Generic
Trimetazidine Dihydrochloride
35 brands available in the market
At a glance
Trimetazidine Dihydrochloride is an anti-anginal medicine used for treating heart-related chest pain (angina). It prevents new attacks of angina but does not stop an acute attack once it has started.
Description
Trimetazidine is a cellular acting anti-ischaemic agent. It inhibits anaerobic glycolysis and fatty acid metabolism, allowing only aerobic glycolysis, helping restore energy balance in the cell. It inhibits acidosis and free radical accumulation.
Indications
- Angina (heart-related chest pain)
Pharmacological class
Cellular Anti-ischaemic Agent
Pharmacology
Trimetazidine is the first 3-keto acyl CoA thiolase inhibitor (KAT), a metabolic anti-ischemic agent. It inhibits fatty acid pathway by inhibiting 3-keto acyl CoA thiolase enzyme and transfers oxygen to glucose pathway. Since glucose pathway is more efficient in producing energy, the same oxygen produces more energy and makes the heart more active.
Mechanism of action
Shifts heart metabolism from fats to glucose, decreasing oxygen requirement.
Dosage
Adult Dose (Oral):
- Angina pectoris: 40-60 mg daily in 2-3 divided doses
- Modified-release tablet: 35 mg twice daily
- Renal impairment: CrCl 30-60: 20 mg twice daily; modified-release 35 mg once daily; CrCl <30: contraindicated
Administration
- Take with meals
- Swallow whole; do not chew, crush or break
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as possible; if almost time for next dose, skip it; do not double the dose.
Drug interactions
- MAOIs, nifedipine
- May potentiate the effects of other antianginals
- No interaction reported with beta-blockers, calcium antagonists, nitrates, heparin, hypolipidemic agents or digitalis
Food interactions
May cause excessive drowsiness with alcohol.
Contraindications
- Hypersensitivity to Trimetazidine Dihydrochloride
- Parkinson's disease, parkinsonian symptoms, tremors, restless legs movement disorders
- Severe renal impairment
Side effects
Common Side Effects:
- Constipation
- Dizziness
- Headache
- Nausea
- Vomiting
- Weakness
- Abdominal pain
- Diarrhea
- Dyspepsia
- Rash
- Pruritus
- Urticaria
Use in pregnancy
Use in Pregnancy: Information not available; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Information not available; consult your doctor.
Precautions & warnings
- May decrease alertness; do not drive
- Prevents new attacks of angina but does not stop an acute attack
- Does not affect heart rate or blood pressure at rest or during exercise
- Improves HbA1c and blood sugar levels in diabetes patients
- Avoid driving or using machinery if you feel dizzy
Pediatric use
Safety and efficacy not established in pediatric patients
Geriatric use
Caution required in elderly patients
Renal / hepatic impairment
Renal Impairment: CrCl 30-60: 20 mg twice daily; CrCl <30: contraindicated
Hepatic Impairment: Limited information; consult your doctor
Overdose effects
Symptoms: Dizziness, headache, hypotension.
Treatment: Supportive care.
Therapeutic class
Other Anti-anginal & Anti-ischaemic drugs
Storage conditions
Keep in a dry place away from light and heat. Keep out of reach of children.