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Actovegin and mildronate. Does Mildronate not generate income? Also an immune drug

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Mildronate is a medicinal product that improves metabolism and energy supply in tissue and cellular level in all organs. Mildronate is used to eliminate energy deficiency and accelerate metabolism in tissues under various chronic diseases and functional disorders, such as coronary heart disease, heart failure, myocardial dystrophy, retinopathy, bronchial asthma, chronic bronchitis, alcoholic withdrawal syndrome, reduced mental and physical performance, overexertion and circulatory disorders in the brain and retina.

Names, release forms, composition and dosages of Mildronate

Currently, Mildronate is available in three dosage forms:
1. Capsules for oral administration;
2. Syrup for oral administration;
3. Solution for injection (intramuscular, intravenous and parabulbar).

All three dosage forms of Mildronate contain the same active substance - meldonium. This active substance is also called mildronate or trimethylhydrazinium propionate dihydrate. Some instructions for use attached to the drug indicate the name of the active substance (INN) meldonium, others - mildronate, and still others - trimethylhydrazinium propionate dihydrate. However, in all cases we're talking about about the same chemical substance, which is designated by different names.

Mildronate capsules as excipients contain gelatin, titanium dioxide, silicon dioxide, calcium stearate and potato starch. The injection solution does not contain any excipients, since it contains only meldonium and purified water. Mildronate syrup contains the following excipients:

Methyl parahydroxybenzoate;
Propyl parahydroxybenzoate;
Propylene glycol;
Glycerol;
Citric acid monohydrate;
Cherry essence;
Allura Red dye (E129);
DyeBrilliant Black BN (E151);

Capsules are available in two dosages - 250 mg and 500 mg of meldonium. The syrup contains 250 mg of meldonium per 5 ml, that is, it has a concentration of 50 mg/ml. And the injection solution contains 100 mg of meldonium in 1 ml (100 mg/ml).

Mildronate capsules are often called tablets. However, since the drug does not have such a dosage form, the term “tablets” means a type of Mildronate for oral administration, and these are capsules. Therefore in in this case capsules = tablets. To indicate the required dosage of capsules is usually used short titles, such as Mildronate 250 And Mildronate 500, where the number corresponds to the dose of the active substance. To designate a solution for injection in everyday life, they often use short forms names such as Mildronate injections And Mildronate ampoules.

Therapeutic effect of Mildronate

Mildronate improves metabolism and energy supply to tissues, and due to this has the following therapeutic effects:

Cardioprotective effect – protecting heart cells from negative influences and improving their viability;
Antianginal effect – reduction in the oxygen needs of myocardial cells (due to this effect, myocardial cells have enough of even a small amount of oxygen supplied under ischemic conditions, which reduces the severity of pain, reduces the frequency of angina attacks and increases the tolerance of physical and emotional stress);
Antihypoxic effect - decrease negative influence oxygen deficiency;
Angioprotective effect – protection and ensuring the integrity of the walls of blood vessels;
Tonic effect.

In addition, Mildronate expands blood vessels and normalizes the cellular component of immunity, which increases the body's resistance to viral infections.

Mildronate injection solution is available in one concentration of 100 ml/ml and is intended for intravenous, intramuscular or parabulbar administration. That is, the same solution is used for any type of injection.

Ampoules with solution should be opened immediately before injection. Do not store the opened solution either outdoors or in the refrigerator. If the ampoule with the solution was opened in advance and stood for more than 20 minutes, then this drug cannot be used, it should be thrown away and a new ampoule should be opened.

Before opening the ampoule, you should carefully inspect the solution for cloudiness, flakes and other inclusions. If there are any, then the solution cannot be used. For injections, only a clean and completely transparent solution can be used.

Injections must be done in the first half of the day, since Mildronate has a stimulating effect. If it is necessary to make several injections a day, then the last one should be made at least 4 - 5 hours before going to bed.

Intramuscular injections can be done independently at home, and intravenous and parabulbar injections only in a clinic or hospital. Intravenous injections Only a qualified nurse can do this at home.

Dosages and rules for administering Mildronate intramuscularly and intravenously

Dosages, frequency of injections and duration of use of the solution for intravenous and intramuscular administration of Mildronate are the same. The choice of injection method - intravenously or intramuscularly is determined mainly by the required speed of obtaining clinical effect.

So, if it is necessary for the drug to act quickly and the effect to occur within a short period of time, then the solution is administered intravenously. This is usually necessary for acute conditions. If it is necessary to ensure a long-term effect of the drug with a not very rapid development of the clinical effect, then the solution is administered intramuscularly. This is usually justified when treating chronic conditions. Thus, we can briefly summarize that intravenous injections are used for acute conditions, and intramuscular injections are used in the treatment of chronic diseases. Parabulbar injections are used only in the treatment of eye diseases.

The standard dosage of solutions for intravenous and intramuscular injections is 500 mg per day (5 ml of solution), and for parabulbar injections - 50 mg per day (0.5 ml). However, these dosages may vary depending on the severity of the person's condition and the type of disease for which the drug is being used. Let's consider the dosages, frequency and duration of intravenous and intramuscular injections of Mildronate for various diseases and conditions.

For unstable angina or myocardial infarction Mildronate should be administered intravenously at 500–1000 mg (5–10 ml of solution) per day. This dosage can be administered at one time or divided into two. That is, if a person does not tolerate injections well, then it is better to inject all of them at once. daily dosage 500 – 1000 mg. If a person tolerates intravenous injections normally, then it is better to divide the daily dosage equally into 2 parts and administer a solution of 250–500 mg twice a day.

Injections are only necessary for one day, after which the person can be switched to taking Mildronate in the form of tablets or syrup. However, if for some reason a person cannot take tablets or syrup, or their effectiveness is low due to illness digestive tract, then the further course of treatment is continued with intramuscular injections. In this case, 500–1000 mg per day is administered intramuscularly every 3 days for 4–6 weeks. The daily dose can also be administered at one time or divided into two.

For chronic heart failure Mildronate is administered intravenously at 500–1000 mg (5–10 ml of solution) once a day or intramuscularly at 500 mg (5 ml of solution) 2 times a day for 10–14 days. After completing the course of intravenous or intramuscular injections, they switch to taking Mildronate in the form of tablets or syrup for another 3 to 4 weeks.

IN acute period violations cerebral circulation Mildronate is administered intravenously at 500 mg (5 ml) once a day for 10 days. After this, the person is transferred to taking the drug in the form of tablets or syrup, or to intramuscular injections. Intramuscular injections are made at 500 mg (5 ml of solution) once a day for 2 - 3 weeks.

At chronic disorders cerebral circulation Mildronate can be taken in tablet form or administered intramuscularly. In such cases, the choice of method of administration of the drug (taking tablets or intramuscular injections) is determined by the person’s personal preferences, as well as his objective condition and the body’s ability to absorb drugs when taken orally. For example, if a person cannot swallow tablets, or they are poorly absorbed due to diseases of the digestive tract, then he should prefer intramuscular injections. If there are no obstacles to taking the pills, then it is better to choose this particular method of using the drug.

So, for chronic cerebrovascular accidents, it is necessary to administer 500 mg (5 ml of solution) Mildronate intramuscularly once a day for 2 to 3 weeks. The course of therapy can be repeated 2–3 times a year.

For pain in the heart due to dyshormonal myocardial dystrophy Mildronate is administered intravenously at 500–1000 mg (5–10 ml of solution) once a day, or intramuscularly at 500 mg (5 ml of solution) 2 times a day for 10–14 days. If the pain does not completely disappear after completing the course of Mildronate injections, the drug is prescribed in tablets for another 12 days.

For mental and physical overload or to speed up rehabilitation after surgery Mildronate can be administered intravenously, intramuscularly or taken in tablets. The choice of method of administration is based on the same criteria as for chronic cerebrovascular accidents. Mildronate is administered intravenously or intramuscularly at 500 mg (5 ml of solution) 1 - 2 times a day for 10 - 14 days. If necessary, the course of therapy is repeated after 2–3 weeks.

For chronic alcoholism Mildronate is administered intravenously for severe lesions nervous system. In this case, administer 500 mg (5 ml of solution) 2 times a day for 7 to 10 days.

In case of pathology of the fundus vessels or retinal dystrophy Mildronate is administered parabulbarly at 500 mg (5 ml solution) once a day for 10 days. Subject to availability inflammatory process in the eyes, Mildronate is combined with intravenous or also parabulbar administration of corticosteroid hormones (Prednisolone, Dexamethasone, Betamethasone, etc.). And for retinal dystrophy, it is rational to combine Mildronate with the use of drugs that improve microcirculation.

Special instructions

Mildronate tablets, syrup and injections are interchangeable methods of using the drug. This means that during one course of treatment you can switch from tablets, for example, to syrup or injections. Such transitions from any dosage form to another can be carried out within the same course of therapy.

People suffering from chronic liver and kidney diseases, with long-term use of Mildronate, should periodically monitor the functioning of these organs.

For myocardial infarction, Mildronate is not a first-line drug, the use of which is mandatory for the effective treatment of an acute condition.

Inclusion of Mildronate in the composition complex therapy for patients suffering from chronic heart failure, it increases their tolerance to physical and emotional stress.

Clinical studies have shown that Mildronate reduces the concentration of atherogenic lipid fractions ("bad cholesterol") in the blood.

Since there is no scientifically proven data on the safety of Mildronate for children, it is recommended to refrain from using this drug in children under 12 years of age.

Impact on the ability to operate machinery

Mildronate does not have a negative effect on the ability to control mechanisms, therefore, while using this drug, a person can engage in any type of activity.

