Trimetazidine Dihydrochloride

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Generic Name of Trimetazidine Dihydrochloride - Learn More

Trimetazidine Dihydrochloride

Trimetazidine Dihydrochloride Precaution - What You Need to Know

Before starting Trimetazidine Dihydrochloride, it is crucial that patients consult their healthcare provider to ensure the medication is suitable for their condition. Below are some important precautions:

- Cardiovascular Conditions: Trimetazidine is commonly used in treating angina pectoris and ischemic heart disease. However, it should be used cautiously in patients with severe arrhythmias, heart failure, or other significant cardiovascular issues. Monitoring is essential to avoid exacerbating underlying cardiac conditions.
- Renal and Hepatic Impairment: Trimetazidine is metabolized by the liver and excreted via the kidneys. Therefore, it should be used with caution in patients with renal impairment or hepatic dysfunction. Dosing adjustments may be necessary in these cases to prevent potential toxicity.
- Parkinsonism: There have been reports of movement disorders, including Parkinsonism-like symptoms (e.g., tremors, rigidity, bradykinesia), associated with the use of Trimetazidine, especially in elderly patients. If any symptoms develop, the medication should be discontinued, and alternative treatment options should be considered.
- Elderly Patients: Older adults are at increased risk of developing neurological side effects like Parkinsonism. Close monitoring is recommended for this group, and dosage may need to be adjusted.
- Pregnancy and Breastfeeding: The safety of Trimetazidine during pregnancy and breastfeeding has not been established. It is classified as a Category C drug, meaning it should only be used if the benefits outweigh the risks. Consultation with a healthcare provider is essential for women who are pregnant or breastfeeding.

Trimetazidine Dihydrochloride Indication - Uses and Benefits

Trimetazidine Dihydrochloride is used for the management of certain cardiovascular conditions, particularly in cases where the heart muscle is not receiving adequate oxygen supply:

- Angina Pectoris: Trimetazidine is often prescribed for chronic stable angina. It works by improving the energy metabolism of heart cells, thus increasing their ability to tolerate lower oxygen levels and reducing symptoms of angina.
- Ischemic Heart Disease: It is used in the management of ischemic heart disease, especially in patients who have chronic, stable conditions but cannot tolerate other treatments.
- Heart Failure: Trimetazidine is sometimes used in combination with other drugs to help improve symptoms of heart failure, particularly by enhancing myocardial efficiency.
- Acute Myocardial Infarction (MI): In some instances, Trimetazidine may be used as part of the post-infarction treatment strategy to reduce further myocardial damage and improve recovery.

Trimetazidine Dihydrochloride Contraindications - Important Warnings

There are several situations where Trimetazidine Dihydrochloride should not be used:

- Hypersensitivity: Patients who have known hypersensitivity to Trimetazidine or any of its components should avoid the drug.
- Severe Renal Impairment: Trimetazidine is contraindicated in patients with severe renal impairment (creatinine clearance less than 15 mL/min), as it is primarily eliminated via the kidneys, and accumulation of the drug can lead to toxicity.
- Severe Hepatic Impairment: In patients with severe liver dysfunction, Trimetazidine should be avoided due to impaired metabolism and increased risk of side effects.
- Parkinson’s Disease: The use of Trimetazidine is contraindicated in patients with Parkinson's disease or those with Parkinsonism-like symptoms, as it may exacerbate these conditions.
- Children and Adolescents: The safety and efficacy of Trimetazidine in children and adolescents have not been established, and it should generally be avoided in these populations.

Trimetazidine Dihydrochloride Side Effects - What to Expect

Trimetazidine Dihydrochloride can cause a range of side effects, both common and severe:

- Common Side Effects:
- Headache: This is one of the most common side effects of Trimetazidine.
- Dizziness or Vertigo: Some patients may feel lightheaded or dizzy, especially when standing up.
- Gastrointestinal Discomfort: Symptoms like nausea, vomiting, or diarrhea can occur, though these are typically mild and transient.
- Fatigue: Trimetazidine may cause some level of fatigue or tiredness, particularly during the early stages of treatment.

