Mildronate® (Meldonium) 500 mg, 60 capsules
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Mildronate® – a general tonic OTC drug, made in Europe. Mildronate® helps with decreased performance, physical and psycho-emotional overstrain by normalizing energy metabolism in the cells of the body.
Indications for use Mildronate
Mildronate® applies to adults after 18 years at a reduced efficiency, physical and psycho-emotional strain, during the recovery period
How does Mildronate work
In high load conditions Mildronate® increases the capacity of the body to carry oxygen, reduce the amount of oxygen that is needed to keep tissues alive by changing the way the muscle cells metabolize substances in the blood. As a result of its use, the body acquires the ability to withstand stress and quickly restore energy reserves. Due to these properties, Mildronate® is used to increase physical and mental performance.
- Has a tonic effect on the body
- Increases mental performance
- Increases exercise tolerance
- Positively affects the recovery process of physical and intellectual functions during the recovery period
How to use Mildronate?
Daily dose 500 mg, 1 capsule per day
The course of treatment is 4-6 weeks
The course of treatment can be repeated 2-3 times a year.
Recommended to be taken in the morning
– Angina pectoris and myocardial infarction (as part of complex therapy)
– Chronic heart failure (in complex treatment)
– Acute violation of cerebral circulation (in complex therapy)
– Hemophthalmos and retinal hemorrhages of various etiologies, thrombosis of the central retinal vein and its branches, retinopathy of various etiologies (diabetic, hypertensive)
– Mental and physical overload, including among athletes
– Chronic alcoholism withdrawal syndrome (in combination with specific alcoholism therapy)
Cases of overdose with Mildronate® are unknown, the drug is low-toxic. In case of overdose – symptomatic treatment.
Meldonium (Mildronate®) is a structural analogue of the carnitine precursor gamma butyrobetaine (hereinafter GBB), in which one hydrogen atom is replaced by a nitrogen atom. Its effect on the body can be explained in two ways.
1) Effect on carnitine synthesis
As a result of inhibition of the activity of butyrobetaine hydroxylase, meldonium reduces the biosynthesis of carnitine and thus inhibits the transport of long-chain fatty acids across the cell membrane, preventing the accumulation of activated derivatives of unoxidized fatty acids in cells – acylcarnitine and acylcoenzyme A, which have pronounced detergent properties. Under conditions of ischemia, Mildronate® restores the balance between oxygen delivery and consumption in cells, eliminates disturbances in ATP transport, while simultaneously activating an alternative energy source – glycolysis, which is carried out without additional oxygen consumption.
With increased stress, as a result of intense energy consumption in the cells of a healthy body, a temporary decrease in the content of fatty acids occurs. This, in turn, stimulates the metabolic process of fatty acids, mainly the synthesis of carnitine. Biosynthesis of carnitine is regulated by its level in blood plasma and stress, but does not depend on the concentration of carnitine precursors in the cell.
Since meldonium inhibits the conversion of GBB into carnitine, this leads to a decrease in the level of carnitine in the blood, which in turn activates the synthesis of the precursor of carnitine, that is, GBB. With a decrease in the concentration of meldonium, the process of carnitine biosynthesis is restored and the concentration of fatty acids in the cell is normalized.
Thus, cells undergo regular training, which contributes to their survival under conditions of increased stress, in which the content of fatty acids in them regularly decreases, and when the load decreases, the content of fatty acids is quickly restored. Under conditions of real overload, cells “trained” with Mildronate® survive under conditions when “untrained” cells die.
2) Function of the mediator of the hypothetical GBD-ergic system
It is hypothesized that a previously undescribed system of transmission of nerve impulses exists in the body – the GBB-ergic system, which ensures the transmission of nerve impulses to somatic cells. The mediator of this system is the direct precursor of carnitine, the GBB ester. As a result of the action of esterase, this mediator donates an electron to the cell, thus transferring an electrical impulse, and itself turns into GBB.
GBB synthesis is possible in any somatic cell of the body. Its speed is regulated by the intensity of the stimulus and energy expenditure, which in turn depend on the concentration of carnitine. Therefore, with a decrease in the concentration of carnitine, GBB synthesis is stimulated.
