I would like to know how Preductal differs from Mildronate and in terms of application and effectiveness
Answer: Preductal is Trimethazine. You can read a detailed article MILDRONATE AND TRIMETAZIDINE: SIMILARITIES AND DIFFERENCES IN THEIR ACTIONS at this link: http://www.webapteka.ru/drugpub/PUB_3/mildronat3.htm
We also provide you with annotations of these drugs:
MILDRONATE.
Mildronate is an original drug for optimizing the use of oxygen in the heart muscle, brain and other tissues of both sick and healthy people and athletes under conditions of increased physical and emotional stress, as well as during the period of recovery from various diseases.
PHARMACOLOGICAL PROPERTIES:
MILDRONATE is a competitive inhibitor of gamma-butyrobetaine hydroxylase, causes a decrease in the content of free carnitine, and reduces carnitine-dependent oxidation of fatty acids. Improves metabolic processes, increases performance, reduces symptoms of mental and physical stress; has a cardioprotective effect. Regulates cellular immunity.
Eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome. Mildronate promotes the redistribution of blood flow to ischemic areas, in particular in the brain. Has a positive effect on dystrophic changes in retinal vessels.
PHARMACOKINETICS:
After oral administration, the drug is quickly absorbed from the gastrointestinal tract.
Bioavailability is 78%. Maximum plasma concentration is achieved 1-2 hours after administration. In the human body, Mildronate is metabolized and excreted mainly by the kidneys. The half-life is 3-6 hours.
SIDE EFFECTS:
Possible skin itching, dyspepsia, agitation, various changes
There is insufficient data on the use of Mildronate in children, pregnant and lactating women.
INDICATIONS FOR USE AND DOSES.
Both drugs exhibit a therapeutic effect due to their influence on the energy and metabolic processes occurring in cells. But their mechanisms of action are different, so a comparison of Mildronate and Preductal shows that these drugs cannot always provide the same effect in different clinical situations.
Mildronate in clinical practice
Mildronate– a remedy that improves metabolism in cells. The active ingredient is trimethylhydrazinium propionate dihydrate, known as meldonium. The medicine is produced in the form of capsules and solution for injection.
Mildronate is prescribed when the cardiovascular system and brain suffer, it helps improve performance during periods of heavy physical and emotional stress: angina pectoris, chronic heart failure, cardiomyopathy, cardiovascular functional disorders, cerebral ischemia, and recovery from central nervous system lesions.
Under the influence of meldonium, cellular metabolic processes and resistance to hypoxia improve, in response, endurance increases and recovery from overload is accelerated. Therefore, this substance has become widespread in sports medicine. In sports it can also be taken as a doping.
Mildronate has several complete analogues containing meldonium in the same doses: Cardionat, Metamax, Vasopro. They can replace other meldonium drugs.
Purpose of the Preductal
The drug contains the active component trimetazidine, which is an antihypoxant that normalizes energy processes in cells at the level necessary for sufficient metabolism in conditions of lack of oxygen. Preductal is characterized by an antianginal effect necessary for the treatment of coronary heart disease. It is prescribed by cardiologists to reduce heart pain.
The medicine is available in the form of trimetazidine slow-release tablets called Preductal MV (or MR - depending on the place of manufacture), one dose contains 35 mg of the active substance. The tablets should be taken 2 times a day for a long course - up to three months.
Comparison of drugs
When choosing drugs with similar effects, you need to focus primarily on data on the effectiveness of the drugs. When figuring out which drug is better and whether Preductal and Mildronate can be taken together, you need to take into account that both drugs are used as adjuncts in complex treatment regimens. Therefore, it is necessary to take into account the breadth of use of the drug, safety and additional effects from its use.
Indications for use
Today, the number of indications for prescribing Preductal has narrowed; according to the instructions, it is recommended as an auxiliary symptomatic remedy for the treatment of angina pectoris. It is not used to relieve acute heart attacks.
Meldonium is used not only in cardiology and for a wider range of indications, which indicates the versatility and versatility of the drug’s action. A comparison of the instructions clearly shows that, unlike trimetazidime, meldonium has a wide range of uses, and in some cases the patient can decide to use it independently - after all, the drug in capsules is dispensed without a doctor’s prescription.
Comparison of the spectrum of drug use, application effects and existing restrictions shows more benefits when using Mildronate.
