Complex therapy of cardiovascular neurological and ophthalmic diseases in a hospital setting may include metabolic drugs aimed at restoring organ function. Meldonium is an active ingredient in medicines to improve metabolism. Stabilization of metabolism, blood flow in ischemic areas, treatment of neuropsychiatric and withdrawal symptoms - an incomplete list of indications for use. "Cardionat" is a drug with Meldonium, which is widely used in clinical practice.
Instructions for use
Appointment of "Cardionat" in the clinic is due to a moderate therapeutic effect, safety and compatibility with other pharmaceuticals. A complex effect on the main cause of the disorders and the developed symptoms, the prevention of complications are the advantages of the remedy. The drug has the greatest effect on the cardiovascular system with an improvement in general hemodynamics and the state of the microvasculature.
Indications
"Cardionat" is a metabolic agent that is used as an adjunct therapy for various diseases with metabolic disorders in organs and tissues (lack of energy molecules, excess of non-oxidized lipids).
Most often, "Cardionat" is used by cardiologists and neurologists for:
- acute and chronic forms of coronary heart disease (IHD): stable, variant, unstable angina pectoris, acute myocardial infarction, coronary syndrome X;
- chronic circulatory failure - to improve the patient's condition and slow down the progression of pathologies;
- cardiomyopathy - nonspecific changes in the myocardial wall with dysfunction caused by hormonal or metabolic abnormalities;
- cerebral hemodynamic disorders: hemorrhagic or ischemic stroke, discirculatory encephalopathy;
- withdrawal syndrome (withdrawal, "withdrawal") in chronic alcoholism, other forms of addiction.
Preparations based on Meldonium are often used by athletes to improve strength and endurance indicators. Normalization of blood flow in the myocardium, delivery of oxygen to muscle tissue and excretion of metabolic products under conditions of overstrain are the advantages of using "Cardionat".
In ophthalmology, the agent is prescribed for diseases of the retina of ischemic or hemorrhagic genesis:
- thrombosis (embolism) of the central artery;
- post-traumatic, dysmetabolic (for example, diabetes mellitus) hemorrhages;
- retinal vein thrombosis (against the background of systemic pathology of the blood coagulation system);
- retinopathy in case of somatic diseases (hypertension, diabetes mellitus).
Mechanism of action and composition of the drug
The therapeutic effects of "Cardioat" are due to the pleiotropy (multidirectional) action of Meldonium (trimethylhydrazinium monohydrate). The active substance is a synthetic analogue of human gamma-butyrobetaine.
The main biochemical and clinical effects of the agent:
- blockade of the transport of polycyclic lipids across the cell membrane;
- inhibition (slowing down) of the hydroxylase enzyme, which converts butyrobetaine into carnitine, a molecule that accelerates the body's metabolism;
- promotes the release of endogenous vasodilators (substances that expand the lumen of the vessel);
- slows down the process of tissue necrosis in acute myocardial infarction;
- prevents the formation of irreversible changes in ischemic stroke;
- stabilizes blood flow in the brain with discirculatory encephalopathy;
- immunomodulatory effect (improving the reactivity of the cellular and humoral immunity);
- anhypoxic effect (regulation of the supply and consumption of oxygen by tissues);
- improvement of carbohydrate metabolism (promotes the breakdown of glycogen and an increase in blood glucose levels).
The drug is available in two forms: capsules for oral administration and solution (5 ml ampoules) for parenteral administration.
The chemical composition of the agent is presented in the table.
| Ingredients | Capsules | Solution |
|---|---|---|
| Active substance | 250 or 500 mg | 10% - 5 ml (in 1 ampoule 500 mg) |
| Supporting components |
| Water for injection (sterile) |
Internal use of capsules "Cardionat" is characterized by rapid penetration (78%) into the bloodstream from the digestive tract. The peak concentration of the substance is reached after 60-90 minutes. The excretion of inactive metabolites (metabolic products) is carried out by the urinary system.
Contraindications and side effects
Restrictions on taking "Cardionat" are due to the vasodilating effect of the drug, the complex effect on the structures of the cardiovascular, central nervous system and metabolism.
