased nervous excitability;
- allergic reactions – itching, urticaria;
- digestive disorders;
- changes in blood pressure downwards or upwards.
With the correct dosage, side effects usually do not occur; if they appear, it is recommended to discontinue the drug.
special instructions
When used together, it enhances the effect of drugs that dilate blood vessels and reduce the heart's need for oxygen, as well as drugs that normalize myocardial function and restore metabolism. Concomitant use with alcohol is not recommended (it is necessary to wait 12 hours between doses).
The medicine has mild toxicity and in case of overdose, symptomatic treatment is carried out.
Prescribed with caution for liver and kidney diseases. In case of an acute heart attack, Meldonium is not the first-line drug of choice. It is not recommended to take it without a doctor's prescription.
Prohibited for pregnant women, nursing mothers and children
Meldonium is contraindicated for use during pregnancy, since there is no data on its effect on the woman’s body and the development of the fetus/embryo (such clinical studies are contraindicated for ethical reasons). And existing data from animal studies are insufficient to draw a conclusion about the effect of the drug on the fetus.
Mildronate passes into breast milk. Unfortunately, it is unknown how the drug affects the body of a newborn child. Therefore, its use by the mother during lactation is contraindicated.
There are no data on the use of the drug in children (under 18 years of age). Therefore, the use of meldonium in this age category of patients is contraindicated.
The product is prohibited for use in pregnant women and nursing mothers
Price, reviews, analogues
The price of Meldonium depends on the number of capsules in the package and the concentration of the main substance. The price for a package of 30 pieces with a dosage of 250 mg costs from 170 rubles, 60 pieces - from 320 rubles, 60 pieces with a dosage of 500 mg - from 550 rubles.
Structural analogues of Meldonium are Mildronate, Idrinol, Cardionate.
Reviews of Meldonia from doctors are generally positive. The drug has shown effectiveness in the treatment of withdrawal symptoms and cardiac pathologies, is well tolerated by patients and increases endurance.
Patients note a surge of strength and faster recovery after training, but it is not recommended to use it in the treatment of diseases of the cardiovascular system without a doctor’s prescription.
Known Side Effects
Side effects of Mildronate are not observed often and appear:
- tachycardia;
- surges in blood pressure;
- feeling of nausea and heaviness in the stomach, belching, heartburn, vomiting, constipation, diarrhea;
- allergies: redness of the epidermis, rashes, itching, swelling;
- reaction of the central nervous system: headaches, severe overexcitation.
When taking the drug orally, an overdose is not observed, but it is not excluded with injections and manifests itself in the form of:
- low blood pressure;
- headache;
- dizziness;
- increased heart rate;
- feelings of general weakness.
Side effects and manifestations of overdose are eliminated by stopping the drug and symptomatic treatment.
Mildronate has good reviews and, when used correctly, has a pronounced positive effect.
Side effects of taking Mildronate can be divided depending on the body system that is affected.
Mildronate is a low-toxic drug. Undesirable effects caused by it do not pose a risk to the human condition
The immune system
Often – allergic skin manifestations.
Rarely - urticaria, angioedema, anaphylactic shock.
Human psyche
Often – overexcitation, pathological feeling of fear, obsessive thoughts, disruption of normal sleep.
Nervous system
Often – headache.
Rarely - tremor of the limbs, sensory disturbances, crawling sensations on the skin, noise and ringing in the ears, attacks of dizziness, gait disturbances, fainting.
The cardiovascular system
Rarely - the development of arrhythmia, tachycardia, a feeling of interruptions in the functioning of the heart, discomfort and pain in the heart area, an increase or decrease in blood pressure, the development of a hypertensive crisis.
Respiratory system
Often – infectious lesions of the respiratory tract.
Rarely – development of dyspnea, apnea.
Digestive organs
Often – dyspeptic manifestations.
Rarely - a feeling of a metallic taste in the mouth, loss of appetite, vomiting, nausea, bloating, diarrhea, dry mouth, increased salivation, abdominal pain.
Musculoskeletal system
Rarely - dorsalgia, muscle spasms and muscle weakness.
Excretory system
Rarely – increased frequency of urination.
General reactions of the body
Increased fatigue, increased temperature and feeling of chills, asthenic manifestations, swelling of soft tissues, feeling of cold or heat, increased sweating.
To avoid the development of side effects during treatment with Mildronate, you must strictly follow the doctor’s instructions.
If a patient taking Mildronate is prescribed certain laboratory and instrumental diagnostic methods, possible changes in the results should be taken into account:
- dyslipidemic manifestations;
- increased concentration of CRP in the blood;
- increased levels of eosinophils in the blood;
- sinus tachycardia on ECG.