Possible interactions and differences in effects
The instructions for the medications do not indicate the inadmissibility of joint administration of Preductal and Mildronate and do not indicate the possibility of unwanted interactions. On the contrary, the annotation for Mildronate states that meldonium can be used together with various antianginal drugs in the treatment of angina pectoris.
Usually, the prescription of auxiliary drugs with a similar effect is not practiced, but taking into account compatibility, in some cases you can take Preductal together with Mildronate. More often this is due to the presence of several diseases that require the use of Mildronate, regardless of the use of Preductal.
However, given that Preductal should be used only as prescribed by a doctor, the decision on their joint use should also be made by a specialist.
Terms of sale and storage
Sales in pharmacies - according to prescriptions (in Latin), which indicate the INN of the drug (in Latin).
Storage does not require special conditions. Temperature regime - up to 25⁰С, dry, ventilated place, to which children do not have access.
Rimekor - an inexpensive analogue
In the list of cheap substitutes for Preductal, it is worth noting Rimecor. This is another trimetazidine-based drug that improves myocardial metabolism under ischemic conditions. The medicine is produced by Nizhpharm JSC, the price is 215 rubles/30 capsules.
The drug gives a pronounced antianginal effect, and also has a positive effect on the organs of hearing and vision.
Rimecor helps reduce the frequency and dose of nitrates (the latter are usually prescribed for severe cardiac ischemia).
Within just 2 weeks of treatment, the product improves exercise tolerance and stops fluctuations in blood pressure, stabilizing it. Other effects of Rimecor therapy:
Due to the peculiarities of its action, Rimecor is prescribed not only for ischemic heart disease. It copes better with cochleovestibular disorders than other drugs; it is indicated for chorioretinal disorders if they have vascular causes. Side effects are rare, sometimes a feeling of palpitations and headache may occur. Some people experience allergic skin reactions.
Varieties
Currently, two types of the same medicine are produced - these are “Preductal” and “Preductal MV”. They have the same therapeutic effect, since they contain one active substance - trimetazidine. So which of these drugs has received the most praise? “Preductal MV” is considered by some to be more effective, since it was created using a special technology, due to which its main active ingredient is released more slowly, and therefore has a longer lasting effect on the body. There are no other differences between these two drugs. Everyone can choose the one that, for subjective reasons, seems better to them.
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:
- Triducard.
- Deprenorm.
- Trimetazidine.
All medications indicated in the table represent one pharmacological group - antihypoxic agents:
| Triducard | Restores metabolic processes in cardiomyocytes and neurons. Maintains homeostasis and adequate functioning of ion channels. Reduces the manifestation of acidosis inside cardiomyocytes. Increases exercise tolerance by increasing cardiac reserve. | For treatment:
For the prevention of attacks of chronic angina. | Pregnancy. Lactation. Age up to 18 years. Liver failure of moderate severity. Kidney dysfunction. Parkinson's disease. Allergy to the composition. |
| Deprenorm MV | |||
| Trimetazidine |
These similar products differ from Preductal only in price, auxiliary components and list of contraindications.
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The best complete analogues
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:
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.
Price
You can buy Preductal MV tablets in Moscow for 780 rubles. This is the price of 60 units of the drug. In Kyiv, the product is sold for 155 hryvnia. In Minsk, pharmacies sell the medicine for 23-39 bel. rubles Preductal MR tablets in Kazakhstan cost 4,250 tenge.
Side effects
For most patients, the drug "Preductal", the instructions and reviews indicate this, is well tolerated. However, in rare cases the following side effects are observed:
- gastralgia;
- dyspeptic disorders;
- pain impulses in various parts of the head;
- muscle tone disorders;
- intense itching and hyperemia of the dermis;
- persistent dizziness;
- hives;
- hypotension.
After stopping the medication, all of the above effects disappear on their own. If an overdose is suspected, it is recommended to consult a specialist and carry out symptomatic measures.
pharmachologic effect
Preductal belongs to the pharmacological group of anti-ischemic and cardioprotective drugs. The effects of the drug are due to the specific mechanism of action of Trimetazidine on the cells of the cardiovascular system.
The main directions of pharmacological action are as follows:
The drug is excreted by the kidneys.
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.
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.
Appearance of dosage forms:
- Tablets, 20 mg – pink, round, marked with the trade name.