Contraindications to taking the medication:
- a history of allergic reactions to Meldonium dihydrate or excipients;
- pathologies with increased intracranial hypertension: volumetric processes (foreign body, tumor), impaired venous outflow and CSF dynamics (congenital or acquired);
- children's age: clinical studies on the efficacy and safety of the drug in persons under 18 years of age have not been conducted;
- the period of pregnancy and lactation - due to the penetration of metabolites through the placental barrier and into breast milk;
- diseases of the hepatobiliary and urinary system: a violation of the metabolism and excretion of the drug is accompanied by the accumulation of products and the development of drug intoxication.
The selection of an effective dose and the duration of treatment is carried out by the attending physician, who assesses the risk of undesirable consequences.
Method of administration and dosage
Instructions for the use of "Cardionat" highlight the basic rules of admission:
- capsules are taken orally, without chewing;
- drink the drug with plenty of clean water (without gas);
- it is recommended to take the remedy before lunch because of the stimulating effect on the nervous system (taking in the evening is accompanied by the risk of insomnia);
- the parenteral form is intended for intramuscular, retrobulbar or intravenous administration;
- at the stationary stage of treatment of acute disorders, a scheme is used: 10 days - injections, then - capsules.
The recommended doses of the agent, the route of administration and the duration of the course are presented in the table.
| Pathology | Daily dose | Application form | Duration of treatment |
|---|---|---|---|
| Chronic forms of coronary heart disease (angina pectoris, cardiosclerosis) | 0.5-1 g |
| 4 weeks, break 2 months |
| Dysmetabolic cardiomyopathy | 0.25 g | capsules | 12-14 days |
| Cerebrovascular encephalopathy | 2 g |
| 2 months |
| Withdrawal symptoms | 2 g | intramuscular injection | 2 weeks |
| Retinopathy, traumatic or dysmetabolic etiology | 0.05 g | subconjunctival or retrobulbar injections | 10 days |
Complex treatment of somatic diseases implies the appointment of "Cardionat" in combination with other drugs. Cautious use of the drug is recommended with:
- cardiac glycosides ("Korglikon", "Strofantin", "Digoxin");
- blockers of alpha-adrenergic receptors (Prazosin, Clonidine);
- nitrates ("Nitroglycerin", "Isoket").
- blockers of slow calcium channels of the dihydropyridine series ("Felodipine", "Amlodipine", "Nifedipine");
Shared use is often accompanied by tachycardia (heart palpitations) and a drop in blood pressure (hypotension).
The most effective combination of the drug in the treatment of ischemic heart disease was revealed with diuretics, anticoagulants and antiplatelet agents. "Cardionat" does not affect the metabolism of drugs used to control bronchial asthma.
The medication is considered clinically safe with insignificant side effects:
- headache;
- increased excitability of the nervous system, irritability;
- insomnia (reception in the evening).
- tachycardia.
If there are undesirable reactions of the body, a violation of the regime (overdose), it is necessary to stop using the drug and consult a doctor to adjust the dose.
The use of "Cardionat" by athletes is regulated by anti-doping committees, due to the effect of the drug on the indicators of strength and endurance.
Analogues and available substitutes
Meldonium dihydrate is a widespread active substance that is produced by various manufacturers for oral or parenteral use. In the absence of "Cardionat" in pharmacies, it is recommended to take pharmaceutical analogues:
- domestic production: "Meldonium Organic", "Angiocardil", "Idrinol";
- Belarus: Meldonat, Mildrocard, Midoniy Farmland.
- Latvia: Midronat, Vazonat.
- Germany: "Mildrocard N"
In case of intolerance or lack of result, it is allowed to use substitutes - drugs with a similar therapeutic effect, another active substance. In clinical practice, Metamax, Methyldronate, Midralex are used to improve myocardial metabolism, increase muscle and vascular tone.
Conclusions
"Cardionat" is a drug with cardiotonic, metabolic and vasodilating effects, which is used in cardiovascular, neurological practice and sports medicine. The agent is not used for monotherapy of diseases. More often as part of a complex as an element that enhances the effect of other medicines. The main advantages of the drug are availability, safety and the minimum number of contraindications. Before using "Cardionat" it is necessary to consult your doctor.