Overdose

For capsules and syrup, no cases of overdose were detected during the entire period of use of the drug. When Mildronate is administered by injection, an overdose is possible and is manifested by the following symptoms:

Decline blood pressure;
Tachycardia (palpitations);
General weakness.

Treatment of an overdose of Mildronate is only symptomatic, aimed at relieving painful symptoms and maintaining the normal functioning of vital organs.

Interaction with other drugs

Mildronate enhances the effects of cardiac glycosides (Strophanthin, Digoxin, Korglykon, etc.), beta-blockers (Propranolol, Metoprolol, Atenolol, Bisoprolol, etc.), as well as some blood pressure lowering agents.

Mildronate combines well with and improves the severity of the clinical effect of the following drugs:

Antianginal agents (Sustak, Nitrong, Betalok, Cordanum, Trental, Dipyridamole, Riboxin, etc.);
Anticoagulants (Warfarin, Thrombostop, etc.);
Antiplatelet agents (Prostacyclin, Aspirin Cardio);
Antiarrhythmic drugs (Adenokor, Amiodarone, Bretilate, Difenin, Cordarone, Moratsizin, Propanorm, Ritalmex, Rhythmiodarone, etc.);
Diuretics (Veroshpiron, Diakarb, Furosemide, etc.);
Bronchodilators (Ventolin, Berotek, etc.).

Mildronate should be combined with caution with Nitroglycerin, Nifedipine, alpha-blockers (Doxazosin, Setegis, Tulazin, etc.), antihypertensive drugs and agents that dilate peripheral vessels (Traklir, Naniprus, Cormagnesin, etc.), since there is high risk development of tachycardia Mildronate is contraindicated for use if a person has the following conditions or diseases:

Increased intracranial pressure (against the background of impaired venous outflow or in the presence of intracranial tumors);
Pregnancy and breastfeeding (due to lack of proof of complete safety);
Hypersensitivity or allergic reactions to the components of the tablets, syrup or solution;
Age under 12 years.

Some instructions for use indicate that Mildronate is contraindicated for children under 18 years of age, however, such terms are reinsurance on the part of the drug manufacturer.

Meldonium - analogues

Analogues of Mildronate on the domestic pharmaceutical market are two groups of drugs - synonyms and actual analogues. Synonyms are drugs that contain meldonium as an active substance, just like Mildronate. Analogs are drugs that have similar therapeutic effects, but contain different active substances.

The following drugs are synonyms for Mildronate:

Angiocardil solution for injection;
Vasomag capsules and solution for injection;
Idrinol solution for injection;
Cardionate capsules and solution for injection;
Meldonium capsules and solution for injection;
Midolate capsules;
Mildrakor solution for injection (only in Ukraine);
Mildrocard capsules (only in Belarus);
Melfor capsules;
Medatern capsules.

The following drugs are analogues of Mildronate:

Angiosil retard tablets;
Antisten and Antisten MV tablets;
Biosynth lyophilisate for the preparation of solution for injection;
Bravadin tablets;
Valeocor-Q10 tablets;
Vero-Trimetazidine tablets;
Histochrome solution for injection;
Deprenorm MV tablets;
Dibicor tablets;
Dynaton solution for injection;
Doppelhertz Cardiovital tablets;
Ezaphosphine lyophilisate and ready solution;
Inosie-F and Inosine-Eskom solution for injection;
Carditrim tablets;
Coraxan tablets;
Coronatora pellets;
Kudevita capsules;
Kudesan drops;
Medarum 20 and Medarum MV tablets;
Mexicor capsules and solution for injection;
Metagard tablets;
Sodium adenosine triphosphate (ATP) solution for injection;
Neoton lyophilisate for the preparation of solution for injection;
Orocamag capsules;
Pedea solution for injection;
Predisin tablets;
Preductal and Preductal MV tablets;
Precard tablets;
Ranexa tablets;
Riboxin capsules, tablets and solution for injection;
Rimecor and Rimecor MV tablets;
Taufon tablets;
Triducard tablets;
Trimectal capsules;
Trimectal MV tablets;
Trimet tablets;
Trimetazide tablets and capsules;
Trimetazidine and Trimetazidine MB tablets;
Trimitard MV tablets;
Ubinon capsules;
Firazir solution for injection;
Phosphaden tablets and solution for injection;
Ethoxydol tablets.

Mildronate - reviews

Almost all reviews about Mildronate are positive, which is due to the effectiveness of the drug in improving the functioning of the heart. vascular system. The entire set of positive reviews can be divided into two groups - those concerning the use of the drug for severe chronic diseases and the use of the drug for functional disorders or overload.

So, in positive reviews regarding the use of the drug for serious illnesses, people indicate that they have taken or periodically take Mildronate for vegetative-vascular dystonia, hypertension, heart failure or angina. With vegetative-vascular dystonia, Mildronate completely normalized the condition of a person for 3 to 5 months, who practically forgot about his disease for this period. When symptoms of dystonia reappear, people take a course of Mildronate and are satisfied with the result.

For hypertension, angina pectoris and heart failure, Mildronate is taken as part of complex therapy. In reviews, people who took Mildronate for these diseases noted that the drug relieves fatigue, eliminates shortness of breath, a feeling of weakness, hopelessness and apathy, reduces the frequency of angina attacks, increases the overall endurance of the body and the tolerance of physical and emotional stress.

People who took Mildronate for functional disorders functioning of the cardiovascular system (for example, low blood pressure, pain in the heart due to stress or high loads, darkening before the eyes when moving from a sitting to a standing position, etc.), reviews note that the drug quickly and completely eliminated their problem , instead of weakness and fatigue, lightness, energy, cheerfulness, clarity in the head and the desire to live appeared.

Many reviews note that Mildronate helped cope with high mental and physical stress, increasing performance and accelerating recovery after work. Athletes note that when using Mildronate it becomes much easier to breathe during aerobic training and endurance increases significantly.

Negative reviews about Mildronate are literally rare and they are associated, as a rule, with the development of a side effect that was poorly tolerated by a person and therefore forced them to stop using the drug.

Mildronate is considered a drug that has a positive effect on metabolism and performance. This drug was previously often prescribed to athletes to increase endurance and strengthen the body, but recently it has been added to the list of doping drugs. Now Mildronate is in demand mainly in cardiology, and it is also used for disorders of the blood supply to the brain. Not everyone knows whether such a medicine is allowed for children and what it can be replaced with if necessary.

Release form and composition

"Mildronat" is presented in the pharmacy in two forms:

Capsules. They are white in color and have a dense gelatinous shell. These capsules are available in two different dosages and are sold in 20, 40 or 60 pieces per pack.
Ampoules with solution for intravenous administration. It is colorless and transparent, bottled in each ampoule of 5 ml. This medicine is also administered parabulbarly. One box contains 10 ampoules.

Each form of Mildronate contains a substance called meldonium as an active ingredient. It is presented in the form of a dihydrate, in 1 ml of injectable medicine with a dosage of 100 mg (one ampoule contains 500 mg), and one capsule can contain either 250 or 500 mg. Additionally, the ampoules contain only sterile water, and the capsules include Ca stearate, silicon dioxide, gelatin, titanium dioxide and potato starch.

Operating principle

Meldonium provides many positive effects. This connection:

Increases heart cell viability and ensures their protection from adverse effects.
Reduces the oxygen needs of heart cells and reduces the negative impact of oxygen deficiency on tissues.
Protects and maintains vascular integrity, and also contributes to their expansion.
Has a tonic effect on the body.
Supports cellular immunity , helping the body resist viral attacks.
Helps eliminate retinal ischemia, myocardium or brain, improving blood supply to these organs.
Stimulates the removal of toxic compounds from cells, protecting them from damage.
Helps with physical activity and quickly restore your own reserves.
Helps relieve symptoms mental stress.

Indications

"Mildronat" is used:

For heart failure, myocardial dystrophy, functional disorders of the heart, myocardial infarction, angina pectoris and other problems with the cardiovascular system.
At chronic bronchitis or bronchial asthma.
For circulatory disorders in the retina or brain.
When overtired, severe physical exertion, decreased performance, and also after surgical treatment.

Is it prescribed for children?

As noted in the annotation for Mildronate ampoules and capsules, these drugs are not used in the treatment of patients under 18 years of age. The main reason is the insufficient amount of information about the effect of meldonium on children's body. If the doctor prescribes this medication for adolescence, he takes responsibility for himself, selecting the dosage and regimen of use individually.

Mildronate is contraindicated for children under 12 years of age.

Contraindications

Side effects

Judging by the reviews, Mildronate extremely rarely provokes any negative reactions. However, in some patients its use may lead to psychomotor agitation, severe weakness, tachycardia, allergic reaction, dyspepsia and other symptoms. If they occur, you should immediately consult a doctor.

Instructions for use

Suitable shape medicines, single dose and the duration of Mildronate therapy are determined individually. For example, during physical overload, the injection solution is injected into a vein once a day - 1 ampoule (for 10-14 days). For adolescents, the dosage of the drug is calculated based on their weight, multiplying their body weight in kilograms by 12.5-25 mg of meldonium.

Older dogs need to increase the content of vitamins A, B1, B6, B12 and E in their food or supplements - now they are more needed than in older dogs. at a young age.

Also to an elderly body and immune system zinc is needed.

It is worth limiting your intake of salty foods. If at a young age salt could be consumed in small quantities, then in old age its use is undesirable.