Thus, an economical chain of reactions exists in the body that provides an adequate response to irritation or stress: it begins with receiving a signal from nerve fibers (in the form of an electron), followed by the synthesis of GBB and its ester, which, in turn, carries the signal on the membranes of somatic cells. Somatic cells in response to stimulation synthesize new molecules, ensuring the propagation of the signal.
After that, the hydrolyzed form of GBB, with the participation of active transport, enters the liver, kidneys and testes, where it is converted into carnitine. As mentioned earlier, meldonium is a structural analogue of GBB, in which one hydrogen atom is replaced by a nitrogen atom. Since meldonium can be exposed to GBB esterase, it can act as a hypothetical “mediator”.
However, GBB hydroxylase does not act on meldonium and therefore, when it is introduced into the body, the concentration of carnitine does not increase, but decreases. Due to the fact that meldonium itself acts as a “mediator” of stress, and also increases the content of GBB, it promotes the development of the body’s response. As a result, the overall metabolic activity also increases in other systems, for example, the central nervous system (CNS).
Strengthens the effect of coronary dilating agents, some antihypertensive drugs, cardiac glycosides.
It can be combined with antianginal drugs, anticoagulants, antiplatelet agents, antiarrhythmics, diuretics, bronchodilators.
Due to the possible development of moderate tachycardia and arterial hypotension, caution should be exercised when combining with drugs that have the same effect.
Patients with chronic liver and kidney disease should be careful with prolonged use of the drug.
Mildronate® is not a first-line drug for acute coronary syndrome.
Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
Care should be taken when driving a vehicle or potentially dangerous machinery.
After oral administration, the drug is rapidly absorbed, bioavailability is 78%. The maximum plasma concentration is reached within 1-2 hours after administration. It is metabolized in the body with the formation of two main metabolites, which are excreted by the kidneys. The half-life for oral administration is 3-6 hours.
– Hypersensitivity to the active substance or to any auxiliary substance of the drug
– Increased intracranial pressure (with impaired venous outflow, intracranial tumors)
– Pregnancy and lactation, due to the lack of data on the clinical use of the drug during this period
– Children and adolescents under 18 years of age, due to the lack of data on the clinical use of the drug during this period
– allergic reactions (redness, rash, itching, swelling)
– dyspeptic symptoms
– fluctuations in blood pressure
– feeling of discomfort in the epigastrium
Mode of application
Assign to adults inside.
As part of complex therapy, 0.5-1.0 g per day orally, taking the entire dose at once or dividing it into 2 doses. The course of treatment is 4-6 weeks.
Cardialgia against the background of cardiomyopathy – inside, 0.5 g per day, taking the entire dose at once or dividing it into 2 doses. The course of treatment is 12 days.
Acute phase – an injectable dosage form of the drug is used for 10 days, then they switch to taking the drug inside at 0.5-1.0 g per day, taking the entire dose at once or dividing it into 2 doses. The general course of treatment is 4-6 weeks.
Chronic disorders of cerebral circulation – 0.5 g orally per day. The general course of treatment is 4-6 weeks. Repeated courses (usually 2-3 times a year) are possible after consulting a doctor.
Hemophthalmos and retinal hemorrhages of various etiologies, thrombosis of the central retinal vein and its branches, retinopathy of various etiologies (diabetic, hypertensive)
An injectable dosage form of the drug is used for 10 days, then they switch to taking the drug orally, 0.5 g per day, taking the entire dose at once or dividing it into 2 doses. The course of treatment is 20 days.
Mental and physical overload, including in athletes
Adults – inside 0.5 g 2 times a day. The course of treatment is 10-14 days. If necessary, repeat the treatment after 2 to 3 weeks.
Athletes 0.5-1.0 g orally 2 times a day before training. The duration of the course in the preparatory period is 14-21 days, during the competition period – 10-14 days.
Chronic alcohol withdrawal syndrome
Inside, 0.5 g 4 times a day. The course of treatment is 7-10 days.
Shelf life – 4 years
Also known as: THP, MET-88, Meldonium, Mildronāts, Angiocardil, Trimethylhydrazinium propionate, Idrinol, Meldonium SOLOpharm, Vazomag, Meldonium-Eskom, Meldonium digidratum, Melfor, Vazopro, Meldonium-MIK, Mildroxyn, Midromax, Milkor
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