TOP 10 analogues of the drug Preductal: list of available substitutes

Preductal belongs to the category of antianginal medications and is officially considered an effective drug for the treatment of angina pectoris, especially when monotherapy with hemodynamic agents is insufficiently effective. Since many are interested in similar, but more affordable medications, let’s look at analogues of Preductal MB, which one is better and how to use them.

Action of the main component

Trimetazidine

acts as a key active component that maintains the energy metabolism of cells in a state of hypoxia in order to prevent a decrease in the presence of ATP inside cells.
Membrane ion channels begin to function normally, cellular homeostasis is maintained, and potassium ions are transported transmembrane. The following properties of trimetazidine have been confirmed experimentally and in practice:

• reduction of myocardial damage;
• reducing the level of infiltration and migration of “poly” in reperfusion and ischemic cardiac tissues;
• the left ventricle gains improved contractility;

• support of neurosensory organs and energy cardiac metabolism during ischemia;
• intracellular acidosis becomes less pronounced;
• angina attacks appear less and less often;
• increase in coronary reserve;
• reducing the severity of deformations of the transmembrane ion flow during ischemia;
• hemodynamic parameters are not directly affected;
• limiting sharp fluctuations in blood pressure.

Preductal with trimetazidine in its composition promotes selective inhibition of long-chain 3-ketoacetyl-CoA thiolase in order to slow down the process of fatty acid oxidation. Glucose oxidation processes are activated and the myocardium is protected from ischemia.

The new guidelines of the European Society of Cardiology have officially approved Preductal MV and recommend the drug for the treatment of angina pectoris.

The drug in question differs in that it does not affect blood pressure, heart rate, or distort the balance between myocardial demand for O2 and coronary perfusion. Some patients believe that Preductal MB analogues are better tolerated by the body, and many of them are cheaper.

Preductal OD caps 80mg N60 (Servier)

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, r

Why is Preductal prescribed?

Preductal is taken as prescribed by a doctor. This is necessary not because it has many side effects (quite the contrary, the product has very few side effects), but because the diseases for which it is prescribed are very serious and cannot be treated independently. Preductal is recommended for use in the treatment of coronary insufficiency that develops against the background of atherosclerosis. In this case, the coronary vessels are so “clogged” with atherosclerotic plaques that the slightest spasm causes a complete cessation of blood flow to the heart muscle.

Lack of nutrition instantly causes very severe pain in the heart - an attack of angina.

With prolonged attacks, necrosis of part of the heart muscle may occur - myocardial infarction. Preductal prevents the development of angina attacks and myocardial infarction. But if the attack has already begun, then to relieve it you need to take nitroglycerin: preductal does not dilate the coronary vessels. Indications for the use of Preductal also include disorders of the hearing system of vascular origin. In this case, against the background of cerebral circulation disorders, the patient may experience hearing impairment, tinnitus, dizziness, and so on. Taking preductal for two weeks reduces all these phenomena.

Exactly the same changes against the background of cerebral circulation disorders can be observed in the organ of vision. They may be accompanied by decreased vision and headaches. All these symptoms decrease after taking the preductal. Preductal is available in tablets of 20 mg and 35 mg (Preductal MB). Take Preductal tablet two to three times a day with meals. Preductal MB is taken one tablet twice a day, also with meals. The use of these drugs should be long-term, since only after two weeks of use can a positive effect be seen. The duration of treatment depends on the individual characteristics of the body and is determined by the doctor.

Analogues and substitutes of Preductal

The drug is original, for this reason it has a high cost. Not every person can afford to purchase Preductal. Therefore, a large number of pharmacological companies from different countries produce analogues (synonyms) of this drug. Russia is among these states. The drug Preductal and its analogues have different prices. The mechanisms of action are similar, but the drugs are available under different trade names, in the form of capsules or tablets. Often, doctors may prescribe replacing the drug with Mexidol or Mildronate. Below we present a list of the most common analogues of the drug.

• Antisthene
  . The Russian medicine Antisten is a cheaper analogue of Preductal. The main component is trimetazidine, which has a positive effect on cardiomyocytes and cells of the central nervous system. The active substance content is 20 mg, the instructions for use are simple, but despite this, a preliminary consultation with a doctor is required.
• Trimetazidine
  . This drug is sold in pharmacies under a name that matches the name of its active substance. This analogue of Preductal is prescribed for coronary heart disease, either alone or as part of complex therapy for pathology. The drug is also used for hearing impairment, which is caused by pathological processes in the blood vessels of the brain. The price of the medicine is cheaper than other analogues. The difference from Preductal is the cost.
• Deprenorm
  . Another analogue. This drug is a Russian analogue of Preductal, the difference is in price, it is much cheaper. The active ingredient is trimetazidine dihydrochloride, tablets can contain 35 and 70 mg of this component. Therefore, Preductal MV can easily be replaced with cheap Deprenorm.

