Preductal OD capsules with prolonged release 80 mg 30 pcs. in Moscow

Compatibility of Preductal and alcohol

? Medicinal and toxic substances enter the body through the gastrointestinal tract. Absorption of the drug is reduced due to the effect of ethanol on the mucous membrane. Dyspeptic disorders develop, causing dehydration of the body. Only a small concentration of trimetazidine enters the systemic circulation.

Both components reduce blood pressure. The patient develops hypotension, accompanied by loss of strength and fainting. Tides are constantly occurring. Due to the effect on the brain, the patient begins to experience insomnia, trembling and numbness of the limbs.

The drug causes stress on the liver. If you add the effect of ethanol, hepatitis is formed. A person develops jaundice, the liver is gradually replaced by connective fibers, and the detoxification function is reduced or absent.

Comparison of addiction between Preductal MV and Preductal OD

Like safety, addiction also involves many factors that must be considered when evaluating a drug.

So, the totality of the values ​​of such parameters as “syndrome o” in Preductal MV is quite similar to the similar values ​​in Preductal OD. Withdrawal syndrome is a pathological condition that occurs after the cessation of intake of addictive or dependent substances into the body. And resistance is understood as initial immunity to a drug; in this it differs from addiction, when immunity to a drug develops over a certain period of time. The presence of resistance can only be stated if an attempt has been made to increase the dose of the drug to the maximum possible. At the same time, Preductal MV has a fairly low “syndrome” value, just like Preductal OD.

Brief characteristics of the drug

This medicine is based on trimetazidine dihydrochloride.

It has the following actions:

• normalization of energy metabolism in myocardial and brain cells;
• elimination of ischemia, angina, hypertension;
• reduction of hypertrophied myocardial tissue under high load on the heart.

The medicine is absorbed in the intestines and distributed throughout the tissues of the heart, liver, kidneys, and central nervous system. Excretion is carried out by the kidneys.

The drug is indicated for use in coronary heart disease, accompanied by complications such as angina, heart attack, and arterial hypertension.

Side effects:

• dyspepsia, abdominal pain, impaired stool formation;
• neuralgia, sleep pathologies;
• arrhythmia, tachycardia, pressure drops, excessive hypotension;
• hepatitis;
• pancytopenia;
• local, systemic allergic reactions.

Contraindications for use:

• increased sensitivity to components;
• Parkinson's disease, parkinsonian syndrome, difficulty moving due to extrapyramidal disorders;
• renal, liver failure, hepatitis;
• intolerance caused by genetic mutations;
• minor age due to insufficient research for this category of patients.

There are no data on the use of trimetazidine for pregnant and lactating women. But your doctor may prescribe it if the effect outweighs the risk of side effects. But a woman should be aware of the risk to the fetus.

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Preductal OD (caps.prolon.high.80mg No.60)

A country

Russia
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.

Compound

For 1 caps.# trimetazidine dihydrochloride (in granules) 80 mg. #1 extended-release hard capsule contains: trimetazidine dihydrochloride film-coated granules: 144.85 mg. Excipients: sugar spheres** (710-850 microns) - 36.68 mg, hypromellose - 6.4 mg. Film shell composition: ethylcellulose - 8 mg, tributylacetyl citrate - 1.2 mg, talc - 12 mg. Composition for dusting granules: talc - 0.43 mg, magnesium stearate - 0.14 mg. Hard gelatin capsule No. 2 with a white body and an orange-red cap, with a white logo printed on the cap*: 61,000 mg. Composition of the capsule body: titanium dioxide (E171) - 0.732 mg, gelatin*** - 35.868 mg. Composition of the capsule cap: titanium dioxide (E171) - 0.122 mg, red iron oxide (E172) - 0.366 mg, gelatin*** - 23.912 mg. 9 pcs. - blisters (3) - cardboard packs. 10 pieces. - blisters (3) - cardboard packs. 10 pieces. - blisters (6) - cardboard packs. * The logo and inscription on the capsule are printed with white ink containing shellac, titanium dioxide, simethicone, propylene glycol, ammonium hydroxide. The total amount of ink per capsule is approximately 0.15 mg. ** Composition of sugar spheres: sucrose - no more than 92% (in terms of dry matter), corn starch. May also contain starch hydrolysis products and dyes. *** Contains an average of 14.5% water (mass loss on drying).

