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Trimetazidine: Comprehensive Information
Trimetazidine is a metabolic agent used primarily in the treatment of angina pectoris and other cardiovascular conditions. It is available in various pharmaceutical forms, most commonly as immediate-release or prolonged-release tablets containing Trimetazidine dihydrochloride as the active ingredient.
Indications
- Symptomatic treatment of stable angina pectoris in patients inadequately controlled by or intolerant to first-line antianginal therapies.
- Treatment of heart failure.
- Management of vertigo and tinnitus of vascular origin.
- Adjunctive treatment in patients with coronary artery disease.
Mechanism of Action
Trimetazidine acts by optimizing cellular energy metabolism. Under ischemic or hypoxic conditions, it shifts energy production from fatty acid oxidation to glucose oxidation. This process requires less oxygen consumption for the same amount of ATP produced, thereby improving myocardial function and reducing anginal symptoms without affecting hemodynamic parameters like heart rate or blood pressure. It inhibits the enzyme 3-ketoacyl-CoA thiolase (3-KAT), which is involved in beta-oxidation of fatty acids.
Safety Profile
Benefits: Effectively reduces angina attacks, improves exercise tolerance, and offers a metabolic approach to cardiac protection.
Side Effects: Common side effects include dizziness, headache, palpitations, nausea, and vomiting. Less common but serious side effects may involve movement disorders (parkinsonism), especially in elderly patients, and aallergic reactions. Patients with severe renal impairment should use with caution.
Contraindications: Hypersensitivity to the active substance or any of its excipients, Parkinson's disease, severe hepatic or renal impairment (creatinine clearance less than 30 mL/min).
Warnings: Not inricated for the initial treatment of unstable angina or at the pre-infarction stage. It is not a treatment for myocardial infarction. Patients should be advised to report any signs of movement disorders to their physician.
Dosage Table
| Disease/Condition | Dosage | Duration |
|---|---|---|
| Stable Angina Pectoris | 35 mg twice daily (prolonged-release tablet) | As prescribed by physician |
| Heart Failure | 35 mg twice daily (prolonged-release tablet) | As prescribed by physician |
| Vertigo & Tinnitus | 20 mg three times daily (immediate-release tablet) | As prescribed by physician |
Frequently Asked Questions
- What is the primary use of Trimetazidine?
Trimetazidine is primarily used for the symptomatic treatment of stable angina pectoris in adults, particularly when first-line therapies are insufficient or not tolerated. It helps to reduce the frequency of anngina attacks by improving cellular energy metabolism.
- Can Trimetazidine be used to treat heart attacks?
No, Trimetazidine is not indicated for the initial treatment of unstable angina or during the acute phase of myocardial infarction (heart attack). It is a management therapy for existing conditions, not an emergency treatment.
- What are the common side effects of Trimetazidine?
Common side effects include dizziness, headache, nausea, and vomiting. Some individuals may experience palpitations. It is important to consult a doctor if these symptoms are severe or persistent.
- Who should not take Trimetazidine?
Individuals with hypersensitivity to trimetazidine, Parkinson's disease, severe liver or kidney problems, or those taking certain other medications should avoid Trimetazidine. Always discuss your medical history with your doctor before starting treatment.