Prices of Preductal and its analogues

The cost of Preductal is an order of magnitude higher than the cost of its analogues. Domestic drugs are, as a rule, sold at a lower price than foreign similar drugs.

Prices for medicines depend on the concentration of the active substance, the amount of the drug in the package and the manufacturer.

Rimecor or Preductal

Rimecor is a cardioprotector based on trimetazidine (20 mg), which directly affects the metabolism of cardiomyocytes and neurons. Helps eliminate oxygen starvation of heart cells by improving metabolic processes. Trimetazidine acts as a key active component that preserves the energy metabolism of cells in a state of hypoxia in order to prevent a decrease in the presence of ATP inside cells. Membrane ion channels begin to function normally, cellular homeostasis is maintained, and potassium ions are transported transmembrane.

Widely used as a therapeutic agent for coronary artery disease, as well as for the prevention of angina attacks. Dosage form - pink biconvex tablets, consisting of an active substance and a film shell. Rimecor is taken orally, 2-3 tablets per day. Experts do not recommend taking Rimecor during pregnancy and lactation, as well as for minor patients. Contraindications to taking Rimecor are:

• Parkinson's syndrome;
• severe liver failure;
• kidney damage.

Unlike Preductal, it is contraindicated in patients with lactose intolerance and does not have modified sustained release trimetazidine.

Cheap analogues of Preductal OD (80 mg) and MV (35 mg)

Preductal is an expensive medicine, so patients try to choose the closest analogues of Preductal in terms of action, but at a much lower cost. Currently, no pharmaceutical company produces analogues containing 80 milligrams of trimetazidine, in addition to the drug Preductal. However, it is successfully replaced by other similar long-acting drugs with a lower content of the active component.

Preductal MB (35 mg) is the most popular form of the drug due to the optimal content of trimetazidine in one unit of medication. Due to the popularity of Preductal, the demand for its inexpensive substitutes is growing.

Predisin

Predizin is a representative of the medicinal group of cardiac drugs, the action of which is based on the substance trimetazidine (35 mg). Available in the form of pink, double-layer, round tablets. The drug is taken orally, 2 times a day during meals. Single dose – 1 tablet. The minimum course of treatment is 3 months.

In addition to the active ingredient, the medicine also contains cellulose, starch (corn), magnesium, talc, soy lecithin, polyvinyl alcohol, silicon dioxide and dyes (yellow and red).

Predisin has an identical mechanism of action and scope of application with Preductal, since these drugs are based on the same active ingredient. The medications differ in price category, as well as in the fact that Predisin is contraindicated for people with allergies to soy and/or peanuts.

Antisten

Antisten is a drug that restores metabolic processes in cardiomyocytes and neurons that have been subject to ischemia. The medication also maintains cell homeostasis by ensuring the proper functioning of ion channels. The active ingredient of the drug is trimetazidine (20 or 35 mg). It differs from Preductal OD in price and release form.

The medicine belongs to the therapeutic group of antihypoxic drugs. Available in the form of extended-release tablets for oral administration. Antisten is used for ischemic heart disease and chronic angina, and the medication also has a positive effect on hearing and vision, which began to deteriorate due to ischemia.

Description of the drug

The average daily dose ranges from 40-60 mg, which is divided into several doses. The medication is contraindicated for children, pregnant and breastfeeding women, the elderly, as well as patients with severe concomitant kidney and liver diseases. The drug is not recommended for use in patients with Parkinson's syndrome.

Angiosil

Angiosil has an antihypoxic effect, which is achieved by accelerating metabolic processes and improving the functional activity of cardiomyocytes and brain cells. Angiosil differs from the main medication in price and the presence of lactose in the composition.

Available in the form of round, film-coated tablets containing 0.035 g of trimetazidine. The form-modeling components are: glucose, silicon dioxide, hypromellose, triacetin, macrogol, MCC, as well as yellow and red dye.

Method of administration: orally, 1 tablet 2 times a day. The duration of therapy is determined by the attending physician depending on the patient’s condition. It is used for a long course of treatment of coronary artery disease, as well as as a prophylactic agent for stable angina pectoris. The medication is contraindicated in children, patients with parkinsonism, and people with severe liver and kidney dysfunction.

Trimetazid

Trimetazide is intended for the treatment of cardiac ischemia, chronic angina and dysfunction of the vestibular apparatus, as well as degradation of the lens due to impaired blood circulation. It is an antihypoxic agent and a complete structural analogue of Preductal. Sold in the form of round, red, film-coated tablets for oral administration.

The average therapeutic dose is 60 mg, which is divided into several doses.

The scope of application, list of contraindications and mechanism of action are completely similar to Preductal. These medications differ in the amount of active substance in the dosage form and the form of implementation itself. This analogue is not sold in the Russian Federation.

Trimectal

Trimectal is a medication with antihypoxic and antianginal action, based on trimetazidine dihydrochloride:

• 20 mg of the active substance provides a short effect of the medication (up to 5-7 hours);
• 35 mg – prolonged action. The tablets are film-coated, providing slow release of the active component.