To avoid stress on the kidneys, older dogs should receive less phosphorus. For the same purpose, reduce the amount of protein food and control the consumption of carbohydrates so that the elderly dog does not gain excess weight.

Medications for older dogs

Drugs and vitamins that are often given to older dogs (be sure to consult a veterinarian before use)

Mildronate is used for disorders of the blood supply to the brain, acute disorders of the blood supply to the retina, etc.

"Glycine" is a metabolic agent that regulates metabolism.

"Coenzyme Q10". The main component of cellular elements is mitochondria, which produce energy, necessary for the body. Coenzyme acts as an antioxidant, slowing down the aging process.

"Cocarboxylase" is a drug that regulates metabolic processes and plays important role in carbohydrate metabolism.

“L-carnitine” is an amino acid synthesized in the body from the amino acids lysine and methionine. It is prescribed to older dogs to prevent muscle, liver, diabetes, and kidney diseases. Amino acid promotes growth muscle mass, increases the tone and activity of the heart muscle.

“Lecithin” is necessary for all cells of the body, as it prevents their oxidation, helps absorb thiamine, etc., helps slow down aging, treats diseases of bones, joints, rheumatoid arthritis, etc.

"Omega-3" - fatty acids, preventing coronary arthrosis disorders, preventing atherosclerosis, have an anti-inflammatory effect in arthritis, prevent stroke, and increase immunity.

Chondroitin and Glucosamine increase joint elasticity, reduce pain and inflammation and restore cartilage tissue joint

Often, aging dogs suffer from heart, kidney, and liver diseases; diseases associated with the musculoskeletal system.

Less commonly, dogs become deaf or lose their vision as they age. Basically, this happens to representatives of the so-called “problem” breeds.

Instructions for use of the drug "Mildronat" for humans, dogs, cats. Methods of using mildronate in medicine and veterinary medicine

Brief characteristics of the drug

Drug name - Mildronate
Method of administration: intravenous, oral, retrobulbar, intramuscular
Active pharmaceutical ingredient: meldonium, trimethylhydrazinium propionate dihydrate
Release form: ampoules of 5 ml (500 mg), capsules of 500 mg and 250 mg.
Analogues (synonyms): Meldonium, Idrinol, Cardionate, Medatern, Meldonium-Organica, Meldonium-Eskom, Meldonium-Binergy, Melfor, Midolate, Midroxin, Trimethylhydrazinium propionate dihydrate
Gross formula - C6H14N2O2
Pharmacological group: metabolic, antihypoxant, cardioprotector, adaptogen
Subject of application of mildronate: humans, dogs, cats and other species of mammals and birds
Where to buy? IN medical pharmacies over the counter

Release form and composition of the drug "Mildronat"

Mildronate 10% solution for injection, 1 ml of the drug contains 100 mg of the pharmacological active ingredient - 3-(2,2,2-trimethylhydrazinium) propionate dihydrate, as an auxiliary substance - water for injection. Release form - Mildronate is produced in ampoules of 5.0 ml in packs of 10 ampoules (2 blisters of 5 ampoules). The drug is a clear, colorless liquid.
Mildronate in capsules of 250 mg and 500 mg, which contain active active substance 3-(2,2,2-trimethylhydrazinium) propionate dihydrate, 250.0 mg and 500.0 mg, respectively. As auxiliary and additive substances: colloidal silicon dioxide, potato starch, calcium stearate, titanium dioxide, gelatin. Release form. Mildronate is available in capsules white 250 mg (capsule size No. 1) and 500 mg (capsule size No. 2), in a pack there are 6 blisters (500 mg capsules) or 4 blisters (250 mg capsules), each blister contains 10 capsules. The contents of the capsule are white powder, in the form of small crystals, with a slight odor, hygroscopic.

Characteristics of the medicinal substance "Mildronat"

Meldonium, the active pharmaceutical ingredient of Mildronate, is a structural analogue of gamma-butyrobetaine, a biologically active substance that is found in all cells of the body of animals, birds and humans.

Pharmacological action of meldonium

Figure - Pharmacological action of mildronate

According to the instructions for use, mildronate has a number of positive pharmacological effects:

angioprotective
antianginal
antihypoxic
cardioprotective

With increased physical activity and psycho-emotional stress, mildronate has a general tonic and adaptogenic effect on the human body, cats, dogs, birds, helps restore the balance regarding the cell need for Oxygen and its delivery, eliminates the accumulation of toxic metabolic products in cells, and provides a cytoprotective effect. With long-term administration of meldonium drugs, the human body, animals and birds are able to quickly restore spent energy reserves, as well as withstand great physical and psycho-emotional stress. Due to the above pharmacological properties, mildronate is used for the treatment of various disorders of the blood supply to the brain, the functional state of the heart and vascular system, as well as to increase mental, mental and physical performance, endurance, tolerance to physical activity. It should be noted that with a decrease in carnitine content in cells, gamma-butyrobetaine is intensively produced, which has a vasodilating effect. In patients with acute ischemic myocardial injury, the drug Mildronate significantly shortens rehabilitation period, and also reduces the area of necrosis. In patients with chronic heart failure (CHF syndrome), there is a tendency to increase the contractility of the myocardium of the left and right ventricle, the tolerance of the human body, dogs, cats and birds to physical activity increases, and in people with angina, the frequency of attacks is significantly reduced. In individuals with chronic and acute ischemic disorders of cerebral circulation, meldonium improves blood microcirculation in the ischemic focus and has the property of redistributing blood circulation in favor of tissue areas in a state of ischemia. The drug "Mildronat" has clinical effectiveness in ophthalmology regarding dystrophic and vascular pathology of the fundus. Meldonium helps eliminate functional disorders of the central nervous system organs in people suffering from chronic forms alcoholism, especially complicated by withdrawal syndrome.

Pharmacokinetics of meldonium

According to the instructions for use of mildronate for humans, dogs, cats, birds, it has been established that the drug is absorbed quite well when taken orally. The bioavailability of meldonium is about 80%. The Cmax of the active pharmaceutical ingredient is reached in minutes. Mildronate is biotransformable in the body of humans, cats, dogs, and birds, resulting in the formation of its two main metabolites, which are excreted by the kidneys. The half-life of meldonium depends on the dose and varies from 3 to 6 hours.

Indications for use of the drug mildronate in medicine and veterinary medicine

Regarding the instructions for use of mildronate for humans, dogs, cats and birds, a number of main indications for its use have been established:

dyshormonal and peripartum cardiomyopathy
chronic circulatory failure
disorders of the blood supply to the brain, chronic and acute discirculatory encephalopathies (cerebrovascular insufficiency, cerebral strokes and other types of cerebrovascular accidents)
complex therapy of people with coronary heart disease (acute myocardial infarction, angina at rest and stress)
withdrawal syndrome in people with chronic forms of alcoholism (as part of a specific combination treatment)
reduced tolerance to physical activity and performance, physical and emotional stress, in particular in athletes (mildronate and other meldonium preparations are not doping)
retinopathy of various origins(hypertensive, diabetic)
thrombosis of the central vein and its branches in the retina
retinal hemorrhages of various origins and hemophthalmos

Contraindications to the use of mildronate

According to the instructions for the use of meldonium in medicine, veterinary medicine and sports, the main contraindications to its use are identified:

Increased intracranial pressure (in particular with intracranial neoplasia, impaired venous outflow).
Allergic reactions of immediate and delayed type, as well as hypersensitivity to the components of the drug.

Features of the use of mildronate and other meldonium preparations during pregnancy and lactation

It should be noted that the safety of using mildronate during pregnancy remains unproven. It has not yet been clarified whether meldonium preparations are excreted in mother's milk. It is recommended to stop breastfeeding during the period of therapy.

Side effects of the drug "Mildronat"

When using mildronate and other meldonium drugs, side effects develop very rarely. Described in in the rarest cases allergic reactions (rashes, swelling, redness, itching), dyspeptic symptoms, as well as tachycardia, changes in blood pressure, agitation.

Compatibility of mildronate with other drugs

Mildronate is compatible with antianginal and anticoagulant drugs, bronchodilators, antiarrhythmic drugs, antiplatelet agents, diuretics.
Caution is necessary when combining meldonium preparations with nifedipine, nitroglycerin, antihypertensives, peripheral vasodilators and alpha-blockers, due to the hypothetical risk of arterial hypotension and moderate tachycardia.
Meldonium potentiates the action of cardiac glycosides, dilators coronary vessels, a number of antihypertensive drugs.
Mildronate combines well with Actovegin, and an additive effect is observed regarding their cardioprotective and cerebroprotective properties. Mexidol is compatible with mildronate, Riboxin - yes, L-carnitine - no.

Method of administration of mildronate and its dose in humans

Mildronate capsules are prescribed orally, the injection solution is used strictly intravenously in the first half of the day.

Adults with cardiovascular diseases, mildronate is used in the composition combination therapy: orally (capsules) - 500–1000 mg per day or slowly intravenously, 5–10 ml of solution for injection. The course of therapy with meldonium drugs is 4–6 weeks.

In patients with cardialgia, which developed against the background of dishormonal dystrophy of the heart muscle (cardiomyopathy), Mildronate capsules are taken orally at a dose of 0.25 g 2 times a day. The course of therapy is days.

In persons with cerebral circulation disorders:

in the acute phase, meldonium preparations are used in 5 ml of solution for injection intravenously once a day for 10 days, then the drug is prescribed orally in capsules of 500–1000 mg per day. The course of meldonium therapy is 4–6 weeks
in persons with chronic cerebrovascular accidents, mildronate capsules are prescribed orally at 500–1000 mg per day. The course of therapy is 4–6 weeks. Repeated therapeutic courses are prescribed by the attending physician (usually 2–3 times a year)

Dystrophic diseases of the retina and vascular pathology fundus: Mildronate is injected parabulbarly in a dose of 0.5 ml of injection solution once a day for 10 days.