- 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.
- 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 established 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.
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Deprenorm and its properties
Among Russian analogues, Deprenorm MV is no less popular at a price of 280 rubles/30 tablets. It is better than the agents listed above because it has modified release properties. This antihypoxant, antianginal drug is produced by CanonPharma.
The drug should be taken only with meals, its daily dose is 2 tablets in 2 doses.
The manufacturer indicates that even if the dosage is exceeded, the medicine will not cause severe side effects.
Overdose phenomena do not occur or are limited to increased heart rate, but you still cannot allow taking a large number of tablets! Indications for treatment are similar:
Trimetazidine in the composition has high bioavailability and acts for a long time. It is thanks to the slow release that the drug works more effectively. But this form of administration has a disadvantage for people with kidney pathologies: their half-life increases, therefore there are restrictions on the treatment behavior. If the glomerular filtration rate is less than 15 ml/minute, you cannot take the product!
Heart diseases are quite common today. Deterioration in health may be a signal of a serious illness. The heart is one of the most important human organs. If pathology develops, other functional systems also suffer. In the field of cardiology, the drugs “Preductal MV” and “Preductal” are widely used. Instructions for use, price and reviews - all this information can be found below. It is worth considering that the medication can only be prescribed by an appropriate specialist.
Compound
The drug helps improve metabolism in the ischemic area of the heart muscle. The medicine is produced in the form of pink, film-coated tablets. The active ingredient is trimetazidine dihydrochloride. One dose contains 35 mg of the main substance.
Additional components are povidone, calcium hydrogen phosphate, magnesium stearate, macrogol, silicon. The medicine is produced in blisters, 30 pieces each. Preductal MV is very popular among specialists. Reviews from cardiologists show that the medication is a real salvation for people who have problems related to the cardiovascular system.
Action
The medicine prevents a decrease in ATP inside cells by maintaining energy balance. This is especially important when they experience oxygen starvation. The drug normalizes the functioning of membrane ion channels, transmembrane transport of potassium and sodium ions is performed, and cellular homeostasis is preserved. The main substance of the tablet slows down the absorption of fatty acids, which leads to the oxidation of glucose. Thus, the drug restores and protects the myocardium from ischemia. The following positive actions are also worth noting:
- neurosensory organs are supported during ischemia;
- the energy metabolism of the heart muscle increases;
- the area of myocardial damage after an ischemic process decreases;
- There is no direct effect on hemodynamic parameters.
For angina pectoris, Preductal MV is also used. Reviews from cardiologists show that the drug is quite effective. The medicine is safe for patients with stable angina, both in individual treatment and in complex therapy. It is no coincidence that Preductal MV is increasingly being used in cardiology departments. The medication in a hospital setting brings patients’ well-being to a normal state.
Indications and contraindications
The drug is indicated for long-term use. It also serves as a high-quality prevention of angina attacks. The product is used singly or as part of complex therapy.
The medicine should not be prescribed for severe signs of renal pathology, as well as for Parkinson's disease. The tablets have not yet been fully studied and are therefore not recommended for use by children under 18 years of age. Also, the product is not used in case of hypersensitivity to the components of the drug. Treatment for liver failure should be prescribed with caution. It is not recommended to use the medicine in patients over 75 years of age. You should study the instructions before using Preductal MV tablets. Reviews from cardiologists show that side effects are more often associated with improper use of the medication.
Dosage
In most cases, you need to take one tablet twice a day. It is recommended to use the product in the morning and evening with meals. The maximum permissible dose of the drug should not exceed 70 mg. The course of treatment depends on the severity of the disease, as well as the individual characteristics of the patient. Only a doctor can determine the daily norm.
The tablet is taken whole, without chewing. You need to drink plenty of water. Patients with renal failure are advised to take no more than one tablet per day. It is advisable to carry out therapy in the morning during breakfast.
To date, the symptoms of an overdose of Preductal MV tablets have not been thoroughly studied. Reviews from cardiologists show that the drug is well tolerated by patients and is not addictive.
Side effects
During treatment with tablets, unpleasant symptoms such as nausea, vomiting, epigastric pain, and flatulence may develop. Dizziness, staggering when walking, and symptoms of parkinsonism may also occur. When taking the drug, there is an increased heartbeat, a noticeable decrease in blood pressure, tremors, and sleep disturbances.
