Post-traumatic rehabilitation, recovery from cardiovascular accidents or long-term abdominal surgery involves the use of metabolic drugs. The action of the latter is aimed at stabilizing the indicators of acid-base and water-electrolyte balance after sudden disturbances. Normalization of the transport of nutrients and rational use of energy are the main goals pursued by the drugs of the group. "Mildronate" is a drug that is widely used in cardiology, the clinic of nervous diseases and sports to achieve the best results without harm to the body.
Instructions for use of the drug
The use of "Mildronat" for the accelerated recovery of patients after injuries, major operations and cardiovascular accidents is due to the effect of the drug on metabolic processes in the cells of the body. Safety, convenient use and effectiveness after short courses are the main reasons for prescribing the remedy.
Uncontrolled use by patients (more often by athletes) often leads to side effects, therefore, Mildronat pharmacies are dispensed only with a doctor's prescription.
Indications: for what and from what is it prescribed?
Instructions for the use of "Mildronat" highlight a list of pathologies for which the effectiveness of the drug has been proven and approved by recommendations in clinical trials.
The conditions in which the use of the medication is recommended are presented in the table.
| Affected organ | Indications for the appointment of "Mildronat" |
|---|---|
| Heart |
|
| Brain |
|
| Respiratory system |
|
| Eyes |
|
Common indications include:
- withdrawal symptoms ("withdrawal") and hangovers in patients with alcoholism;
- decreased exercise tolerance, chronic fatigue and drowsiness;
- decreased memory and performance, accompanied by headaches, tinnitus;
- in children - cardialgic variant of vegetative-vascular dystonia.
In addition, Mildronat is often used among athletes (boxing, powerlifting and others) to achieve high results in competitions, improve endurance and strength.
The composition of the drug and the mechanism of action
"Mildronate" (international non-proprietary name - Meldonium) belongs to a group of metabolic agents that affect metabolic processes and are widely used in cardiology and neurology.
Mechanisms for the implementation of the drug's effects:
- Inhibition of the oxidation process of fatty acids (FA) in cells and their transport across membranes. An excess of FA contributes to the development of "oxygen starvation" due to the increased consumption of gas for the utilization of metabolic products.
- Stimulation of the synthesis of nitric oxide by the endothelium of the vascular wall, which causes an expansion of the lumen and reduces the signs of cardiac ischemia (clinically manifested by the elimination of chest pain).
- Decrease in the total resistance of peripheral vessels, reducing blood pressure indicators (relevant for hypertension).
- Decrease in oxygen consumption due to the transition to more economical metabolic pathways (aerobic glycolysis).
- Prevention of the development of sclerosis after acute ischemia of the myocardium or brain tissue.
- Slowing down the process of platelet aggregation (blood clot formation).
The drug is available in different forms for ease of use at the outpatient and hospital stages of treatment:
- capsules (250; 500 mg);
- oral syrup;
- 10% solution in ampoules for intravenous, intramuscular and parabulbar injections.
Method of administration and dosage
The choice of the regimen, the optimal dosage and duration of therapy with Mildronate depends on:
- the underlying disease (duration of the course, severity);
- concomitant pathologies;
- age, gender, weight of the patient.
In clinical practice, doctors often use stepwise therapy for acute conditions: transferring patients from parenteral use (injection) to oral administration while maintaining the effective dose.
Oral intake
Meldonium capsules and syrup are intended for internal use. Key recommendations:
- in the first half of the day (taking in the afternoon is accompanied by the risk of insomnia);
- do not chew the capsules;
- drink plenty of water;
- regardless of food intake.
Doses of the drug for various indications for the use of "Mildronat" are presented in the table.
| Disease | Application scheme |
|---|---|
| IHD, CHF | 1 capsule (500 mg) 2 times a day for 2 weeks |
| ONMK | 500 mg 2 times a day for 1-1.5 months |
| Dysmetabolic cardiomyopathy | 1 capsule (500 mg) once a day - 10-12 days |
| Bronchial asthma | 250 mg once a day - 1 month |
| Encephalopathy | 500 mg / day 1-1.5 months |
| Chronic alcoholism | 500 mg 4 times a day for 1-2 weeks |
| Decreased exercise tolerance | 1 capsule (250 mg) 2-3 times a day for 2 weeks |
Dose adjustment is carried out depending on the patient's sensitivity to the drug. Oral use is most often prescribed for non-severe patients for outpatient treatment.
Intramuscular and intravenous administration options
"Mildronate" for parenteral use is produced in the form of a solution for injection (or droppers), which is prescribed to patients at the stage of inpatient treatment in the complex therapy of various diseases. The method of administration and the duration of the course are selected by specialists depending on the course of the pathology.
The treatment regimen with "Mildronate" for parenteral use is presented in the table.
| Diseases | Dosage regimen |
|---|---|
| Acute conditions: myocardial infarction (MI), stroke | 500-1000 mg / day for 10-14 days, followed by switching to the oral form |
| Cerebrovascular insufficiency | 500 mg / day - 14 days |
| CHF | 500-1000 mg / day - 1-1.5 months |
| Alcoholism and other forms of addiction | 500-1000 mg / female - 7-10 days |
| Asthenovegetative syndrome after trauma, major operations | 500 mg / day - 2 weeks |
| Post-traumatic or dysmetabolic retinopathies | 50 mg / day for 10 days parabulbar (in the lower eyelid) or subconjunctivally. |
The prophylactic dose is prescribed to patients with a high risk of recurrent stroke or heart attack (assessed on special scales) and is half of the therapeutic dose.
Contraindications for use
Instructions for the use of "Mildronat" defines a number of conditions in which the use of the product is prohibited or restricted.