pharmachologic effect

Mechanism of action. Trimetazidine prevents a decrease in intracellular adenosine triphosphate (ATP) concentration by maintaining the energy metabolism of cells in a state of hypoxia. Thus, the drug ensures the normal functioning of membrane ion channels, transmembrane transport of potassium and sodium ions and the preservation of cellular homeostasis. Trimetazidine inhibits the oxidation of fatty acids due to the selective inhibition of the enzyme 3-ketoacyl-CoA thiolase (3-CAT) of the mitochondrial long-chain isoform of fatty acids, which leads to increased oxidation of glucose and acceleration of glycolysis with oxidation of glucose, which determines the protection of the myocardium from ischemia. The switch of energy metabolism from fatty acid oxidation to glucose oxidation underlies the pharmacological properties of trimetazidine. Pharmacodynamic properties - supports the energy metabolism of the heart and neurosensory tissues during ischemia; — reduces the severity of intracellular acidosis and changes in the transmembrane ion flow that occur during ischemia; - reduces the level of migration and infiltration of polynuclear neutrophils in ischemic and reperfused heart tissues; - reduces the size of myocardial damage; - does not have a direct effect on hemodynamic parameters. In patients with angina pectoris, trimetazidine increases coronary reserve, thereby slowing the onset of exercise-induced ischemia, starting from the 15th day of therapy; limits fluctuations in blood pressure caused by physical activity without significant changes in heart rate; significantly reduces the frequency of angina attacks and the need for short-acting nitroglycerin; improves contractile function of the left ventricle in patients with ischemic dysfunction. The results of clinical studies have confirmed the effectiveness and safety of trimetazidine in patients with stable angina, both in monotherapy and as part of combination therapy when the effect of other antianginal drugs is insufficient. In a study of 426 patients with stable angina, the addition of trimetazidine (60 mg/day) to metoprolol 100 mg/day (50 mg twice daily) for 12 weeks statistically significantly improved exercise test scores and clinical symptoms compared with placebo: total duration of stress tests was +20.1 s, p=0.023, total time of exercise +0.54 METs, p=0.001, time to development of ST segment depression by 1 mm +33.4 s, p=0.003, time to development of angina attack + 33.9 s, p In a study of 223 patients with stable angina, the addition of trimetazidine 35 mg twice daily to atenolol 50 mg once daily for 8 weeks increased the time to development of ischemic depression ST segment by 1 mm (+34.4 s, p = 0.03) during stress tests in a subgroup of patients (n = 173), compared with placebo, 12 hours after taking the drug. This difference was also shown for the time of development of angina attacks (p=0.049). There were no significant differences between groups for other secondary endpoints (total exercise test duration, total exercise time, and clinical endpoints). In a study of 1962 patients with stable angina, trimetazidine at two doses (70 mg/day and 140 mg/day) was added to atenolol 50 mg/day versus placebo. In the general population, including patients with both asymptomatic and symptomatic angina, trimetazidine did not demonstrate benefit on ergometric (total duration of exercise tests, time to ischemic ST-segment depression of 1 mm, and time to onset of angina) and clinical endpoints. . However, in a post-hoc analysis of a subgroup of patients with symptomatic angina (n=1574), trimetazidine (140 mg) significantly improved total exercise test time (+23.8 s versus +13.1 s for placebo; p=0.001) and time to angina onset (+46.3 s versus +32.5 for placebo; p=0.005).

Indications for use

- long-term therapy of coronary artery disease: prevention of attacks of stable angina as part of mono- or combination therapy.

