Preductal MB

Preductal MB - antihypoxant drug, which improves myocardial metabolism under conditions ischemia, which activates the energy metabolism of cells, which exerts a coronarodilating and antianginal action.

This drug is used mainly in cardiology for the treatment of coronary heart disease and prevention of seizures stable angina pectoris, but in some cases it can be claimed in otolaryngology and ophthalmology.

Preductal MB is an original drug produced by the pharmaceutical company "Servier" and its numerous branches.

Clinical and pharmacological group

Antianginal drug that improves myocardial metabolism in ischemic conditions.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Preductal MB in pharmacies cost? The average price is at the level of800 rubles.

Form of issue and composition

Tablets Preductal MB have a pink color, a round biconvex shape. The main active substance of the drug is trimetazidine dihydrochloride.

As an active ingredient, trimetazidine is contained in various dosages -
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in the conventional Preductal- 20 mg in one tablet, and inPreductal MB35 mg.

Packed in a blister for 30 pieces. Cardboard pack of the drug contains 2 blisters with tablets, as well as instructions.

Preductal and Preductal MB - what's the difference?

Both medicines contain the same active substance, but in Preductal MB, due to special technology, it is released slowly, due to which a longer therapeutic effect is achieved in comparison with Preductal.

In this connection, Preductal MB is taken less often than simply by Preductal.

Otherwise, there are no differences between these varieties of the drug and one can use one that is more convenient or for any subjective reasons.

Pharmacological effect

The mechanism of action of trimetazidine is based on preventing the decrease in the intracellular concentration of ATP (adenosine triphosphate) by maintaining the energy metabolism of cells in a state of hypoxia. Thus, the normal functioning of membrane ion channels, preservation of cellular homeostasis and transmembrane transfer of sodium and potassium ions are ensured.

Due to the selective inhibition of the enzyme 3-CAT (3-ketoacyl-CoA-thiolase), trimetazidine inhibits the oxidation of fatty acids of the mitochondrial long chain isoform of fatty acids. As a result, the oxidation of glucose increases and glycolysis accelerates with the oxidation of glucose, which is the basis of myocardial protection from ischemia. The basis of the pharmacological properties of trimetazidine is the switching of energy metabolism from the oxidation of fatty acids to the oxidation of glucose.

As a result of the studies, it was found that trimetazidine:

maintains the energy metabolism of neurosensory tissues and the heart during ischemia;
reduces the severity of intracellular acidosis and changes in the transmembrane ion flow, concomitant ischemia;
reduces the size of myocardial damage;
reduces the level of migration and infiltration of polynucleated neutrophils in reperfused and ischemic heart tissues.

On the parameters of hemodynamics, trimetazidine does not directly affect.

The effects of Preductal MV in patients with angina pectoris:

an increase in the coronary reserve, which leads to a delay in the onset of ischemia associated with physical exertion starting from the fifteenth day of treatment;
a significant reduction in the frequency of angina attacks and the need for short-acting nitroglycerin;
limiting fluctuations in blood pressure associated with physical activity, while the heart rate does not change significantly;
improvement of the contractile function of the left ventricle against ischemic dysfunction.

The effectiveness and safety of the use of Preductal MV in patients with stable angina as a monotherapy and in combination with other medicines with antianginal action (in case of insufficient therapeutic effect from their application).

Combined therapy with metoprolol showed a statistically significant improvement in the results of exercise tests and clinical symptoms in comparison with placebo. In particular, this improvement relates to the total duration of the stress tests, the total time of loading, the time to the development of the segment depression ST, time to the onset of an angina attack, the number of strokes per week and the consumption of short-acting nitrates per week.

Also, there are improvements in the performance with simultaneous use of trimetazidine with atenolol.

Indications for use

Preductal MB is recommended for long-term treatment of coronary heart disease: prevention attacks of stable angina during monotherapy or as part of a combination treatment.

Contraindications

Take the drug Preductal is contraindicated when:

sensitivity to it;
severe renal failure;
the age of 18 years;
lactation, pregnancy;
Parkinson's disease, Parkinson's symptoms, tremor, restless legs syndrome and other motor disorders.

Caution is necessary when prescribing a drug for patients with severe or moderate hepatic and renal failure.

Use in pregnancy and lactation

Do not use drugs Preductal and Preductal MB during the entire pregnancy and the period of breastfeeding, because there are no clinically validated data on its safety for the mother and fetus.

