Mildronate® [Meldonium]

Mildronate is a trade name of Meldonium. It is used to treat several cardiovascular and cerebrovascular conditions as well as fatigue. Mildronate also used as a performance-enhancing drug, althought there is few evidence that it can significantly improve physical performance.

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Available since: 2019-09-19

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Meldonium (primarily known as Mildronate) is a cardiac medication, also widely known as performance-enhancing drug.

Mildronate approved for medical use in Russia and some eastern European countries to treat ischemic heart disease, cerebrovascular disorders, mental and physical exhaustion, and alcohol withdrawal syndrome.

The main mechanism of action of Mildronate is inhibition of carnitine biosynthesis. Inhibition of carnitine biosynthesis, transport, and reabsorption prevents the accumulation of cytotoxic intermediate products of fatty acid oxidation in ischemic tissues. Moreover, cell metabolism shifts to increased glucose consumption, which is beneficial in ischemic conditions, since the oxidation of glucose requires less oxygen.

Besides having cardioprotective effect, Mildronate has neuroprotective action as suggested by several studies [neuroprotective]. In clinical trials on patients suffering from cerebrovascular disorders, the drug shown to improve patients’ overall mood and condition, and relieve chronic fatigue and nausea.

You can read more about Meldonium and its mechanism of action here.

Meldonium is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Idrinol	Sotex	Russia	capsules
Idrinol	Sotex	Russia	solution
Idrinol	Sotex	Russia	ampoules
Cardionate	Nizhpharm	Russia	solution
Cardionate	Nizhpharm	Russia	capsules
Mildronate®	Grindex	Latvia	capsules
Mildronate®	Grindex	Latvia	ampoules

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Dosage and Administration

For oral use.

Disruption of cerebral circulation: in the acute phase of cerebrovascular disease, an injection form of the drug is used for 10 days, after which it is administered orally at 500 mg / day. The course of treatment is 4-6 weeks.

Chronic disorders of cerebral circulation: 500 mg / day, preferably in the morning. The course of treatment is 4-6 weeks. Repeated courses - 2-3 times a year.

In cardiology in complex therapy: 0.5–1 g per day. The course of treatment is 4-6 weeks.

Cardialgia on the background of dyshormonal dystrophy of the myocardium: 250 mg 2 times a day (morning and evening). The course of treatment is 12 days.

Mental and physical overloads (including athletes): adults, 250 mg 4 times a day. The course of treatment is 10-14 days. If necessary, repeat the treatment after 2–3 weeks.

At 0.5–1 g 2 times a day before training; preferably in the morning. The duration of the course during the preparatory period is 14–21 days, and during the competition period it is 10–14 days.

Abstinence alcohol syndrome: 500 mg 4 times a day. The course of treatment is 7-10 days.

Adverse reactions

Since the cardiovascular system: rarely - tachycardia, decrease or increase in blood pressure.

From the side of the central nervous system: rarely - psychomotor agitation.

On the part of the digestive system: rarely - dyspeptic disorders.

Allergic reactions: rarely - pruritus, rash, hyperemia of the skin, angioedema; very rarely - eosinophilia.

Other: very rarely - general weakness.

Contraindications

hypersensitivity;

increased intracranial pressure (in violation of the venous outflow and intracranial tumors);

pregnancy;

lactation period;

children's age up to 18 years.

With care: diseases of the liver and / or kidneys.

Drug interactions

Can be combined with antianginal agents, anticoagulants, antiplatelet agents, antiarrhythmic agents, diuretics, bronchodilators.

Enhances the action of cardiac glycosides.

Due to the possible development of moderate tachycardia and hypotension, caution should be exercised in combination with nitroglycerin, nifedipine, alpha-blockers, antihypertensives and peripheral vasodilators.

Pregnancy and Lactation

The safety of the drug during pregnancy is not proven. In order to avoid possible adverse effects on the fetus should not be prescribed the drug during pregnancy.

It is not known whether the drug is excreted in breast milk. If necessary, the use of the drug Idrinol during lactation breastfeeding should be discontinued.