Triduktan MB

General characteristics. Structure:

Active agent: trimetazidina of dihydrochloride of 35 mg;

Excipients: Mannitolum, cellulose microcrystallic, wax montanic, magnesium stearate, methacrylate ammonium copolymer (type B), a covering for drawing a cover of Opadry II Pink.

Pharmacological properties:

Pharmacodynamics. Trimetazidin acts on cellular level, normalizes power balance in cells at a hypoxia, preventing decrease in intracellular content of ATP. Supports a cellular homeostasis, providing normal functioning of ion channels of a membrane. Interfering with metabolic processes and optimizing use of oxygen at myocardium ischemia, drug keeps energy potential, interfering with decrease in power reserves of ATP in myocardium cells. Optimization of energy balance in heart by means of drug is result of oppression of oxidation of fatty acids at the expense of the selection ingibition long-chain 3 SOA ketoacyl thiomanholes (3-KAT). It leads to strengthening of oxidation of glucose and to the improved glycolysis combination to glucose oxidation that provides protection of heart at ischemia. At the same time триметазидин increases exchange of phospholipids and their inclusion in a membrane, providing thereby protection of a membrane against damages.
Anti-anginal properties of a trimetazidin can be explained with transferring of energy balance from oxidation of fatty acids on glucose oxidation.  Trimetazidin supports power metabolism of heart and neurosensory bodies during the periods of episodes of ischemia; reduces the size of intracellular acidosis and extent of changes in the transmembrane ion flux arising at ischemia; reduces the level of migration and infiltration of polynuclear neutrophils of an ischemic and reperfuzirovanny myocardium; at the same time does not influence a hemodynamics, and also interferes with adverse influence of free radicals thanks to decrease in intensity of peroxide oxidation of lipids and increase in capacity of system of antioxidant protection.
At patients with stenocardia drug increases a coronary reserve, raises
tolerance to exercise stresses, without influencing ChSS, reduces the frequency of attacks of stenocardia; against the background of treatment by drug the use of nitrates considerably decreases.
In otorhinolaryngological practice drug improves portability of a message -
bulyarny tests, increases auditory acuity, eliminates a sonitus, dizzinesses at Menyer's disease and dizzinesses of a vascular origin.
Patients with chorioretinal vascular disorders have drug sposobst-
vut to recovery of functional activity of a retina that is shown by normalization of indicators of the electroretinogram.

Pharmacokinetics. Drug is completely and quickly absorbed from a digestive tract. The maximum concentration in a blood plasma is reached in 5 hours. Bioavailability – more than 85%. Stable concentration is established approximately in 60 hours after repeated receptions and remains such throughout the entire period of treatment. About 16% contact proteins of in vitro. It is well distributed in fabrics. The volume of distribution makes 4,8 l/kg.
It is removed in an invariable look, preferential by kidneys. The elimination half-life – about 7 hours for healthy people and 12 hours for persons, is more senior than 65 years. The renal clearance of means directly correlates with clearance of creatinine, the hepatic clearance decreases with age.

Indications to use:

Cardiology: long therapy of an ischemic heart disease – prevention of attacks of stenocardia in monotherapy or in a combination with anti-anginal drugs.
Otorhinolaryngology: cochlear and vestibular disturbances of an ischemic origin, such as faints, sonitus, hearing impairment.
Ophthalmology: the chorioretinal frustration caused by ischemia.

Route of administration and doses:

Triduktan MV appoint inside on 1 tablet, 2 times a day, in the morning and in the evening, during food, to wash down drug with a glass of water. Duration of treatment is determined by the doctor. If necessary the scheme of treatment can be revised in 3 months.

Features of use:

Drug is intended for basic therapy of stenocardia and is not applied to stopping of attacks of stenocardia.
In case of need Triduktan's uses MV in the period of a lactation, stop breastfeeding as ability of drug to get into breast milk is not studied.
Triduktan MV do not recommend to patients with a renal failure, with clearance of creatinine less than 15 ml/min., and also to patients with the expressed abnormal liver functions.
Experience of use of drug by children is absent.
Use of drug for treatment of patients of advanced age does not demand change of a dose.
Drug does not influence ability to manage transport and mechanical means.
  The special structure of a tablet (matrix) is developed for achievement of the modified (slowed-down) release of active substance. The active ingredient providing therapeutic effect of Triduktan of MV is gradually released from a tablet at its passing through digestive tract. However in certain cases the frame structure of a matrix can leave a human body in the form of a tablet. This feature of influence does not render on therapeutic properties of drug.

Side effects:

Triduktan of MV is well had.
However at use of drug such side reactions are possible:

- from a digestive tract – pain in epigastric area of a stomach, dyspepsia, diarrhea, nausea and vomiting;
- from a nervous system – a headache, dizziness;
- very seldom – emergence of extrapyramidal symptoms (a tremor, rigidity, an akineziya, unstable equilibrium), in particular at patients with  Parkinson's disease is possible;
- vascular disorders – occasionally: orthostatic hypotension, face reddening;
- from integuments and hypodermic fabrics – rashes, an itch, urticaria;
- the general disturbances – an adynamy.

Interaction with other medicines:

About interaction of drug with other medicines it was not reported.

It is possible to appoint drug in a combination with heparin, kaltsipariny, antagonists of vitamin K, peroral lipidosnizhayushchy drugs, acetylsalicylic acid, β-blockers, antagonists of calcium, digitalis drugs, other anti-anginal drugs.

Contraindications:

The increased individual sensitivity to drug. Triduktan of MV is not recommended to appoint during pregnancy and feeding a breast (due to the lack of clinical data on safety of use).

Overdose:

About cases of overdose of Triduktan of MV it was not reported. If necessary – symptomatic therapy.

Storage conditions:

Store in the place, unavailable to children, at a temperature of 15 - 25 ºС.

Issue conditions:

According to the recipe

Packaging:

On 10 tablets, coated, in a blister strip packaging; on 3 or 6 blister strip packagings in a cardboard pack.
On 20 tablets, coated, in a blister strip packaging; on 1 or 3 blister strip packagings in a cardboard pack.