Trimetazidine

Trimetazidine

Clinical data
Routes of administration	Orally
ATC code	C01EB15 (WHO)
Pharmacokinetic data
Excretion	Mainly via kidney (unchanged)
Identifiers
IUPAC name 1-[(2,3,4-trimethoxyphenyl)methyl]piperazine
CAS Number	5011-34-7
PubChem CID	21109
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C14H22N2O3
Molar mass	266.336 g/mol
3D model (JSmol)	Interactive image
SMILES COC1=C(C(=C(C=C1)CN2CCNCC2)OC)OC

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Trimetazidine is a drug for angina pectoris sometimes referred to by the brand name Vastarel MR. Each tablet contains 35 mg of trimetazidine. Trimetazidine is an anti-ischemic (anti-anginal) metabolic agent, that improves myocardial glucose utilization through inhibition of Fatty acid metabolism.

By preserving the energy metabolism in cells exposed to hypoxia or ischemia, trimetazidine prevents a decrease in intracellular adenosine triphosphate levels, thereby ensuring the proper functioning of ionic pumps and transmembranous sodium-potassium flow whilst maintaining cellular homeostasis.

The drug also inhibit b oxidation of fatty acid in blood vessles

Controlled studies in angina patients have shown that trimetazidine increases coronary flow reserve, thereby delaying the onset of ischemia associated with exercise, limits rapid swings in blood pressure without any significant variations in heart rate, significantly decreases the frequency of angina attacks, and leads to a significant decrease in the use of nitrates.

It improves left ventricular function in diabetic patients with coronary artery disease. Recently, it has been shown to be effective in patients with heart failure of different etiologies.

It is described as the first cytoprotective anti-ischemic agent, acts by directly counteracting all the major metabolic disorders occurring within the ischemic cell. The actions of trimetazidine include limitation of intracellular acidosis, correction of disturbances of transmembrane ion exchanges, and prevention of excessive production of free radicals.

It is usually prescribed as a long-term treatment of angina pectoris, and in some countries (including France) for tinnitus and dizziness.

Interactions

Vastarel MR has high safety and tolerability profile.

Q. Can i use sildenafil(viagra) while taking Vastarel MR?

A. Go on, unlike nitrates, Vastarel MR with sildenafil is fully safe (allowed).

Vastarel MR is very safe (no drug-drug interactions)

Dosage and Administration

Vastarel MR tablets is taken twice daily, providing 24-hr cardioprotection.

World Wide

Vastarel MR is also distributed as: Vastarel 35 mg, Vastarel 20 mg, Vastarel LM, Vastarel LP, Preductal MR, Flavedon MR and Trizedon MR.

References

1. Sellier P, Broustet JP. Am J Cardiovasc Drugs. 2003;3:361-369. 2. Génissel P, Chodjania Y, Demolis JL, Ragueneau I, Jaillon P. Eur J Drug Metab Pharmacokinet. 2004;29: 61-68. 3. Kantor PF, Lucien A, Kozak R, Lopaschuk GD. Circ Res. 2000;86:580-588. 4. Stanley WC, Marzilli M. Trimetazidine for the treatment of stable angina: biochemical mechanisms and clinical efficacy. Fundamental Clin Pharmacol. 17:133–145, 2003.

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