Mode of application

The drug is taken orally, 1 capsule 1 time/day, in the morning, during breakfast. Capsules should be taken whole, without chewing, with water. Evaluation of the benefit of treatment can be carried out after 3 months of taking the drug. Taking Preductal® OD should be stopped if there is no improvement within this time. The duration of treatment is determined by the doctor. Special groups of patients. Patients with renal failure. In patients with moderate renal failure (creatinine clearance 30-60 ml/min) (see sections “Pharmacokinetics” and “Special instructions”), a dose reduction is recommended, i.e. 1 tablet containing 35 mg trimetazidine per day. Patients with impaired liver function. Caution should be exercised when treating patients with severe hepatic impairment (see section "Special Instructions") due to the fact that the available data are limited and do not allow us to completely exclude the lack of influence of liver dysfunction on the metabolism of trimetazidine. Patients over 75 years of age. In patients over 75 years of age, increased exposure to trimetazidine may occur due to age-related decline in renal function (see Pharmacokinetics section). In patients with moderate renal failure (creatinine clearance 30-60 ml/min), a dose reduction is recommended, i.e. 1 tablet containing 35 mg trimetazidine per day. Dose selection in patients over 75 years of age should be done with caution (see section "Special Instructions"). Patients under 18 years of age. The safety and effectiveness of trimetazidine in patients under 18 years of age have not been established. No data available.

Interaction

Not observed. The patient must inform the doctor about all medications taken.

Side effect

Adverse reactions, defined as adverse events at least possibly related to treatment with trimetazidine, are given in the following gradation: very often (? 1/10); often (?1/100, From the central nervous system: often - dizziness, headache; unspecified frequency - symptoms of parkinsonism (tremor, akinesia, increased tone), "unsteadiness" of gait, restless legs syndrome, other associated motor disorders, usually reversible after cessation of therapy. Sleep disturbances (insomnia, drowsiness). From the cardiovascular system: rarely - palpitations, extrasystole, tachycardia, marked decrease in blood pressure, orthostatic hypotension, which may be accompanied by general weakness, dizziness or loss of balance, especially with simultaneous use of antihypertensive drugs, "flushes" of blood to the skin of the face. From the digestive system: often - abdominal pain, diarrhea, dyspepsia, nausea, vomiting; unspecified frequency - constipation. From the liver and biliary tract: unspecified frequency - hepatitis. With from the hematopoietic and lymphatic systems: unspecified frequency - agranulocytosis, thrombocytopenia, thrombocytopenic purpura. From the skin and subcutaneous fat: often - skin rash, itching, urticaria; unspecified frequency - acute generalized exanthematous pustulosis, Quincke's edema. General disorders: often - asthenia.

Contraindications

- hypersensitivity to any of the components of the drug; - Parkinson's disease, symptoms of parkinsonism, tremor, restless legs syndrome and other associated movement disorders; - severe renal failure (creatinine clearance less than 30 ml/min); - fructose/sucrose intolerance, the presence of glucose-galactose malabsorption syndrome, sucrase-isomaltase deficiency and other enzymopathies associated with intolerance to sucrose, which is part of the drug; - due to the lack of sufficient clinical data, the drug is not recommended for patients under 18 years of age; The drug should be prescribed with caution to patients with severe liver failure (from 10 to 15 points on the Child-Pugh scale), moderate renal failure (creatinine clearance 30-60 ml/min), patients over 75 years of age (see sections "Regimen" dosing" and "Special instructions").

Overdose

There is only very limited information on trimetazidine overdose. In case of overdose, symptomatic therapy should be carried out.

