Meldonium: what is the drug and how to take it correctly

Meldonium is a medication to increase metabolism in cells. It is used by athletes to improve endurance and performance. It has shown effectiveness in the treatment of cardiac abnormalities and alcohol addiction.

Composition and product form

The drug is produced by several manufacturers, and its composition depends on the form of release. On the pharmaceutical market it is presented in two forms:

• solution for injectable administration, 1 ml contains 100 mg of meldonium dihydrate;
• capsules with a dosage of the main active substance of 250 or 500 mg.

The capsules contain excipients – magnesium stearate, potato starch, silicon dioxide and microcrystalline cellulose. The contents are hygroscopic powder of white color. In pharmacies it is sold in cardboard boxes of 30, 40, 60 pieces.

The solution is a slightly yellowish or transparent substance that contains water for injection as an excipient. It is sold in 5 ml ampoules of 10 units, packed in carton packs.

It is the solution for injections into a vein or muscle that has the fastest absorption (immediately after injection), but it is more convenient to take capsules at home.

Action of the drug

Meldonium improves metabolic processes in the heart muscle and provides energy to the myocardium as well:

• improves blood circulation in the brain;
• normalizes blood inflow and outflow in the nidus with insufficient blood supply;
• slows down the formation of tissue death zone;
• brings myocardial performance to normal;
• provides the brain and heart cells with oxygen;
• removes toxins;
• normalizes the work of the nervous system;
• reduces the period of rehabilitation after heart surgery, stroke;
• helps in the treatment of alcoholism.

Indications for use

Meldonium is prescribed as adjunctive therapy for serious diagnoses and certain conditions:

• coronary heart disease;
• Myocardial dysfunction;
• impaired blood supply to the brain as a result of a stroke;
• period of rehabilitation after surgical interventions;
• heavy physical exertion;
• low performance, weakness and chronic fatigue;
• withdrawal syndrome in alcoholism in chronic form;
• dyshormonal cardiomyopathy.

The drug is injected through the skin of the lower eyelid in hemorrhages, circulatory disorders or retinal vein thrombosis, fundus vascular abnormalities, as well as in diabetic or hypertensive retinopathy.

Do I need to wash down Meldonium

The capsules are taken before meals, whole, and must be washed down with enough water. It is better to take the drug in the morning or before 5 p.m., because it has an excitatory effect on the nervous system. Athletes should preferably take capsules 1-2 hours before training.

Uses and Dosages

Depending on the dosage form used, the drug is prescribed by oral, intravenous, intramuscular or eye injection.

The method, duration of therapy and doses are established based on the indications and the severity of the condition individually.

The instructions for use of Meldonium provides several regimens for prescribing capsules:

• In heart disease – 500-1000 mg per day, once or in two doses, with a treatment course of 1-1.5 months;
• In case of impaired cerebral circulation, 500-1000 mg per day for 1-1.5 months;
• In chronic alcohol intoxication, the dose reaches 500 mg in 4 doses per day, the course of treatment – up to 10 days;
• During systematic heavy physical exertion, during rehabilitation after surgery – 250 mg 4 times a day for two weeks.

Sportsmen are prescribed capsules 500-1000 mg twice a day before training and during the competition for 2-3 weeks.

When injections are prescribed, the dose is 500-1000 mg per day.

In unstable angina, condition after myocardial infarction, the solution is administered intravenously in 1-2 ampoules once a day for 4 days.

In the retina, 0.5 ml of the drug with a concentration of meldonium 500 mg in 5 ml is injected, the course of treatment is 10 days.

Can Meldonium be used by pregnant women

Due to the lack of sufficient studies on the safety of the drug for pregnant women, women should not use Meldonium while they are pregnant. If it is necessary to use the drug during lactation, breastfeeding should be stopped for the period of treatment, as it is unknown whether the substance can penetrate into the breast milk.

Can Meldonium be used in children

Age under 18 years is a contraindication for the prescription of Meldonium both in the form of capsules and in the form of a solution for injection.

Contraindications and side effects

The drug is contraindicated in:

• Individual intolerance;
• Hypersensitivity to the components;
• Increased intracranial pressure due to impaired venous outflow or brain tumors.

Negative effects are rare, can be expressed in:

• tachycardia;
• hyperexcitability of the nerves;
• allergic reactions – itching, urticaria;
• digestive disorders;
• changes in blood pressure in the direction of increasing or decreasing.

If the dosage is correct, side effects usually do not appear, if they occur, it is recommended to cancel the drug.

Conditions of storage and expiration date

The drug is stored at a temperature of up to 25°C for two years from the date of manufacture.

Special indications

When used concomitantly, increases the effect of drugs that dilate blood vessels and reduce the need for oxygen in the heart, as well as drugs that normalize myocardial function and restore metabolism.

Simultaneous use with alcohol is not recommended (it is necessary to wait 12 hours between doses).

The drug has low toxicity and in case of overdose symptomatic treatment is carried out.

It is prescribed with caution in liver and kidney diseases. During an acute heart attack, Meldonium is not the first-line drug of choice. It is not recommended to take it without a doctor’s prescription.

Reviews, analogues

Structural analogues of Meldonium are Mildronate, Idrinol, Cardionate.

Reviews about Meldonium by doctors are generally positive. The drug has shown effectiveness in the treatment of withdrawal syndrome, cardiac pathologies, is well tolerated by patients and increases endurance.

Patients note a burst of strength, faster recovery after training, but in the treatment of cardiovascular diseases, it is not recommended to use without a doctor’s prescription.