- Serious Side Effects:
- Neurological Effects: Parkinsonism-like symptoms, such as tremors, rigidity, and bradykinesia, can develop, especially in elderly patients. If these symptoms occur, the medication should be stopped immediately.
- Hypersensitivity Reactions: Some patients may experience allergic reactions, including skin rashes, itching, and in rare cases, anaphylaxis.
- Heart Issues: Though rare, cardiac arrhythmias and other heart-related side effects may occur.
- Liver Enzyme Elevation: Liver function may be affected, and elevated liver enzymes should be monitored in patients undergoing long-term treatment.

Trimetazidine Dihydrochloride Mode of Action - How It Works

Trimetazidine Dihydrochloride works by improving the energy metabolism in heart cells:

- Cellular Metabolism: Trimetazidine acts by modulating fatty acid oxidation within heart cells. During periods of reduced oxygen supply (e.g., during an ischemic event), the heart typically relies on fatty acid metabolism, which is less efficient under low-oxygen conditions. Trimetazidine shifts metabolism toward the more efficient glucose oxidation pathway, improving energy production and reducing the oxygen demand of the heart muscle.
- Anti-ischemic Effect: By optimizing energy use in myocardial cells, Trimetazidine reduces the ischemic damage caused by oxygen deprivation, improving myocardial function and preventing further deterioration.
- Reduced Oxygen Consumption: This results in better tolerance to ischemia, decreasing angina frequency and intensity in patients with coronary artery disease.

Trimetazidine Dihydrochloride Drug Interactions - What to Avoid

Trimetazidine Dihydrochloride may interact with other drugs, and it is important to inform healthcare providers of all medications being taken:

- CYP3A4 Inhibitors: Trimetazidine is metabolized by the cytochrome P450 (CYP) enzymes, and drugs that inhibit CYP3A4, such as certain antifungals (e.g., ketoconazole) or antibiotics (e.g., clarithromycin), may increase its blood levels and the risk of side effects.
- Antiarrhythmic Drugs: Trimetazidine may have additive effects when used with other antiarrhythmic drugs, leading to an increased risk of cardiac arrhythmias.
- Other Cardiovascular Medications: While Trimetazidine is often used in combination with other cardiovascular drugs like beta-blockers, ACE inhibitors, or calcium channel blockers, patients should be monitored for any unusual interactions that could affect heart rate, blood pressure, or fluid balance.
- Insulin and Oral Hypoglycemics: Though Trimetazidine is not typically associated with significant effects on blood glucose, patients with diabetes should be monitored for any changes in blood sugar levels while taking the drug.

Trimetazidine Dihydrochloride Adult Dose - Recommended Dosage

For adults, the usual dose of Trimetazidine Dihydrochloride is:

- Initial Dose: The standard starting dose is 35 mg twice daily (morning and evening).
- Maximum Dose: The maximum recommended dose is 70 mg per day, divided into two doses.
- Adjustment: In patients with mild to moderate renal impairment, the dose may be reduced, and the drug should be used with caution.

It is important to follow the prescribed dosage schedule and to avoid exceeding the recommended dose.

Trimetazidine Dihydrochloride Child Dose - Dosage for Children

Trimetazidine Dihydrochloride is not recommended for children. The safety and efficacy of this drug have not been established in pediatric populations, and its use in children is generally not advised.

Consulting a healthcare provider is essential before starting treatment with Trimetazidine, particularly in the case of elderly patients, those with pre-existing cardiovascular conditions, or those with renal or hepatic impairments.

Trimetazidine Dihydrochloride Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, Trimetazidine Dihydrochloride requires careful dose adjustment:

- Mild to Moderate Renal Impairment (creatinine clearance 30-60 mL/min): The usual dose can be maintained at 35 mg twice daily, but patients should be monitored closely for any signs of adverse effects.
- Severe Renal Impairment (creatinine clearance less than 30 mL/min): The use of Trimetazidine is contraindicated in patients with severe renal dysfunction due to the increased risk of drug accumulation.