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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › OTHER CARDIAC PREPARATIONS › Other cardiac preparations
meldonium
C01EB22
Forms & Strengths
- Capsules: 250 mg, 500 mg
- Solution for injection: 100 mg/mL (5 mL ampoules)
Adult Dosing
- Ischemia and chronic heart failure: 500 mg to 1000 mg orally once daily, or 500 mg IV once daily for 4-6 weeks
- Cerebrovascular disorders: 500 mg IV once daily for 10 days, followed by 500 mg orally once daily for 2-3 weeks
- Athletic performance/endurance (off-label): 500 mg to 1000 mg orally twice daily prior to competition
Pediatric Dosing
- Safety and efficacy in pediatric patients (< 18 years) have not been established
Indications
- Adjunctive treatment in stable angina pectoris
- Chronic heart failure (NYHA Class I-III)
- Acute and chronic ischemic cerebrovascular disorders
- Decreased work capacity and physical overexertion
Mechanism of Action
- Inhibits gamma-butyrobetaine hydroxylase, reducing the biosynthesis of carnitine
- Lowers carnitine-dependent transport of long-chain fatty acids across mitochondrial membranes
- Shifts cellular energy metabolism from fatty acid oxidation to glucose oxidation, which requires less oxygen
Contraindications
- Hypersensitivity to meldonium or its excipients
- Severe hepatic impairment
- Severe renal impairment
- Intracranial pressure elevation, intracranial tumors, and venous outflow obstruction
- Pregnancy and lactation
Adverse Reactions
- Tachycardia
- Blood pressure fluctuations (hypotension or hypertension)
- Psychomotor agitation
- Dyspepsia and gastrointestinal discomfort
- Allergic reactions (rash, pruritus, urticaria, angioedema)
Drug Interactions
- May enhance the effects of coronary vasodilators (e.g., nitroglycerin)
- May enhance the effects of antihypertensive agents, leading to increased risk of hypotension
- May interact with antiarrhythmic drugs
- Concurrent use with other metabolic modulators may alter therapeutic efficacy
Curated Content: Needs Vetting Before Put to Clinical Use