For physical and mental overload, in particular among athletes: the optimal daily dose of meldonium is 1000 mg (500 mg 2 times a day or 250 mg 4 times a day). The course of therapy is 10–14 days. If necessary, the course of therapy is re-prescribed after 2-3 weeks. IN sports medicine I use meldonium preparations orally in capsules, 500–1000 mg 2 times a day immediately before training. The duration of a course of meldonium therapy is on average 14–21 days during the preparatory period and on average 10–14 days during the competition period. The properties of meldonium as a doping have not yet been proven.

In patients suffering from chronic forms of alcoholism: mildronate intravenously, 5 ml of injection solution slowly 2 times a day; capsules prescribed orally, 500 mg 4 times a day. The duration of the standard course of therapy is 7–10 days.

Method of using mildronate in veterinary medicine and its dosage for dogs, cats and birds

For cerebral, cardiovascular and other pathologies of animals and birds, meldonium is prescribed as part of a complex treatment, dividing the dose in half or administering the entire dose at once. Mildronate is administered intravenously or orally to dogs, cats and birds. Quite good therapeutic effect with a minimum adverse reactions noted with intramuscular administration of mildronate to both dogs, cats, and birds.

How to give Mildronate to a dog

Relatives live in a deep village, not far from the nearest large town. about 100 km, the dog got sick, the local “collective farm” veterinarians don’t even bother trying to treat it, there is no way to take the dog to the regional center for examination (most likely, it won’t even survive the journey).

The situation is this: mastino-napoletano, female, 11 years old, a month and a half ago she began to feel noticeably worse, then there were several fainting spells during walks, lasting about 2 minutes, then severe shortness of breath began even after minor exertion (walking) palpitations, the belly increased, there was practically a period of refusal of food, I thought the dog would die.

They contacted me, told me the symptoms over the phone, went to the veterinary hospital, they were very reluctant to say that most likely the dog had CHF, they advised to give the dog Mildronate and during fainting glycine and after Corvalol. We followed this advice for a couple of days, with no improvement.

I went to see a doctor I know, he advised me to take a course (20 days) of sulfocamphocaine 2 ml 2 times a day, I read the article on your website http://www.vet.ru/node/130, on my own responsibility, I advised Digoxin (dose according to instructions) + Enalapril (dose according to instructions) + Furosemide, limit drinking. After a week or two, the dog’s condition was already satisfactory, the dog began to eat (albeit a little), although the shortness of breath remained, it decreased and increased somewhat physical activity dogs, although on the street they still lay down every 10 meters.

Yesterday I finished a course (20 days) of sulfocamphocaine, today my relatives called and said that the dog, after stopping the injections, became noticeably heavier, they could barely take him outside, he stops to rest every 2 meters, the appetite is weak but there is.

I understand that it is very difficult to make a diagnosis, much less prescribe any treatment without first special studies, but the situation is such that you can either try to do something or just wait for the dog to die, I think the first is more correct.

Help with advice if possible.

Here she is (still able) The dog lived a decent life, once saved a child from certain death (attacked by feral dogs), she deserved the last care of herself!

How to give Mildronate to a dog

vegetables. Every day to maintain calcium-phosphorus balance we give

calcium gluconate, calcium glycerophosphate (I think that’s what it sounds like),

activated carbon and brewer's yeast. Now we bought Vitabon vitamins (for medium dogs). We don’t know whether we can (should) continue giving

calcium-phosphorus supplements, or limit yourself to vitamins? As far as I know, an overdose of calcium-phosphorus in the body is harmful, inhibits growth and leads to early ossification. What do you recommend? Thank you..

Stool and urine tests were taken. The diagnosis is as follows: feces - severe deficiency of pancreatic enzymes, moderate deficiency of bile secretion, malabsorption, dysbacteriosis; urine - chronic pilonephritis, urogenital chlamydia. What can you recommend? This is all serious. There are no signs of the disease, only a little peeing under oneself. Tell me how to treat.

They gave me a vitamin complex called “bone”.

At the veterinary clinic (somewhere in mid-April) they said to inject Cocarboxylase and ATP 2 ml each, alternating every other day.

The dog became livelier.

In the 20s of April, my ears started to hurt; the veterinary clinic cleaned them and prescribed “Tsiprinol”, continued cardiac treatment, the ears returned to normal,

But on the 5th day of treatment, the dog lay down during a morning walk and noticed that his legs were swollen.

We went to the veterinary clinic and they said it was joints, they did an X-ray of the hind limbs,

everything is fine there, taking into account age-related changes, but they still suggested injecting hydrocartisone inside the joints,

we refused and turned to a private veterinarian.

He diagnosed heart failure due to old age. His recommendations:

inject cocarboxylase every day, in the morning;

Furasemide 2 ml once a day

sculfocamphocaine 2 ml 2 times a day

Mildronate 5 ml once a day

asparkam 1 tablet 3 times a day

Give milk thistle (dietary supplement) 1 teaspoon 1 or 2 times a day (she sometimes won't eat it).

and something antihistamine (press pipolfen 0.5 tablet at night, go on 0.5 loratodine)

Mildronate was injected for 7 days, then switched to capsules 1 drop 3 times a day.

Furasemide according to the scheme: 1,2,4,6,9 days. Sulphocamphocaine was injected for 4 days, then the dog lost its appetite,

Because the taste was distorted, so we switched (on the doctor’s advice) to Cordiamine 2 ml 2 times a day.

The dog felt much better; she started playing with dogs on walks, but it was still difficult to climb to the 3rd floor,

although before arriving, we put the dog to rest for 5-10 minutes and stop on the floors.

Without injecting furasemide for 4 days, the dog’s legs are swollen again! this is on day 14.

I give furasemide on day 15, day 17, we also give all other medications, the dog feels better.

The vet said I should try Celanide, but it is only available by prescription, but will it help?

but she began to itch and there are small wounds on her chest - she scratches.

He walks with difficulty, but his living gaze is interested in the world,

breathes heavily at the slightest exertion,

coughs in the evenings and mornings

yawns while walking, walks, stops, stands, yawns and moves on.

with food and toilet, as usual. She was never put into strict boundaries,

wants to eat and eats, sometimes he can refuse breakfast, and sometimes he will have a snack at lunch. She's not fat, she's normal weight.

We feed: beef stomach 300 g every two days, boiled wheat cereal + oatmeal + steamed wheat bran

with boiled udder, Once every 2 days I give 200g cottage cheese and/or we buy whole cow’s milk.

In between the main feedings, we give him black (rye) bread and occasionally (the teeth are not the same) beef bones.

Only furasemide really helps, it expels water and microelements; if it is injected for a long time, this in itself can cause death.

The doctor says old dog what you want. Essentially he is abandoning us.

We are in despair and don’t know what to do. How long to inject all this and what is the prognosis.

Help, please, advise what to do. At least a plan of necessary measures.

If possible, tell me what you think, what could happen to the dog and what the prognosis is.

We value the dog very much, she looks younger than her age, we really want her to live.

Thank you very much in advance.

I would like to ask some advice about the hairball in cats. Our kitten, about 5 months old, often began to try to vomit something, but then swallowed it back. My husband said that it was a hairball and the kitten would definitely “throw it up.” But weeks after weeks pass, and he still suffers. Can you advise what should I do: go to the vet to help remove this hair ball or can I help it with home remedies? And how can one determine whether it is a hairball that is tormenting him? Thank you in advance.

Veterinary forum

Everyone attributed it to the fact that the dog was wearing a collar and could have been strangled by accident, plus they met a girl who seemed overexcited. A week later, while walking, the same thing happened. But this time he was wearing a harness (nothing was choking him), he walked calmly, and did not interact with dogs. And suddenly it’s almost the same picture. By the time we got to the clinic, my tongue began to turn pink on its own. The doctor injected him with medications (caffeine, riboxin, prednisolone, furosemide, piracetam). Diagnosed with cardiac depression, bradycardia, congestion in the lungs. Ten minutes later the pug was running around the office like he was scalded (this is his normal behavior), and the doctor said that she did not understand at all what was wrong with him. She prescribed Riboxin and Mildronate. Now the dog is too excited. He does not sit in one place and is very alert, barks at every sound. Maybe it's from riboxin and mildronate? Shortness of breath only after walking, but not more than a minute. When he gets mad at home, he breathes hoarsely through his mouth. Without sticking out your tongue. But not for long either. On the third day after the attack, my appetite disappeared. He turned his face away even from something tasty. There's a hurricane in my stomach. True, later I still picked the meat out of the rice.

Perhaps these are also symptoms:

During one of the “attacks of joy”, when meeting the owner, he coughed, as if he was choking on something. But this happened only once.

He often snorts through his nose as if something is stuck there.

He constantly sneezes while walking.

When he is happy, he begins to lick the air.

Breathing is not smooth. In a dream, he may not breathe at all for half a minute, and then, on the contrary, he breathes very often.

Drinks little water (always)

Very picky about food. There is no way he will eat raw meat. When fed dry food, he could go hungry for weeks. Weighed less than 7 kg. Now she weighs 9.5 kg in real life.