special instructions

Preductal® OD is not intended for the relief of angina attacks and is not indicated for the initial course of treatment of unstable angina or myocardial infarction in the prehospital stage or in the first days of hospitalization. If an attack of angina occurs, treatment (drug therapy or revascularization procedure) should be reviewed and adapted. Preductal® OD can cause or worsen symptoms of parkinsonism (tremor, akinesia, increased tone), so patients should be regularly monitored, especially the elderly. In doubtful cases, patients should be referred to a neurologist for appropriate examination. If movement disorders appear, such as symptoms of parkinsonism, restless legs syndrome, tremor, unsteadiness of gait, Preductal® OD should be permanently discontinued. Such cases are rare and symptoms usually resolve after discontinuation of therapy: in most patients, within 4 months after discontinuation of the drug. If symptoms of parkinsonism persist more than 4 months after discontinuation of the drug, you should consult a neurologist. There may be cases of falls associated with instability in the Romberg position and “wobbly” gait or a pronounced decrease in blood pressure, especially in patients taking antihypertensive drugs (see section “Side effects”). Preductal® OD should be prescribed with caution to patients in whom its exposure may increase: - with moderate renal failure (see sections “Pharmacological action” and “Dosage regimen”); - in elderly patients over 75 years of age (see section "Dosage regimen"). The drug contains sucrose, so the drug is not recommended for patients with fructose intolerance, glucose-galactose malabsorption syndrome and sucrase-isomaltase deficiency. Influence on the ability to drive vehicles and operate machinery. During clinical studies, no effect of trimetazidine on hemodynamic parameters was revealed, however, during the period of post-registration use, cases of dizziness and drowsiness were observed (see section “Side effects”). These symptoms can affect the ability to drive vehicles and perform work that requires increased speed of physical and mental reactions.

Dispensing conditions in pharmacies

On prescription

Use of the drug for alcoholism

Chronic dependence on alcoholic beverages causes hepatitis, liver failure, nephritis, glomerulonephritis. These conditions are contraindications for taking capsules. The active component increases the damage, and the organ gradually stops working.

People with alcoholism experience brain damage. Delusions, hallucinations, insomnia, neurological disorders, and delirium tremens develop. The condition is aggravated by the influence of the drug. It penetrates the central nervous system and causes extrapyramidal pathologies.

The therapeutic effect is eliminated, since the load on the cardiovascular system is high. Severe hypotension appears, causing fatigue, weakness, drowsiness, and loss of consciousness. Pressure changes lead to heart attack and angina.

Consequences of drinking alcohol

If you combine a substance with alcohol, the following consequences arise:

• nausea, vomiting, heartburn, flatulence, constipation, diarrhea;
• trembling of arms and legs, unsteady gait, insomnia, difficulty coordinating in space, headache;
• increased heart rate, extrasystoles, hypotension;
• increased bleeding of wounds due to a decrease in the number of platelets;
• inflammation of the liver parenchyma, cirrhosis, liver failure;
• kidney inflammation, worsening diuresis;
• local allergies in the form of rash, itching, redness;
• systemic allergies in the form of angioedema, urticaria, which is dangerous to health and life;
• exhaustion of the body.

Serious consequences appear when a person drinks alcohol together with capsules. If the rule is violated once, dyspepsia and inflammation of internal organs will occur.

Organs affected by the toxin

The combined use of pharmacological agents and alcohol has a toxic effect on the internal organs and environments of the body. Alcohol, entering into a chemical reaction with a medicine, leads to poisoning, disrupts physiological processes, enhances or weakens the healing properties of drugs.

The liver suffers more than other organs. She gets hit twice. Many medications have a side effect - hepatotoxicity, destroy cells, and disrupt the physiology of the organ. In the liver, alcohol breaks down to ethanal, a substance 20-30 times more toxic than ethanol, which causes the death of hepatocytes.

Dangerous groups of drugs for the organ in combination with alcohol:

• anti-inflammatory;
• hormonal;
• antibacterial;
• antifungal;
• glucose control agents for diabetes mellitus;
• anti-tuberculosis;
• cytostatics (chemotherapy drugs);
• tranquilizers (anti-epileptic, psychotropic).

In second place among the internal organs exposed to the harmful effects of alcohol together with medications are the heart and vascular system. Strong drinks during drug therapy constrict blood vessels and increase blood pressure. The simultaneous intake of alcohol and chemical substances leads to failure of the myocardium and increases the risk of developing an attack of angina pectoris and a heart attack.

