What is Meldonium Dihydrate Mildronat®?
Meldonium (INN; trade name Mildronate, among others) is a limited-market pharmaceutical, developed in 1970 by Ivars Kalviņš at the USSR Latvia Institute of Organic Synthesis, and is now manufactured by the Latvian pharmaceutical company Grindeks and several generic manufacturers. It is primarily distributed in Eastern European countries as an anti-ischemia medication.
Since 1 January 2016, it has been on the World Anti-Doping Agency (WADA) list of substances banned from use by athletes. Meldonium can be used as a metabolic modulator, changing how some hormones accelerate or slow down enzymatic reactions in the body. However, there are debates over its use as an athletic performance enhancer. Some athletes are known to have used meldonium before it was banned, most notably Maria Sharapova. Nevertheless, many athletes have been suspended or disqualified officially in relation to this drug.
Mildronat is prescribed in complex therapy: with ischemic heart disease (including angina pectoris, myocardial infarction); with reduced performance or physical overstrain (for example, y athletes); with chronic heart failure; with dyshormonal cardiomyopathy; with acute/chronic disorders of cerebral blood supply (stroke, cerebrovascular insufficiency); with thrombosis of the central retinal vein, its branches; with hemophthalmos (vitreous hemorrhage); with retinal hemorrhage; with retinopathy (diabetic, hypertensive); with withdrawal syndrome (in the complex treatment of alcoholism).
Mildronat composition active substance: meldonium phosphate;
Excipients: mannitol (E 421), povidone, potato starch, silicon dioxide, microcrystalline cellulose, magnesium stearate.
It is a remedy that improves metabolic processes. The drug restores the balance between the need for oxygen and its delivery to the cells and eliminates the accumulated toxic products of cellular metabolism. Also has a tonic effect. In the case of heart failure, it increases the contractility of the myocardium, reduces the incidence of angina attacks, and increases exercise tolerance. In the case of cerebral circulation ischemic disorders, it improves blood flow in the ischemic focus, and promotes blood redistribution in favor of the area suffering from a lack of oxygen. The drug helps to eliminate functional disorders of the nervous system.
Mildronat is a metabolic drug. It is a structural analog of a substance present in every human cell – gamma-butyrobetaine. Under conditions of increased stress, the drug restores the balance between the need for oxygen and its delivery to cells, and also eliminates the accumulation of toxic products of cellular metabolism, protecting them from damage. Also, the medicine has a tonic effect. When applied, the human body acquires the ability to quickly restore energy reserves, to withstand heavy loads. Due to these properties, this drug can be used to treat disorders of cardiovascular activity, blood supply to the brain, as well as to increase mental and physical performance. Due to a decrease in the concentration of carnitine, gamma-butyrobetaine, which has vasodilating properties, is intensively produced. In the case of acute oxygen deficiency of the heart muscle (ischemic myocardial damage), the drug slows down the formation of a zone of tissue death, shortens the rehabilitation period. In the case of heart failure, the drug increases the contractility of the myocardium, reduces the incidence of angina (angina pectoris) attacks, and increases exercise tolerance. In acute/chronic disorders (ischemic) of cerebral circulation, it improves blood flow in the ischemic focus, contributes to the redistribution of blood volume in favor of the area suffering from a lack of oxygen. The drug is effective for vascular (vascular) and degenerative changes in the fundus. It relieves functional disorders of the nervous system in people with chronic alcoholism with withdrawal symptoms (disorders caused by alcohol withdrawal).
Mildronat is prescribed in complex therapy:
- with ischemic heart disease (including angina pectoris, and myocardial infarction);
- with reduced performance or physical overstrain (for example, y athletes);
- with chronic heart failure;
- with dyshormonal cardiomyopathy;
- with acute/chronic disorders of cerebral blood supply (stroke, cerebrovascular insufficiency);
- with thrombosis of the central retinal vein, and its branches;
- with hemophthalmos (vitreous hemorrhage);
- with retinal hemorrhage;
- with retinopathy (diabetic, hypertensive);
- with withdrawal syndrome (in the complex treatment of alcoholism).
In the complex therapy of the following diseases:
- diseases of the heart and vascular system: stable exertional angina, chronic heart failure (NYHA I – IIІ functional class), cardiomyopathy, functional disorders of the heart and vascular system;
- acute and chronic ischemic disorders of cerebral circulation;
- decreased performance, physical and psycho-emotional overstrain;
- during the recovery period after cerebrovascular disorders, head trauma, and encephalitis.
Mildronat GX should not be prescribed:
- with intolerance to the components;
- with increased intracranial pressure (with impaired venous outflow, and the growth of intracranial tumors).
How to use Mildronat® Meldonium
- For cardiovascular diseases, 500–1000 mg/day is indicated. The standard course is 4-6 weeks.
- With cardialgia (pain in the heart) against the background of dyshormonal myocardial dystrophy – 250 mg x 2 times/day. Standard course – 12 days.
- In acute disorders of cerebral circulation, 500–1000 mg/day is indicated. The general course is 4-6 weeks. For chronic – 500 mg/day, course – 4-6 weeks.
- Repeated courses (2-3 times a year) are allowed after consultation with a doctor.
- For mental/physical overload, 250 mg x 4 times/day is indicated, and the course of treatment is 10-14 days. If necessary, repeat the treatment in 2–3 weeks.
- Athletes are prescribed 500-1000 mg x 2 times/day by mouth before training. The duration of taking Mildronate in the preparatory period is 14-21 days, in the competitive period – 10-14 days.
- In chronic alcoholism, 500 mg x 4 times/day is prescribed, and the course of treatment is 7-10 days.
- In view of the stimulating effect, the medicine is recommended to be taken in the morning.
Intravenously. The use of Mildronat does not require any special preparation before administration.
Due to the possible stimulating effect, the drug is recommended to be used in the morning.
- The dose is 500-1000 mg (5-10 ml) in a vein, it is administered at one time or divided into two doses. The duration of treatment is usually 10-14 days, after which treatment is continued with an oral dosage form.
- The duration of the course of treatment is 4-6 weeks. The course of treatment can be repeated 2-3 times a year.
Overdose: Overdose cases are not known. The drug is low-toxic and does not cause adverse reactions dangerous to human health, even in case of an overdose.
Side effects: Possible tachycardia, agitation, fluctuations in blood pressure, allergic reactions (exanthema, angioedema, urticaria, shock), and dyspeptic symptoms.