Mildronate for children

Release form and composition

"Mildronat" is presented in the pharmacy in two forms:

Capsules. They are white in color and have a dense gelatinous shell. These capsules are available in two different dosages and are sold in 20, 40 or 60 pieces per pack.
Ampoules with solution for intravenous administration. It is colorless and transparent, bottled in each ampoule of 5 ml. This medicine is also administered parabulbarly. One box contains 10 ampoules.

Operating principle

Meldonium provides many positive effects. This connection:

Increases the viability of heart cells and ensures their protection from adverse effects.
Reduces the oxygen needs of heart cells and reduces the negative effects of oxygen deficiency on tissues.
Protects and maintains the integrity of blood vessels, and also promotes their expansion.
Has a tonic effect on the body.
Supports cellular immunity, helping the body resist viral attacks.
Helps eliminate ischemia in the retina, myocardium or brain, improving blood supply to these organs.
Stimulates the removal of toxic compounds from cells, protecting them from damage.
Helps you endure physical activity and quickly restore your own reserves.
Helps eliminate symptoms of mental stress.

Indications

For heart failure, myocardial dystrophy, functional disorders of the heart, myocardial infarction, angina pectoris and other problems with the cardiovascular system.
For chronic bronchitis or bronchial asthma.
For circulatory disorders in the retina or brain.
In case of overwork, heavy physical exertion, decreased performance, as well as after surgical treatment.

All about Actovegin

All about the unique drug - Actovegin

Pages

Actovegin and Mildronate (meldonium). Cardionate. Instructions for Mildronate. Compatibility of Mildronate

Actovegin and Mildronate - n eurology, kardiology, sports. .. Mildronate and alcohol. Mildronate and medications. Mildronate and potency. Reviews. Price

Let's focus on the drug Mildronate.

This drug began to be used back in 1984, and today it is quite popular in Ukraine (recognized as the best prescription drug in 2007), Russia, and other former republics of the Union. The drug Mildronate was created for the treatment of the cardiovascular system (s/s disease) in Latvia, namely at the Institute of Organic Synthesis under the leadership of prof. Ivars Kalvins. Mildronate is a medicine intended for the treatment of the cardiovascular system, produced by JSC Grindeks (Latvia): it meets all GMP standards of the European Union, which is a guarantee of the effectiveness and safety of the drug.

Mildronate is used in cardiology (in complex therapy):

Used in combination with other medications.

Not available for use as drinking ampoules!

2. Cardialgia(dishormonal myocardial dysfunction) – two hundred and fifty mg twice a day (twelve days).

Mildronate also has a positive effect on patients diabetes mellitus Type 2 (for example, immediately after myocardial infarction).

Wikipedia writes that meldonium (Mildronate) reduces blood glucose levels without affecting insulin levels. It is also indicated that meldonium prevents loss of sensitivity to pain in diabetes. Here we can also find information about a study on mice that proves the effectiveness joint use Meldonium and metformin for diabetes mellitus.

Mildronate is used in neurology (in combination with other medications):

acute cerebrovascular accident (ONMK): IV infusion of five hundred milligrams of the drug once a day (ten days).

After this - oral administration of capsules: from five hundred mg to a gram per day of Mildronate (month - one and a half months);

chronic cerebrovascular accident (KhNMK): capsules are taken for a month - one and a half months - five hundred mg - one gram per day.

Mildronate therapy can be repeated two to three times a year as prescribed by a specialist.

Due to organic brain damage, it may develop dementia(disorder of thinking, memory, speech.). Mildronate can be successfully used to correct cognitive impairment.

You can administer the drug intravenously, half a gram twice a day.

From a week to ten days.

If necessary, you can repeat taking Mildronate after a couple of weeks.

Since we describe in this article not only Mildronate, but also Actovegin, we would like to draw your attention to the use of Actovegin in sports.

Contraindications to take Mildronate are:

high intracranial pressure ( ICP- quite rare, but dangerous symptom- diagnosed in cases of extreme dangerous diseases requiring immediate inpatient care: tumors, venous outflow disorder);

hypersensitivity to the medicine.

Pregnancy and breastfeeding

Russia issues Cardionate(C ardionate) - an analogue of Mildronate - in capsules and ampoules (10% 5 ml N.10). INN - Meldonium. Indications for use are the same.

Why should Mildronate be taken together with other medications? recommended only for doctor's prescription? Let's give examples.

For example, Mildronate enhances the effect from taking cardiac glycosides (digoxin...), enhances the effect of nitroglycerin, drugs to lower blood pressure, etc.

With a number of medications Mildronate is compatible:

with Riboxin and Panangin (potassium and magnesium aspartate). However can enhance mutual action ;

with Cytochrome, L-carnitine, Atarax, Phenotropil, Cardiomagnyl, Cocarboxylase, Phezam, Cavinton, Trental, Emoxipin, etc.

As we can see from the above, when taking Mildronate with some medications there is a mutual enhancement of action !

Let's give another example: it is allowed to take Mildronate and Tanakan (= Bilobil; Ginkgo biloba extract), but not simultaneously, but in turn, because both drugs have stimulating effect.

Or, say, simultaneous administration Mildronate with Nootropil(Piracetam) not recommended: Both drugs have a tonic effect on the body.

Readers often ask whether it is possible to take Mildronate smokers. Our answer is trivial: no one should smoke, but taking Mildronate does not in any way affect your well-being as a smoker.

Patients of the second group received intravenous jet injections of Mildronate (5.0 ml).

The use of metabolic drugs Actovegin, Mildronate and Coraxan in therapy not only improves the quality of treatment for such patients, but is also economically feasible (when it comes to reducing costs, it is emphasized that the use of Mildronate and Coraxan in complex treatment is especially economically beneficial). Actovegin and Mildronate help reduce the level of NT-pro BNP (brain natriuretic peptide) - an important indicator in the diagnosis of CHF.

Open comparative randomized studies have proven high efficiency and the safety of using Actovegin as part of standard therapy for coronary artery disease: the severity of cardiac ischemia decreases, tolerance to physical activity increases, etc. Moreover, the use of Actovegin in patients with heart disease not only prevents MI, but also prevents cerebrovascular pathology in this category of patients.

Studies have shown that the use of Actovegin contributes to the fact that reperfusion syndrome (in 30% or more cases occurs additional damage heart, which poses a fatal threat to the patient’s life) during thrombolytic therapy for AMI ( acute heart attack myocardium) develops half as often!

This list includes the substance meldonium (included, among other things, in the drug Mildronate): thereby, the agency indirectly confirmed the effectiveness of Mildronate.

The World Anti-Doping Agency's justification for this ban: there is evidence that athletes use the drug Mildronate to improve their performance.

At the beginning of 2016, more than a hundred athletes in whose blood traces of meldonium were found were suspended from competition. More details about the outbreak doping scandal; about the drug Mildronate, which was at the center of this scandal; You can read about in what cases an athlete can still use meldonium here (here you can also read about expert reviews in about Mildronate) .

I was prescribed Mildronate with Riboxin intravenously. I felt better. Do not mix the solutions. Mildronate, they said, should be administered in the first half of the day, preferably before five o’clock in the evening.

I was injected and Mi Ldronate, and Actovegin intravenously. But not at the same time. We tried to do Mildronate in the morning, and Actovegin in the afternoon. He tolerated both medications well. Actovegin has an analogue. It is probably possible to combine Mildronate with Solcoseryl: what is known about this?

I have arrhythmia. I took medicine against arrhythmia and at the same time they gave me Mildronate injections. The course is ten uk tins. My heart ached at times, and then I took Validol under my tongue. Of course, you can’t make the heart new, but this treatment relieves the pain.

Before using Mildronate, you should always consult a specialist!

And here you can watch a video review of Aktove Gin.

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Brief characteristics of the drug

Drug name - Mildronate
Method of administration: intravenous, oral, retrobulbar, intramuscular
Active pharmaceutical ingredient: meldonium, trimethylhydrazinium propionate dihydrate
Release form: ampoules of 5 ml (500 mg), capsules of 500 mg and 250 mg.
Analogues (synonyms): Meldonium, Idrinol, Cardionate, Medatern, Meldonium-Organica, Meldonium-Eskom, Meldonium-Binergy, Melfor, Midolate, Midroxin, Trimethylhydrazinium propionate dihydrate
Gross formula - C6H14N2O2
Pharmacological group: metabolic, antihypoxant, cardioprotector, adaptogen
Subject of application of mildronate: humans, dogs, cats and other species of mammals and birds
Where to buy? In medical pharmacies without a prescription

Release form and composition of the drug "Mildronat"

Mildronate 10% solution for injection, 1 ml of the drug contains 100 mg of the pharmacological active ingredient - 3-(2,2,2-trimethylhydrazinium) propionate dihydrate, as an auxiliary substance - water for injection. Release form - Mildronate is produced in ampoules of 5.0 ml in packs of 10 ampoules (2 blisters of 5 ampoules). The drug is a clear, colorless liquid.
Mildronate in capsules of 250 mg and 500 mg, which contain the active ingredient 3-(2,2,2-trimethylhydrazinium) propionate dihydrate, 250.0 mg and 500.0 mg, respectively. As auxiliary and additive substances: colloidal silicon dioxide, potato starch, calcium stearate, titanium dioxide, gelatin. Release form. Mildronate is produced in white capsules of 250 mg (capsule size No. 1) and 500 mg (capsule size No. 2), in a pack of 6 blisters (500 mg capsules) or 4 blisters (250 mg capsules), each blister. 10 capsules. The contents of the capsule are white powder, in the form of small crystals, with a slight odor, hygroscopic.