Contraindications to the use of the medication:
- a history of allergic reactions to the use of Meldonium or other components of the drug;
- the period of pregnancy (active metabolites of the drug penetrate the blood-placental barrier into the child's body);
- women during breastfeeding: clinical studies have not confirmed the penetration of the drug into milk, but it is not recommended to use it during lactation;
- oncological pathologies;
- children's age (for capsules and oral administration - 18 years, for syrup - 12 years);
- intracranial hypertension of various etiologies (malignant neoplasms, trauma, congenital cysts and cerebrospinal fluid dynamics).
- renal or hepatic failure: impaired metabolism and excretion of the drug contributes to the development of overdose and toxic effects.
Cautious use is recommended in patients with epilepsy due to the pronounced stimulating effect of the drug. If there are contraindications to "Mildronat", it is necessary to use funds with similar properties.
Side effects
Metabolic drugs, to which Mildronate belongs, are distinguished by their safety and a small number of undesirable consequences after administration.
Side effects from consumption:
- allergic reactions (itchy rash, dermatitis, swelling and redness of tissues in the area of administration);
- headaches, dizziness (more often in hypertensive patients due to increased intracranial pressure);
- increased excitability, irritability, sleep disorders (more often - insomnia);
- rhythm disturbances: atrial fibrillation, sinus tachycardia with a feeling of interruptions in the work of the heart;
- lability of blood pressure ("jumps" of high and low rates);
- dyspeptic disorders: abdominal discomfort, nausea, metallic taste in the mouth, diarrhea;
- muscle weakness, back pain;
- with parenteral administration: a feeling of heat or cold, tissue edema, pain at the injection site.
In laboratory studies, changes in the ratio of lipids, an increase in the level of C-reactive protein (a marker of inflammation) and eosinophils are determined.
"Mildronate" is one of the few drugs that are used in sports without affecting potency in men, unlike hormonal anabolic steroids.
Overdose symptoms and methods of dealing with them
Exceeding the dose of the drug, impaired excretion (due to liver or kidney pathology) contribute to the accumulation of active metabolites of Mildronate and the development of intoxication.
Signs of an overdose with a remedy:
- headache;
- general weakness;
- vertigo (dizziness);
- noise in ears;
- loss of consciousness (rare);
- sudden hypotension (drop in blood pressure);
- tachycardia (heart palpitations).
There is no specific antidote; detoxification (infusion) therapy with monitoring of the functional state of the excretory system is recommended. The effectiveness of the use of extracorporeal methods (for example, hemodialysis) has not been confirmed.
Alcohol compatibility
The appointment of "Mildronat" is carried out by therapists strictly according to the indications and the dispensing of the drug in the pharmacy according to prescription forms. Caution and control of use is due to the pronounced effect of the active ingredient on the cardiovascular and central nervous system.
The results of studies on the compatibility of Mildronat with alcoholic beverages:
- Meldonium enhances the depressing effect of ethanol on the centers in the brain;
- the enzyme system of the liver is activated, which contributes to the early elimination of the drug from the body.
The drug is used to relieve abstinence in patients with alcohol dependence, so drinking alcohol negates the effect of therapy.
"Mildronat" for a long time without a doctor's prescription: is it dangerous or not?
Metabolic drugs are one of the components of the complex therapy of neurological and cardiovascular diseases (sometimes in the process of recovery in oncology, surgery and traumatology). The peculiarity of the use of drugs in this group is a wide range of dose-dependent effects on various organs of the body, therefore, a specific amount is selected for each patient in a short course (maximum - 6 weeks).
Uncontrolled use of "Mildronat" is accompanied by the risk of:
- the development of arrhythmias;
- the formation of cardiomyopathy (due to the restructuring of the heart muscle);
- drop in blood pressure;
- violations of the excretory function of the liver and kidneys.
If necessary, take the product for a long time (according to indications), it is recommended to take 30-day breaks every 2 weeks.
Use by athletes
The widespread use of "Mildronat" by athletes is due to:
- increased endurance due to the transfer of muscle fibers to more economical ways of spending energy;
- improving metabolism and uniform formation of the muscle frame (important for bodybuilders);
- accelerating recovery from physical exertion or injury.
The scheme of application - 500-1000 mg / day before training during the 21 days of the preparatory period and 10-14 days during the competition.
In 2016, the International Anti-Doping Committee banned the intake of Mildronat by athletes.
Analogues and substitutes
In case of intolerance or other contraindications to taking Mildronate, it is recommended to select a substitute depending on the desired effect.
The most used analogues of the drug are presented in the table.
| Group | Trade names |
|---|---|
| Nootropics (drugs for normalizing metabolic processes in the brain, improving cognitive abilities) |
|
| Metabolic agents with a predominant effect on the cardiovascular system |
|
| Vitamins for pathologies of the nervous system |
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| Angioprotectors prescribed in neurological practice |
|
The selection of an effective substitute is carried out by the attending physician, taking into account the concomitant diseases of the person.
"Mildronate" is used among athletes as a doping to activate the body, stimulate activity and increase muscle mass. For the same purpose, steroids are used - artificial hormones of the adrenal cortex, which accelerate the process of gaining weight due to the muscles (Danabol, Boldabol, Deca, Andropen).
Conclusions
Mildronate is a widely prescribed agent in the complex therapy of cardiovascular and neurological pathologies. The effectiveness of the drug is explained by the effect on the metabolism in cardiomyocytes, rehabilitation after "catastrophes" and prevention of complications. The use of "Mildronat" by athletes improves endurance and strength indicators, the speed of recovery without the side effects characteristic of anabolic steroids. The drug should be used only after consulting a doctor, according to the annotation and the regimen.