A mixture of ethanol and pharmaceuticals disrupts the quality of the blood and reduces clotting. This is dangerous due to internal bleeding and strokes.

Comparison of safety of Preductal MV and Preductal OD

The safety of a drug includes many factors.

At the same time, for Preductal OD it is higher than for Preductal MV. It is important where the drug is metabolized: drugs are excreted from the body either unchanged or in the form of products of their biochemical transformations. Metabolism occurs spontaneously, but most often involves major organs such as the liver, kidneys, lungs, skin, brain and others. When assessing the metabolism of Preductal OD, as well as Preductal MV, we look at which organ is the metabolizing organ and how critical the effect on it is.

The risk-benefit ratio is when the prescription of a drug is undesirable, but justified under certain conditions and circumstances, with the obligatory observance of caution in use. At the same time, Preductal OD has fewer risks when used than Preductal MB.

Also, when calculating safety, it is taken into account whether only allergic reactions occur or possible dysfunction of the main organs. In other matters, as well as the reversibility of the consequences of using Preductal OD and Preductal MV.

Rules for taking medications and alcohol

Drinking alcohol during treatment minimizes the clinical effect of therapy and creates a risk of developing complications of the disease.

If this cannot be avoided, follow the rules of behavior that will reduce the occurrence of negative consequences:

1. Do not drink strong drinks (vodka, cognac, whiskey), choose dry wine (100-150 ml), beer (no more than 300 ml). Don't drink alcohol on an empty stomach.
2. The interval between taking the medicine and alcohol should be at least 2 hours.
3. To reduce the toxic effect, take medications that protect the liver (hepatoprotectors), pancreas (pancreatin), and stomach (antacids ─ Rennie, Almagel).

If a person takes antiviral medications for colds, anti-inflammatory drugs, alcohol in moderation does not pose a threat to the body.

Alcoholic drinks during treatment are strictly contraindicated in cases of liver cirrhosis, severe infectious diseases, and during a course of chemotherapy.

Medicines, alcohol and chronic diseases

If a person has chronic diseases, simultaneous use of alcohol and medications is potentially dangerous for the functioning of vital organs. Since patients systematically take prescribed medications, the influence of alcohol can lead to negative consequences.

People with chronic heart disease (angina pectoris, heart defects) develop arrhythmias of varying severity. Heart attacks with severe pain syndrome develop, which is not relieved by Nitroglycerin, and the risk of developing myocardial infarction increases significantly.

In case of chronic liver diseases (viral hepatitis, hepatosis), alcohol during treatment can become a trigger in the development of cirrhosis and hepatocellular carcinoma (cancer).

Drinking alcohol during cirrhosis leads to the following consequences:

• bleeding into the abdominal cavity;
• liver decomposition, infection, peritonitis;
• hepatic coma;
• death.

If a person is on long-term treatment with sedatives, psychotropic drugs, tranquilizers, he is contraindicated in drinking alcohol. This leads to severe depression and the appearance of obsessive states (hallucinations, phobias). Suicidal feelings develop. Such a patient needs constant monitoring and assistance from a psychiatrist.

Comparison of ease of use of Preductal MV and Preductal OD

This includes dose selection taking into account various conditions and frequency of doses. At the same time, it is important not to forget about the release form of the drug; it is also important to take it into account when making an assessment.

The ease of use of Preductal MV is approximately the same as Preductal OD. However, they are not convenient enough to use.

The drug ratings were compiled by experienced pharmacists who studied international research. The report is generated automatically.

Last update date: 2020-12-13 10:32:32

The most dangerous combinations and consequences

The combination of alcohol and chemical-based drugs can lead to serious disorders in the body, and in some cases to fatal consequences.

List of medications and their side effects in combination with alcohol:

What to choose: Preductal MV or Preductal OD?

Preductal MV or Preductal OD are drugs used to eliminate ischemia as part of complex therapy. They have both the same properties and some differences.

Preductal MV or Preductal OD are drugs used to eliminate ischemia as part of complex therapy.