Characteristics of the medicinal substance "Mildronat"

Pharmacological action of meldonium

Figure - Pharmacological action of mildronate

According to the instructions for use, mildronate has a number of positive pharmacological effects:

angioprotective
antianginal
antihypoxic
cardioprotective

With increased physical activity and psycho-emotional stress, mildronate has a general tonic and adaptogenic effect on the human body, cats, dogs, birds, helps restore the balance regarding the cell need for Oxygen and its delivery, eliminates the accumulation of toxic metabolic products in cells, and provides a cytoprotective effect. With long-term administration of meldonium preparations, the human body, animals and birds are able to quickly restore spent energy reserves, as well as withstand great physical and psycho-emotional stress. Due to the above pharmacological properties, mildronate is used for the treatment of various disorders of the blood supply to the brain, the functional state of the heart and vascular system, as well as to increase mental, mental and physical performance, endurance, and tolerance to physical activity. It should be noted that with a decrease in carnitine content in cells, gamma-butyrobetaine is intensively produced, which has a vasodilating effect. In patients with acute ischemic myocardial injury, the drug mildronate significantly shortens the rehabilitation period and also reduces the area of necrosis. In patients with chronic heart failure (CHF syndrome), there is a tendency to increase the contractility of the myocardium of the left and right ventricle, the tolerance of the human body, dogs, cats and birds to physical activity increases, and in people with angina, the frequency of attacks is significantly reduced. In individuals with chronic and acute ischemic disorders of cerebral circulation, meldonium improves blood microcirculation in the ischemic focus and has the property of redistributing blood circulation in favor of tissue areas in a state of ischemia. The drug "Mildronat" has clinical effectiveness in ophthalmology regarding dystrophic and vascular pathology of the fundus. Meldonium helps eliminate functional disorders of the central nervous system in people suffering from chronic forms of alcoholism, especially complicated by withdrawal syndrome.

Pharmacokinetics of meldonium

Indications for use of the drug mildronate in medicine and veterinary medicine

Regarding the instructions for use of mildronate for humans, dogs, cats and birds, a number of main indications for its use have been established:

dyshormonal and peripartum cardiomyopathy
chronic circulatory failure
disorders of the blood supply to the brain, chronic and acute discirculatory encephalopathies (cerebrovascular insufficiency, cerebral strokes and other types of cerebrovascular accidents)
complex therapy of people with coronary heart disease (acute myocardial infarction, angina at rest and stress)
withdrawal syndrome in people with chronic forms of alcoholism (as part of a specific combination treatment)
reduced tolerance to physical activity and performance, physical and emotional stress, in particular in athletes (mildronate and other meldonium preparations are not doping)
retinopathy of various origins (hypertensive, diabetic)
thrombosis of the central vein and its branches in the retina
retinal hemorrhages of various origins and hemophthalmos

Contraindications to the use of mildronate

According to the instructions for the use of meldonium in medicine, veterinary medicine and sports, the main contraindications to its use are identified:

Increased intracranial pressure (in particular with intracranial neoplasia, impaired venous outflow).
Allergic reactions of immediate and delayed type, as well as hypersensitivity to the components of the drug.

Features of the use of mildronate and other meldonium preparations during pregnancy and lactation

Side effects of the drug "Mildronat"

When using mildronate and other meldonium drugs, side effects develop very rarely. In rare cases, allergic reactions (rashes, swelling, redness, itching), dyspeptic symptoms, as well as tachycardia, changes in blood pressure, and agitation have been described.

Compatibility of mildronate with other drugs

Mildronate is compatible with antianginal and anticoagulant drugs, bronchodilators, antiarrhythmics, antiplatelet agents, and diuretics.
Caution is necessary when combining meldonium preparations with nifedipine, nitroglycerin, antihypertensives, peripheral vasodilators and alpha-blockers, due to the hypothetical risk of arterial hypotension and moderate tachycardia.
Meldonium potentiates the effect of cardiac glycosides, coronary vasodilators, and a number of antihypertensive drugs.
Mildronate combines well with Actovegin, and an additive effect is observed regarding their cardioprotective and cerebroprotective properties. Mexidol is compatible with mildronate, Riboxin - yes, L-carnitine - no.

Method of administration of mildronate and its dose in humans

Mildronate capsules are prescribed orally, the injection solution is used strictly intravenously in the first half of the day.

For adults with cardiovascular diseases, mildronate is used as part of combination therapy: orally (capsules) - 500–1000 mg per day or slowly intravenously, 5–10 ml of injection solution. The course of therapy with meldonium drugs is 4–6 weeks.

In persons with cerebral circulation disorders:

in the acute phase, meldonium preparations are used in 5 ml of solution for injection intravenously once a day for 10 days, then the drug is prescribed orally in capsules of 500–1000 mg per day. The course of meldonium therapy is 4–6 weeks
in persons with chronic cerebrovascular accidents, mildronate capsules are prescribed orally at 500–1000 mg per day. The course of therapy is 4–6 weeks. Repeated therapeutic courses are prescribed by the attending physician (usually 2–3 times a year)

Dystrophic diseases of the retina and vascular pathology of the fundus of the eye: Mildronate is injected parabulbarly in a dose of 0.5 ml of injection solution once a day for 10 days.

For physical and mental overload, in particular among athletes: the optimal daily dose of meldonium is 1000 mg (500 mg 2 times a day or 250 mg 4 times a day). The course of therapy is 10–14 days. If necessary, the course of therapy is re-prescribed after 2-3 weeks. In sports medicine, I use meldonium preparations orally in capsules, 500–1000 mg 2 times a day immediately before training. The duration of a course of meldonium therapy is on average 14–21 days during the preparatory period and on average 10–14 days during the competition period. The properties of meldonium as a doping have not yet been proven.

Method of using mildronate in veterinary medicine and its dosage for dogs, cats and birds

For cerebral, cardiovascular and other pathologies of animals and birds, meldonium is prescribed as part of a complex treatment, dividing the dose in half or administering the entire dose at once. Mildronate is administered intravenously or orally to dogs, cats and birds. A fairly good therapeutic effect with a minimum of adverse reactions was observed with intramuscular use of mildronate in both dogs, cats, and birds.

Is it possible to combine Actovegin and Mildronate together?

The compatibility of Actovegin and Mildronate is unknown: their developers general studies were not carried out. But the instructions for each product describe drug interactions with other substances. Therefore, doctors safely prescribe both drugs separately or simultaneously for many pathologies that negatively affect the heart, brain, vascular and nervous systems.

Differences and common properties of drugs

The active component of Actovegin is a hemoderivative of calf blood. This natural substance belongs to the stimulators of tissue regeneration, has neuroprotective properties (prevents the destruction of neurons), accelerates capillary microcirculation and well corrects blood circulation in peripheral arteries and veins. Mainly prescribed for vascular diseases, including diabetes.

The active component of Mildronate is meldonium. This substance has antianginal and cardio+angioprotective effects. It relieves pressure in the atrium and pulmonary artery, improves the structure of the myocardium and blood vessels. Mainly prescribed for cardiopathy of various etiologies.

Comparison of Actovegin with the drug Mildronate:

Both drugs belong to metabolic agents and improve energy metabolic processes in the tissues of the brain and other organs;
Both Actovegin and Mildronate have an antihypoxic effect. They reduce the sensitivity of cells to oxygen starvation and prevent their destruction, accelerate metabolic processes in damaged tissues;
Both drugs are used for metabolic and vascular disorders in the brain, the consequences of cerebrovascular diseases, and deterioration of peripheral circulation;
Both Actovegin and Mildronate are allowed to be used by people involved in sports. But anti-doping control in 2018 left meldonium on the prohibited list.

The compatibility of Actovegin with other drugs has not been studied, so the result of their combination is unknown. Mildronate enhances the effect of nifedepine, nitroglycerin, antihypertensive drugs, coronadilators. It cannot be combined with other meldonium medications.

Comparison of drug effectiveness

Actovegin and Mildronate are second-line drugs, and for complex diseases they can only be prescribed in combination with basic medications. But each of them also has individual healing properties.

Which medicine is better:

Mildronate works better for retinopapia, withdrawal symptoms, all cardiac diseases, hypertensive disorders, cerebral ischemia or stroke, psychophysical fatigue;
Actovegin works better for intracranial trauma, vascular dementia, psychoneurotic disorders, diabetic polyneuropathy and various diseases of peripheral arteries or veins;
It will be better to take drugs together in case of extensive damage to the vascular system, regardless of the etiology of the disorder, heart attacks or ischemia of the brain or heart. In these situations they expand the range therapeutic action, increase the prognosis of treatment.

It is important for each person to remember: only the doctor decides which is better - Actovegin or Mildronate separately, or their combined use.

Features of joint treatment with drugs

When administered intravenously, it is prohibited to mix a solution of both drugs in one container - the liquid becomes unusable. Since meldonium has a psychomotor stimulating effect, doctors use an intravenous infusion of Mildronate in the morning, and an Actovegin drip in the afternoon.

It is allowed to take Actovegin in tablets and capsules simultaneously with Mildronate. But doctors recommend a 20-30 minute interval between their use. You can also combine different dosage forms: one drug is used for injections or droppers, and the second is taken orally.

Analogues and substitutes for drugs

A structural analogue of Actovegin is Solcoseryl. Medicines with identical effects include Cerebrolysin, Curantil, Mexidol, Cortexin.

Synonyms for the second drug are all trade names drugs corresponding to ATC class C01EB22 “Meldonium”. These include structural analogs of Celebis, Trypizin Long, Cardionate, Ripronate, Milcardil and other meldonium preparations. A Mildronate substitute is needed if there are contraindications to active substance. Predizin, Riboxin, Metazidin and other drugs with identical effects are suitable for this.

