Composition, form of production and packaging
Solution for injection is colorless, transparent.
1 ml of 1 amp.
meldonia dihydrate 100 mg 500 mg
Auxiliary substances: water d / u - up to 1 ml.
5 ml - glass ampoules (10) - packings of cellular contour (1) - packs cardboard.
INSTRUCTION FOR THE SPECIALIST.
Description of the drug approved by the manufacturer for the printed edition of 2014.
PHARMACHOLOGIC EFFECT
A drug that improves the metabolism and energy supply of tissues. Meldonium is a structural analogue of gamma-butyrobetaine, it suppresses gamma-butyrobetaine hydroxynase, reduces the synthesis of carnitine, which leads to a decrease in the transport of long chain fatty acids through the mitochondrial membranes; prevents the accumulation in the cells of activated forms of unoxidized fatty acids - derivatives of acylcarnitine and acylcoenzyme A, thus preventing their negative effects.
Under conditions of ischemia, it optimizes the processes of oxygen delivery and its consumption in cells, prevents the violation of ATP transport; simultaneously, it activates glycolysis, which proceeds without additional consumption of oxygen. As a result of the decrease in carnitine concentration, the synthesis of gamma-butyrobetaine is enhanced, which leads to an increase in the content of nitric oxide II and causes endothelium-dependent vasodilation.
The mechanism of action determines the variety of pharmacological effects of meldonia: increasing efficiency, reducing symptoms of mental and physical overstrain, cardioprotective action. In the case of acute ischemic damage, the myocardium slows the formation of the necrotic zone, shortens the rehabilitation period. With heart failure increases myocardial contractility, increases exercise tolerance, reduces the incidence of angina attacks. In acute and chronic ischemic disorders of cerebral circulation improves blood circulation in the ischemic focus, promotes redistribution of blood in favor of the ischemic site. Effective in the case of vascular and dystrophic pathology of the fundus. Characteristic is also a tonic effect on the central nervous system, the elimination of functional disorders of somatic and autonomic nervous systems in chronic alcoholism during the period of withdrawal.
PHARMACOKINETICS
Distribution
With iv administration, bioavailability is 100%. C max in plasma is achieved immediately after administration.
Metabolism and excretion
Metabolized in the body with the formation of two major metabolites, which are excreted by the kidneys.
INDICATIONS
- as a part of combined therapy with IHD (unstable angina pectoris, myocardial infarction, stable angina pectoris), chronic heart failure, cardialgia against dyshormonal myocardial dystrophy;
- in the combined therapy of cerebral circulation disorders (ischemic stroke of the brain, chronic circulatory disorders of the brain);
- as part of combined therapy of vascular pathology of the fundus and retina of various etiologies (hemophthalmia and retinal hemorrhage of various etiologies, thrombosis of the central vein of the retina and its branches, diabetic and hypertensive retinopathy);
- physical overload, postoperative period to accelerate rehabilitation;
- withdrawal alcohol syndrome (in combination with specific therapy).
DOSING MODE
The drug is administered iv, in / m, parabulbar, retrobulbarno, subconjunctivally.
In view of the possible exciting effect, it is recommended to apply the drug in the morning.
In the combination therapy with IHD:
Unstable angina pectoris, myocardial infarction - in / in struyno 500-1000 mg (1-2 ampoules) 1 time / day for the first 3-4 days, then prescribe inside 250 mg 2 times / day for the first 3-4 days, after 2 times a week for 250 mg 3 times / day. The course of treatment is 4-6 weeks.
Stable angina: in / in struyno 500-1000 mg 1 time / day for 3-4 days, after that appoint inward 2 times a week for 250 mg 3 times / day. The course of treatment is 4-6 weeks.
Chronic heart failure (as part of a combination therapy) -injection at 500-1000 mg once or twice a day, or 500 mg once or twice a day, the course of treatment is 10-14 days, then it is administered orally in dose of 500-1000 mg / day. The course of treatment is 4-6 weeks.
Cardialgia against the background of dyshormonal myocardial dystrophy (as part of a combination therapy) -in the 500-1000 mg jet once or twice a day, 500 mg 1-2 times / day for 10-14 days, then it is administered orally 250 mg 2 times / day (morning and evening). The course of treatment is 12 days.
Disorders of cerebral circulation (as part of combination therapy):
Ischemic stroke - IV infusion of 500 mg 1 time / day for 10 days, after that is prescribed by mouth at a dose of 500 mg / day. The course of treatment is 2-3 weeks.
Chronic disorders of cerebral circulation - in / m 500 mg 1 time / day, preferably in the morning. The course of treatment is 2-3 weeks.
Vascular pathology of the fundus and retina of various etiologies (hemophthalmia and retinal haemorrhage of various etiologies, thrombosis of the central vein of the retina and its branches): 0.5 ml injection for injection of 100 mg / ml 1 time / day for 10 days is administered retrobulbarno or subconjunctivalally, with diabetic and hypertensive retinopathy - retrobulbarno.
Physical overload, postoperative period for acceleration of rehabilitation: in / in 500-1000 mg once / day or in / m 500 mg 1-2 times / day. The course of treatment is 10-14 days. If necessary, treatment can be repeated after 2-3 weeks.
An abstinent alcoholic syndrome (as part of a combination of specific therapy): IV 500 mg 2 times / day for 7-10 days.
SIDE EFFECT
Rarely: allergic reactions (skin itching, rashes, redness and swelling of the face), dyspepsia, tachycardia, agitation, lowering blood pressure, insomnia.
CONTRAINDICATIONS
- Increased intracranial pressure (with a violation of venous outflow and brain tumors);
- Pregnancy;
- the period of lactation (breastfeeding);
- children's age till 18 years;
- Hypersensitivity to the components of the drug.
Caution should be used in patients with chronic liver and kidney disease.
PREGNANCY AND LACTATION
Contraindicated in pregnancy and lactation (breastfeeding).
APPLICATION FOR FUNCTIONS OF THE LIVER
With caution in chronic kidney disease.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
With caution in chronic liver disease.
APPLICATION FOR CHILDREN
Contraindicated in children under 18 years.
SPECIAL INSTRUCTIONS
Impact on the ability to drive vehicles and manage mechanisms
There are no data on the adverse effect of the drug on the ability to drive vehicles.
OVERDOSE
Cases of an overdose of Vasomag are not established.
DRUG INTERACTION
Do not use concurrently with other drugs containing meldonium (risk of aggravation of side effects).
Strengthens the coronarodilating and hypotensive drugs, cardiac glycosides.
In view of the possible development of moderate tachycardia and arterial hypotension, caution should be exercised when combined with nitroglycerin, nifedipine, beta-adrenoblockers, antihypertensive drugs and peripheral vasodilators.
You can combine with antianginal drugs, anticoagulants, antiaggregants, antiarrhythmic drugs, diuretics, bronchodilators.
TERMS OF RELEASE FROM PHARMACY
The drug is released by prescription.
TERMS AND CONDITIONS OF STORAGE
The drug should be stored out of reach of children at a temperature of no higher than 25 В° C. Shelf life - 2 years.