Mechanism of action of the drug

Appearance of dosage forms:

1. Tablets, 20 mg – pink, round, marked with the trade name.
2. Tablets, 35 mg – white or yellow tablets, without inclusions or markings.

The drug helps restore metabolism and adequate transmembrane transmission of potassium and sodium ions in heart and brain cells impaired due to ischemia. By having a positive effect on coronary reserve, the medication stabilizes blood pressure levels and reduces the risk of angina.

Trimectal is used for ischemic heart disease and its consequences (dizziness, visual and hearing impairment), as well as for angina pectoris (to prevent attacks). The drug is contraindicated for the same diseases and conditions as Preductal, except for intolerance to milk sugar, since the second medication does not contain lactose.

Rimecore

Rimecor is a cardioprotector based on trimetazidine (20 mg), which directly affects the metabolism of cardiomyocytes and neurons. Helps eliminate oxygen starvation of heart cells by improving metabolic processes.

Widely used as a therapeutic agent for coronary artery disease, as well as for the prevention of angina attacks. The dosage form is pink biconvex tablets consisting of an active substance and a film shell. Rimecor is taken orally, 2-3 tablets per day.

Experts do not recommend taking Rimecor during pregnancy and lactation, as well as for minor patients. Contraindications to taking Rimecor are:

• Parkinson's syndrome;
• severe liver failure;
• kidney damage.

Unlike Preductal, it is contraindicated in patients with lactose intolerance and does not have modified sustained release trimetazidine.

Precard

Cardioprotective medication with modified release of the active ingredient. This substance has a positive effect on the metabolism and exchange of potassium and sodium in the muscle cells of the heart.

Sales form: tablets for oral administration. One tablet contains 35 mg trimetazidine. Therapeutic dose – 2-3 tablets per day. The course of therapy is determined by a specialist based on data about the disease. The drug is prohibited for use by people with renal dysfunction, liver dysfunction and secondary parkinsonism.

Pharmacological properties of trimetazidine

Precard is effective as:

• prophylactic for angina pectoris;
• the main medicine for ischemic heart disease and all somatic symptoms (dizziness, blurred vision and hearing) that arose against the background of ischemia.

The main difference from Preductal is that Precard is prohibited for people with an allergy to milk sugar.

The best complete analogues

The category of complete analogues of this medicine includes drugs whose composition, release form and dosage are completely identical to Preductal MB.

Carmetadine

Carmetadine is relevant in ophthalmology, otolaryngology and cardiology in order to maintain energy metabolism in cells during hypoxia or ischemia. Thanks to this medication, cellular homeostasis is maintained, and the transmembrane sodium-potassium flow and ion pumps work correctly.

The frequency of angina attacks is reduced, and the doses of nitroglycerin used are also reduced.

This drug is not prescribed in the first days of hospitalization, before hospitalization, and is not suitable for the initial treatment of various manifestations and exacerbations of coronary artery disease.

Blood pressure stabilizes without changes in heart rate. The drug should be taken with meals, one tablet in the morning and evening.

Predisin

Predisin promotes the following changes in the treatment of angina:

• reduction of left ventricular dysfunction;

• reducing the body's need for nitrates;
• reducing the number of angina attacks;
• stabilization of blood pressure fluctuations without affecting heart rate;
• increase in coronary reserve;
• the development of ischemia due to physical activity is delayed from the 15th day of therapy.

Hemodynamics do not change due to cessation of treatment. Contraindications include acute intolerance to the main component or excipient, lactation and pregnancy.

Triductane

The relevance of using the drug is observed when it is necessary to prevent attacks of angina pectoris.

Efficacy has been proven both in complex therapy with antianginal drugs and in monotherapy.

Taking the drug with food helps maximize the therapeutic effect.

Application must be oral; crushing and chewing is prohibited. At a dosage of 35 mg, take the drug twice, 1 tablet at a time. At a dosage of 20 mg - 1 tablet three times a day.

The medicine goes well with calcium antagonists, beta-blockers and nitrates; does not distort the effect of ACE inhibitors, acetylsalicylic acid, lipid-lowering drugs, vitamin K antagonists and heparin.

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Cheap analogues

The table shows a group of drugs whose cost is much lower compared to Preductal. The dosage form and composition are identical.

All of these analogues and the original medication itself are contraindicated during pregnancy and lactation, despite the fact that there is no official data on the negative effects of the active substance on the body during these periods.

When prescribing one of these medications, breastfeeding should be interrupted. The effect on a woman at any stage of pregnancy is unpredictable.

Russian-made analogues

The Russian pharmaceutical market has a number of analogues of Preductal from the Heart, which differ significantly in cost. Structural analogues of Preductal of domestic production include:

1. Triducard.
2. Deprenorm.
3. Trimetazidine.

All medications indicated in the table represent one pharmacological group - antihypoxic agents:

These similar products differ from Preductal only in price, auxiliary components and list of contraindications.