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Which is better – Mildronate or Mexidol

Today, the pharmaceutical industry presents numerous drugs that can improve metabolic processes at the cellular level.

What is better Mexidol or Mildronate in each specific case will be determined by the attending physician, instructions for use, as well as studying additional information about the drugs.

Release form, manufacturer

Mildronate is a Latvian medicine produced by JSC Grindeks containing meldonium as the main substance.

Mexidol is a domestic drug that is produced by several enterprises at once: Pharmasoft, ZiO-Zdorovye CJSC, ALSI Pharma CJSC based on ethylmethylhydroxypyridine succinate.

Mildronate is produced in capsules, syrup for oral use and as a solution for intramuscular, intravenous and parabulbar injections.

Mexidol is produced in tablet form, as well as in the form of a solution for intravenous and intramuscular administration.

Pharmadynamics and therapeutic effects

There is an opinion that Mexidol and Mildronate have the same effect, however, it is not entirely true. Despite the fact that the drugs have many of the same effects, the difference between them is quite significant.

Presence of an active member in Mildronate active component– meldonium, gives the drug the following effects:

Angioprotective. Suppresses the production of inflammatory mediators. Normalizes the permeability of the walls of blood vessels, increasing their tone. Helps improve blood microcirculation.
Angianal. Helps eliminate coronary insufficiency, actively fights angina attacks. Thanks to the drug, oxygen delivery to the heart muscle increases.
Antihypoxic. Increases the tolerance of the body as a whole or its individual tissues to a lack of oxygen caused by various reasons.
Cardioprotective. Corrects and restores myocardial activity.

improving cellular metabolism;
normalization of blood microcirculation by eliminating vasoconstriction;
slowing down the process of necrosis;
reducing the period of recovery of the body after surgical interventions or illnesses;
improving myocardial contractility;
increasing the body’s resistance to physical and mental stress;
increasing immunity at the cellular level;
elimination of some eye diseases.

Mexidol has the following effects:

Antioxidant. Neutralization of free radicals leads to increased immunity, normalization of the functional abilities of all organs, prevention of aging, etc.
Membrane stabilizing. Helps restore and increase the stability of cell membranes, their structure and properties.
3Antihypoxic. Participates in supplying cells with oxygen when it is lacking.
Nootropic. Normalizes nutrition and blood circulation in the brain. This effect improves higher mental properties (memory, perception, speech, thinking). In addition, the drug protects gray matter brain from overload and lack of oxygen.
Anticonvulsant. Eliminates and prevents the appearance involuntary contraction muscles.
Anxiolytic. Helps cope with feelings of anxiety, restlessness, and normalize the emotional background.

Mexidol also reduces toxicity levels antifungal agents and antibiotics when used.

The use of Mexidol leads to:

to increase the level of dopamine in the brain, normalize metabolism in the organ and improve cerebral blood supply;
improving blood microcirculation, its rheological parameters and reducing red blood cell aggregation;
reduction of low-density lipoprotein levels;
stabilization of cell membranes;
normalization of metabolism and blood flow in ischemic areas of the heart muscle;
reducing the area affected by necrosis;
restoration and improvement of cardiac electrical activity and contractility of the organ;
restoration of higher mental properties of the brain;
improving the mental state after suffering stressful conditions;
eliminating manifestations of intoxication (neurological and neurotoxic) after prolonged consumption of alcoholic beverages.

Indications

Mildronate and Mexidol have many of the same indications, but there are still differences.

Monotherapy with Mexidol is less effective than its use as part of complex treatment

for disorders of blood circulation in the brain;
traumatic brain injuries;
vegetative-vascular dystonia;
causeless anxiety and restlessness, accompanied by neurotic and neurosis-like conditions;
acute heart attack;
primary open-angle glaucoma;
post-alcohol syndrome;
symptoms of poisoning of the body with antipsychotic drugs;
necrotic pancreatitis, perinonitis and other purulent-inflammatory processes in the abdominal cavity;
ischemic disease;
non-inflammatory brain diseases;
ischemic disease;
convulsive attacks, etc.

manifestations of ischemia;
pathological changes in peripheral arteries;
decreased performance;
dyscirculatory encephalopathy;
symptoms of physical overexertion (also when playing sports);
chronic heart failure;
pain syndrome on the left side of the chest associated with dishormonal myocardiopathy;
bronchial asthma;
strokes;
consequences overuse alcoholic drinks;
chronic obstructive pulmonary disease;
excessive irritability and psychological crises (fears, panic, anxiety).

Mildronate is also relevant in ophthalmology for the treatment of thrombosis, various types retinopathy and hemorrhage.

Contraindications and unwanted effects

Instructions for use of drugs also contain differences in the list of their contraindications and side effects.

Both drugs are not used if you are hypersensitive to their ingredients. In addition, Mildronate is contraindicated in intracranial hypertension, and the use of Mexidol is prohibited in case of acute liver and kidney failure.

Medicines are generally well tolerated by patients, side effects are observed in rare cases

Taking Mildronate in some cases can lead to:

to allergic reactions (redness and rashes on the skin, swelling, etc.);
dyspeptic symptoms in the form of belching, nausea, vomiting, heartburn;
increase in heart rate;
increased arousal;
hypotension.

The use of Mexidol is fraught with:

allergies;
drowsiness, weakness, lethargy;
nausea, flatulence and other dyspeptic disorders.

Negative manifestations do not seem to be life-threatening and disappear as you stop taking the medication.

Compatibility of Mexidol and Mildronate

Although the drugs have similar effects, their interaction enhances the therapeutic effect of the treatment.

Specialists can combine drugs:

for brain pathologies;
ischemic stroke (together with Actovegin);
cerebral ischemia, as well as vestibulo-atactic syndrome (appearance of spots before the eyes, nausea, dizziness, etc.);
abnormal heart rhythm;
non-inflammatory damage to the heart muscle;
withdrawal syndrome.

As part of complex treatment, it is possible to use various forms of drugs

It is impossible to give an exact answer: which is better, Mildronate or Mexidol. Each drug is designed to get rid of certain diseases and the advisability of their use depends on the choice of the doctor.

Reviews

Elena, 34 years old, Kyiv

My father has a strong craving for alcohol. Usually he drinks for about two weeks, and it is difficult to come out of the binge. His heart begins to ache, his hands shake, convulsions appear, feelings of anxiety, fear, a depressive state gives way to aggression, and sleep is disturbed. Encodings don't help. It becomes scary for his health. The narcologist advised me to take Mexidol at the same time as Mildronate. A few days of treatment with these medications allows dad to return to normal, he begins to feel well, and his behavior becomes adequate.

Igor, 44 years old, Moscow, university teacher

IN lately became very unbalanced. At work I lost my temper with students and colleagues, my wife and children constantly irritated me, and I developed a feeling of fear. Because of his character, he was constantly in conflict with someone. Friends advised me to drink Mildronate. I started taking one capsule in the morning and evening. It was possible to fall asleep only in the morning, almost before getting up. The condition only worsened. I had to see a doctor. As it turned out, Mildronate should not be taken immediately before bedtime. The specialist advised me to undergo a course of treatment with Mexidol. The drug gave me real help. Now neurotic manifestations disappeared. Thanks Mexidol.

Irina Vasilievna, 60 years old, pensioner

A few years ago I began to feel unpleasant symptoms: strong heartbeat, alternating intermittently, shortness of breath, chest pain on the left side. The doctor diagnosed ischemic disease heart, prescribed Mildronate. The medicine is quite expensive, but completely worth it. Not only has my health improved markedly, but my performance has also increased. Now I work in the garden with my children and feel almost no fatigue.

Mildronate or Actovegin which is better

In the section Diseases, Medicines, to the question Actovegin or Mildronate, which is better? The best answer given by the author is Gans. Both drugs have basically a similar effect and improve metabolism in the affected tissues of the body. However, their mechanism of action is somewhat different, they seem to complement each other, and therefore they are not compared. Given their different mechanisms of action, they are most often used together in complex treatment.

In general, they are made as a course, you can do it together. it all depends on what you use them for

COMPATIBILITY OF MEDICINES

I am given six drugs in two injections. Is it possible to carry out injections according to the “cocktail in one syringe” principle:

The main principles of the Pharmacy are reliability, professionalism, quality assurance of medicines and all products, polite and fast service.

Is this correct? Is it not dangerous?

Intravenously, 3 drugs are mixed in one syringe: Actovegin, 2 ml + Mildronate, 10 ml + Cerebrolysin, 5 ml;

Is this correct? Is it not dangerous?

How compatible are the drugs mixed in one syringe with each other? Is such a COCKTAIL effective (not each drug separately)? Isn’t it necessary to administer each drug separately, as they did in my previous courses?

All about Actovegin

All about the unique drug - Actovegin

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Actovegin and Mildronate (meldonium). Cardionate. Instructions for Mildronate. Compatibility of Mildronate

Actovegin and Mildronate - n eurology, kardiology, sports. .. Mildronate and alcohol. Mildronate and medications. Mildronate and potency. Reviews. Price

Let's focus on the drug Mildronate.

This drug began to be used back in 1984, and today it is quite popular in Ukraine (recognized as the best prescription drug in 2007), Russia, and other former republics of the Union. The drug Mildronate was created for the treatment of the cardiovascular system (s/s disease) in Latvia, namely at the Institute of Organic Synthesis under the leadership of prof. Ivars Kalvins. Mildronate is a medicine intended for the treatment of the cardiovascular system, produced by JSC Grindeks (Latvia): it meets all GMP standards of the European Union, which is a guarantee of the effectiveness and safety of the drug.