As a rule, any unpleasant symptoms are observed only at the initial stage of treatment. Within a week, the patient's condition improves significantly.
The tablets should be stored in a dry place, out of reach of children. In pharmacies, the drug is dispensed according to a doctor's prescription. The medication is not prescribed during pregnancy and lactation. It is necessary to carefully study the instructions if Preductal is prescribed. Discussing therapy with a cardiologist is also the key to successful treatment. You should not use medications on your own.
Preductal MV tablets. Reviews from specialists and patients about the drug
In most cases, cardiologists safely prescribe treatment with this drug. Experts believe that Preductal works better and more effectively as part of complex therapy. It is not used to provide first aid during an attack of angina. This is due to the fact that the tablets have a cumulative effect. A positive result is not immediately noticeable.
The drug is mainly prescribed for patients. The price of the drug pleases patients. The cost of the tablets is about 800 rubles. Many cardiac drugs will require much more significant costs. Despite the positive aspects, you should not use the medicine without the advice of a specialist. A professional cardiologist will be able to advise which drug is better to use in treatment, Mildronate or Preductal.
Despite the fact that Mildronate and Preductal stimulate metabolic (absorption of proteins, fats, carbohydrates) and energy (processes that result in the release of energy) processes in cells, the drugs differ in the active substance and indications for use. In different clinical situations, Preductal and Mildronate may exhibit different effects.
What is the difference between Preductal and Mildronate?
1) Main active ingredient:
Preductal – trimedazine
Mildronate – meldonium
2) Preductal has a fairly narrow range of applications; according to the instructions, it is used as an additional adjuvant in the treatment of angina pectoris (pain in the heart during stressful situations) and in the treatment of coronary heart disease (impaired blood supply to the heart).
Mildronate is used not only in cardiology, but also in sports, which indicates its versatility. Mildronate is used in sports to increase endurance and protect the heart under high loads, in everyday life with increased fatigue, chronic fatigue, excessive mental and physical stress.
Which is better Mildronate or Preductal?
Preductal is recommended only for use in patients with coronary heart disease. In addition, Mildronate is used in the treatment of a number of other diseases associated with circulatory disorders (cerebral, cardiovascular), and is used in sports to increase endurance and protect the heart from overload. For cardiac ischemia, Mildronate is more effective, as it has a wider spectrum of action that improves the psychological and physical state of the body.
Preductal MV or Mildronate, expert opinion
Today there are not many medical observations in which the effectiveness of Mildronate and Trimetazidine (Preductal) would be directly compared. But in one of the first clinical studies in which a comparative assessment of the effectiveness of 12 different antihypoxants (drugs that protect the heart from oxygen starvation) was carried out during the active treatment of 620 patients with acute myocardial infarction, Mildronate was found to be more effective compared to Trimetazidine (Preductal) ( Semigolovsky N.I., 1998).
Which is better in practice?
Based on the above facts, we can conclude that Mildronate is a more effective and better drug than Preductal.
Compatibility of Preductal and Mildronate
The instructions for both drugs indicate that the drugs can be used with antianginal drugs (drugs that increase oxygen access to cells), which are Mildronate and Preductal. Accordingly, it is possible to combine these medications.
Is it possible to take Preductal and Mildronate together?
As already written in the previous paragraph, you can take Mildronate and Preductal together, the drugs are well compatible, but you should know that Preductal is available in pharmacies with a prescription. In this regard, taking Mildronate and Preductal at the same time is possible only after the doctor’s permission.
Price comparison Mildronate and Preductal
Mildronate:
Mildronate capsules 500 mg, 60 pcs. – 627 rubles.
Mildronate capsules 250 mg, 40 pcs. - 300 rubles.
Mildronate ampoules 10%, 5 ml, 10 pcs. – 374 rubles.
Preductal:
Preductal MV tablets 35 mg, 60 pcs. – 1000 rubles.
Cost of admission course
Mildronate
Average cost of a course of Mildronate in capsules:
0.5 – 1 gram per day from 4 to 6 weeks – 627 rubles.
Average cost of a course of Mildronate in ampoules:
5 ml per day (1 ampoule) for 5 weeks – 1500 rubles.
Preductal
One - two tablets (35 milligrams each), two - three times a day, from one to three months - 2000 rubles.
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