In animal experiments, Preductal MB and Preductal showed no signs of teratogenicity and toxicity to the fetus and the mother. However, these experimental studies can not be extrapolated to pregnant women, and so doctors consider it prudent and correct not to use drugs when bearing and breastfeeding a child.

No data are available on whether Preductal and Preductal CF penetrates into breast milk, so it is not known whether drugs can in principle affect the baby. Therefore, the risk for a newborn who is breastfed is not excluded. Due to such circumstances, do not take Preductal and Preductal MB during breastfeeding.

Dosage and route of administration

The instructions for use indicate that the pill should be taken internally, without chewing and washing with water.

Preductal MV appoint 1 tab. 2 times / day during meals in the morning and evening. The maximum daily dose is 70 mg. The duration of treatment is determined by the doctor.

Patients over the age of 75 may experience increased exposure to trimetazidine because of an age-related decline in kidney function. Choose a dose with caution.

In patients with moderate renal insufficiency (KK 30-60 ml / min) daily dose is 35 mg (1 tab.). Tablets should be taken in the morning, during breakfast.

Side effects

Preductal MB can cause the following side effects:

Common disorders are asthenia.
From the skin - itching, rashes, urticaria, swelling of Quincke.
From the central nervous system - sleep disturbance, headache, dizziness, symptoms of parkinsonism.
From the digestive system - dyspeptic disorders, diarrhea, vomiting, nausea, constipation.
From the cardiovascular system - lowering blood pressure, tachycardia, orthostatic hypotension, extrasystole, dizziness, loss of balance, flushes to the skin.
Other side effects: hepatitis, thrombocytopenia, agranulocytosis.

Overdose

Exact data on the overdose of tablets Preductal MB to date, no. In case of overdose, seek medical attention.

special instructions

1) In the case of an angina attack, the treatment (drug therapy or revascularization procedure) should be reviewed and adapted.

2) Preductal MB is not intended for arresting angina attacks and is not indicated for the initial course of therapy unstable angina or myocardial infarction at the prehospital stage or in the first days of hospitalization.

3) The drug may cause or worsen symptoms of parkinsonism (tremor, akinesia, tone increase), therefore, regular monitoring of patients, especially of the elderly, should be carried out. In doubtful cases, patients should be referred to a neurologist for an appropriate examination.

4) When there are motor disorders, such as Parkinson's symptoms, restless legs syndrome, tremor, instability in the Romberg position and the "unsteadiness" of the gait, Preductal MB should be finally abolished. Such cases are rare and symptoms usually go away after discontinuation of therapy: in most patients - within 4 months after discontinuation of the drug. If the symptoms of parkinsonism persist for more than 4 months after discontinuation of the drug, you should consult a neurologist.

5) There may be cases of falls associated with instability in the Romberg position and the "shakiness" of the gait or a pronounced decrease in blood pressure, especially in patients taking antihypertensive drugs.

6) Care should be taken to prescribe MB Premedital in patients who may have an increase in exposure:

with renal insufficiency of moderate and severe degree;
in elderly patients older than 75 years.

7) In the course of clinical studies, the effect of Preductal MB preparation on hemodynamic parameters was not revealed, however, in the period of post-marketing use, cases dizziness and drowsiness, which can affect the ability to drive vehicles and perform work that requires an increased speed of physical and mental reactions.

Drug Interactions

At present, there is no evidence of a possible interaction of Preductal MB with any medications. Therefore, drugs can be used in combination with any additional medication necessary to man.

Reviews

We picked up some reviews of people who used the drug Preductal MB:

Leonid. This drug helps the heart muscle, I was assigned to it because of the ECG, there the T teeth are periodically negative, indicating a lack of muscle nutrition. The doctor has prescribed a course of reductase, I will drink ...
Nastya. Many years ago I drank Preductal and it was all good. Has now bought or purchased in a drugstore has drunk and a burning sensation in a mouth, an easy dyspnea. I think falsified to me stuck ((
Irina. My grandmother takes it, it helps, but I write about myself. I also had an acquaintance with this drug. I suffer from my heart, there are interruptions, tachycardia. On the cardiogram the doctor did not like my teeth, she noticed ischemia, prescribed a preductal, said popesh, look at the teeth, it happens that they are aligned with the preductal and everything passes. Began to take, I was afraid that it was not worse, because the reductase is a serious drug. Thank God, I drank and all was normal. The drug improves metabolic processes in the myocardium, reduces the heart burden. The quality of life improves, the load is more easily tolerated.