Mildronate is used in cardiology (in complex therapy):

Used in combination with other medications.

Not available for use as drinking ampoules!

2. Cardialgia(dishormonal myocardial dysfunction) – two hundred and fifty mg twice a day (twelve days).

Mildronate also has a positive effect on patients with type 2 diabetes mellitus (for example, immediately after myocardial infarction).

Wikipedia writes that meldonium (Mildronate) reduces blood glucose levels without affecting insulin levels. It is also indicated that meldonium prevents loss of sensitivity to pain in diabetes. Here we can also find information about a study on mice proving the effectiveness of the combined use of meldonium and metformin in diabetes mellitus.

Mildronate is used in neurology (in combination with other medications):

acute cerebrovascular accident (ONMK): IV infusion of five hundred milligrams of the drug once a day (ten days).

After this - oral administration of capsules: from five hundred mg to a gram per day of Mildronate (month - one and a half months);

chronic cerebrovascular accident (KhNMK): capsules are taken for a month - one and a half months - five hundred mg - one gram per day.

Mildronate therapy can be repeated two to three times a year as prescribed by a specialist.

Due to organic brain damage, it may develop dementia(disorder of thinking, memory, speech.). Mildronate can be successfully used to correct cognitive impairment.

You can administer the drug intravenously, half a gram twice a day.

From a week to ten days.

If necessary, you can repeat taking Mildronate after a couple of weeks.

Since we describe in this article not only Mildronate, but also Actovegin, we would like to draw your attention to the use of Actovegin in sports.

Contraindications to take Mildronate are:

high intracranial pressure ( ICP- a rather rare but dangerous symptom - diagnosed in the case of extremely dangerous diseases that require immediate hospital care: tumors, venous outflow disorder);

hypersensitivity to the medicine.

Pregnancy and breastfeeding

Russia issues Cardionate(C ardionate) - an analogue of Mildronate - in capsules and ampoules (10% 5 ml N.10). INN - Meldonium. Indications for use are the same.

Why should Mildronate be taken together with other medications? recommended only for doctor's prescription? Let's give examples.

For example, Mildronate enhances the effect from taking cardiac glycosides (digoxin...), enhances the effect of nitroglycerin, drugs to lower blood pressure, etc.

With a number of medications Mildronate is compatible:

with Riboxin and Panangin (potassium and magnesium aspartate). However can enhance mutual action ;

with Cytochrome, L-carnitine, Atarax, Phenotropil, Cardiomagnyl, Cocarboxylase, Phezam, Cavinton, Trental, Emoxipin, etc.

As we can see from the above, when taking Mildronate with some medications there is a mutual enhancement of action !

Let's give another example: it is allowed to take Mildronate and Tanakan (= Bilobil; Ginkgo biloba extract), but not simultaneously, but in turn, because both drugs have stimulating effect.

Or, say, simultaneous administration Mildronate with Nootropil(Piracetam) not recommended: Both drugs have a tonic effect on the body.

Readers often ask whether it is possible to take Mildronate smokers. Our answer is trivial: no one should smoke, but taking Mildronate does not in any way affect your well-being as a smoker.

Patients of the second group received intravenous jet injections of Mildronate (5.0 ml).

Open comparative randomized studies have proven the high effectiveness and safety of the use of Actovegin as part of standard therapy for coronary artery disease: the severity of cardiac ischemia decreases, tolerance to physical activity increases, etc. Moreover, the use of Actovegin in patients with heart disease not only prevents MI, but also prevents cerebrovascular pathology in this category of patients.

Studies have shown that the use of Actovegin contributes to the fact that reperfusion syndrome (in 30% or more cases additional heart damage occurs, which poses a fatal threat to the patient’s life) during thrombolytic therapy for AMI (acute myocardial infarction) develops half as often!

This list includes the substance meldonium (included, among other things, in the drug Mildronate): thereby, the agency indirectly confirmed the effectiveness of Mildronate.

The World Anti-Doping Agency's justification for this ban: there is evidence that athletes use the drug Mildronate to improve their performance.

At the beginning of 2016, more than a hundred athletes in whose blood traces of meldonium were found were suspended from competition. More details about the outbreak doping scandal; about the drug Mildronate, which was at the center of this scandal; You can read about in what cases an athlete can still use meldonium here (here you can also read about expert reviews in about Mildronate) .

Before using Mildronate, you should always consult a specialist!

And here you can watch a video review of Aktove Gin.

Compatibility of Actovegin and Mildronate

In one Mildronate capsule- two hundred and fifty mg of meldonium (or five hundred mg) + auxiliary ingredients.

Mildronate increases endurance body in case of increased stress. However, Mildronate is used not only to improve performance, but also in therapy various pathologies: impaired blood supply to the brain, cardiovascular pathology, fundus diseases; pathologies associated with withdrawal syndrome.

Available Mildronate(INN - meldonium) and in the form injection solution(five ml per ampoule).

The main cases of using Mexidol and / or Mildronate:

In the initial (acute) stage of the disease Mildronate is administered at a dose of five hundred mg once a day intravenously(ten days) after which they move for oral administration(another twenty to forty days) Mildronate, five hundred mg of the drug per day. The length of therapy depends on the type of stroke and how much neurological damage there is.

Taking antioxidants, which include Mexidol and Mildronate, may be included in complex treatment of ischemic stroke(along with, for example, Actovegin).

The daily dosage of Mildronate capsules and the duration of therapy with this medication is the same as for acute cerebrovascular accident (see above!).

Both drugs help in the complex treatment of dyscirculatory encephalopathy, or CCI. Positive changes are especially obvious towards the end of the course of therapy (not earlier than the thirtieth to fortieth day): noise in the head decreases, short term memory, attention, etc.

Mildronate is well tolerated by most patients.

Atherosclerosis and hypertension lead to chronic cerebral ischemia, which is the cause of a number of very serious diseases, including the above-mentioned syndrome. Unfortunately, very often only surgery gives a positive result in treatment. But on initial stage therapy resort to conservative methods.

In complex treatment, medications such as Instenon, Mexidol, Mildronate (see instructions!), Actovegin, Trental, Cavinton, etc. are used.

What can cause such a pathology? IHD, CHF, heart defects, thyroid pathology, hypertension, etc. is an organic extrasystole that requires very serious treatment of the underlying disease.

There are many reasons for this disease: from poisoning (poisons, alcohol, etc.) or, say, anemia to severe disorders caused by diabetes mellitus or other diseases. The disease cannot be neglected: this can lead to heart failure. Depending on the cause that caused myocardial dystrophy in the patient, he is referred to other specialists to eliminate the root cause of the disease. Then it is necessary to restore the heartbeat and relieve the patient of shortness of breath. The effect of therapy depends largely on the correctly prescribed treatment, correctly prescribed medications (doses and duration of therapy).

5. Another area of application of Mexidol / Mildronate that should be mentioned is the relief of withdrawal symptoms. We have already written about the use of Mexidol in the treatment of this pathology. Mildronate is also used in complex treatment.

Mildronate eliminates pathological changes nervous system in patients chronic alcoholism for withdrawal symptoms: a course of Mildronate therapy usually lasts a week to ten days (orally five hundred mg four times a day).

Only a great desire to get rid of this severe addiction, long-term therapy (at least two to three years if treatment is carried out on an outpatient basis), support from loved ones and a complete renunciation of “friendship” with former drinking buddies will help achieve success.

Please note that parenteral infusions of Mildronate are carried out separately from other drugs(i.e. separate infusions even when used together)!

Let us briefly repeat that this original Russian drug, related to antihypoxants with nootropic, antioxidant. properties increases the body's resistance to a wide variety of extreme factors: stress, brain injury, hypoxia and ischemia, intoxication, physical strain; helps eliminate fear and anxiety, overcome insomnia; improves learning and memory; reduces even those pathological changes that have already occurred as a result of severe stress in the brain, myocardium, etc.

Mexidol and Mildronate in sports

Metabolic agent Mildronate is recommended for use not only sick, but and practically healthy people to increase exercise tolerance and improve intellectual activity brain It should be noted that the oral effect of taking Mildronate is almost healthy people quite good (and there is no need for intravenous administration): athletes are recommended to take from two to four capsules of Mildronate (in the preparatory period - for two to three weeks; during the competition - from ten days to two weeks).

However, it should be noted that an excessive increase in physical capabilities, due to this medicine, does not happen.

And yet, this drug increases the body’s ability to work in extreme conditions.

Mildronate dosing principle depends on the weight of the athlete and his loads.

Mildronate is a medicine and should only be prescribed sports doctor, which will take into account the interaction of Mildronate with other drugs and contraindications. In case of overwork of an athlete, speech it'll go already about the treatment of the patient, and here the doses may change.

Everything happens exactly the opposite: scientific studies have proven that when using Mildronate, fat consumption in the liver increases.

The World Anti-Doping Agency has decided to ban the use of Mildronate athletes ( officially since January 2016): the agency claims that athletes use the drug to improve their performance ( thereby WADA indirectly confirmed the effectiveness of Mildronate).

Unfortunately, in the first months of 2016, more than 100 athletes (including the famous tennis player Maria Sharapova) have been suspended from competitions: the prohibited meldonium was found in their blood.

If you want to know details of the ban on meldonium for athletes, about the doping scandal with Mildronate at the beginning of 2016 (and also in what cases athletes are still allowed to take meldonium),