Mildronate for animals. Features of joint drug treatment

chPRTPU # 7185 (05/11/2004 10:40)

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chPRTPU # 7186 (05/11/2004 11:11)

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chPRTPU # 7187 (05/11/2004 11:53)

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chPRTPU # 7188 (05/11/2004 11:54)

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chPRTPU # 7189 (11.05.2004 12:02)

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chPRTPU # 7190 (05/11/2004 12:24 pm)

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chPRTPU # 7191 (05/11/2004 12:36 pm)

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pFCHEF:

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chPRTPU # 7192 (05/11/2004 12:42)

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ChPRTPU # 7193 (05/11/2004 13:22)

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pFCHEF:

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chPRTPU # 7194 (05/11/2004 14:02)

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pFCHEF:

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ChPRTPU # 7195 (05/11/2004 14:27)

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chPRTPU # 7196 (05/11/2004 14:48)

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ChPRTPU # 7197 (05/11/2004 15:14)

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ChPRTPU # 7198 (05/11/2004 16:09)

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chPRTPU # 7199 (05/11/2004 16:20)

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Injection transparent, colorless.

Water d / i.

5 ml - ampoules (5) - plastic blister packs (2) - cardboard packs.

Clinical and pharmacological group

pharmachologic effect

A drug that improves metabolism. It is a structural analogue of the carnitine precursor gamma-butyrobetaine (GBB), in which one hydrogen atom is replaced by a nitrogen atom.

It is assumed that there are 2 mechanisms of action of Mildronate on the body

1. Effect on carnitine synthesis

As a result of the inhibition of the activity of butyrobetaine hydroxylase, Mildronate reduces the biosynthesis of carnitine and inhibits the transport of long-chain fatty acids through the cell membrane, preventing the accumulation in cells of activated derivatives of non-oxidized fatty acids - acylcarnitine and acylcoenzyme A, which have pronounced detergent properties. Under conditions of ischemia, Mildronate restores the balance between the delivery and consumption of oxygen in cells, eliminates ATP transport disorders, while activating an alternative energy source - glycolysis, which is carried out without additional oxygen consumption.

With an increased load as a result of intensive energy consumption in the cells of a healthy body, a temporary decrease in the content of fatty acids, mainly carnitine, occurs. It is known that the biosynthesis of carnitine is regulated by its level in blood plasma and stress, but does not depend on the concentration of carnitine precursors in the cell. Since Mildronate inhibits the conversion of GBB to carnitine, this leads to a decrease in the level of carnitine in the blood, which in turn activates the synthesis of the carnitine precursor - GBB.

With a decrease in the concentration of Mildronate, the process of carnitine biosynthesis is restored and the concentration of fatty acids in the cell is normalized. Thus, cells undergo regular training, which contributes to their survival in conditions of increased stress, in which the content of fatty acids in them regularly decreases, and when the load decreases, the content of fatty acids is quickly restored. Under conditions of real overload, cells "trained" with Mildronate survive in those conditions when "untrained" cells die.

2. Function of the mediator of the hypothetical GBB-ergic system

It is hypothesized that there is a previously undescribed system of transmission of nerve impulses in the body - the GBB-ergic system, which ensures the transmission of nerve impulses to somatic cells. The mediator of this system is the immediate precursor of carnitine, the GBB ester. As a result of the action of esterase, this neurotransmitter gives up an electron to the cell, thus transferring an electrical impulse, and itself turns into GBB.

Synthesis of GBB is possible in any somatic cell of the body. Its speed is regulated by the intensity of the stimulus and energy expenditure, which in turn depend on the concentration of carnitine. Therefore, with a decrease in the concentration of carnitine, the synthesis of GBB is stimulated. With an increase in the concentration of the mediator (HBB ester) in any place in the body, with the participation of the central nervous system, regulatory mechanisms are activated that are "responsible" for it.

Thus, there is an economical chain of reactions in the body that provides an adequate response to irritation or stress: it begins with the receipt of a signal from nerve fibers (in the form of an electron), followed by the synthesis of GBB and its ester, which, in turn, carries the signal on somatic cell membranes. Somatic cells, in response to irritation, synthesize new molecules, ensuring signal propagation. After that, the hydrolyzed form of GBB, with the participation of active transport, enters the liver, kidneys and testes, where it turns into carnitine.

As mentioned earlier, Mildronate is a structural analogue of GBB, in which one hydrogen atom is replaced by a nitrogen atom. Since Mildronate can be exposed to the action of GBB-esterase, it can act as a hypothetical "mediator". However, GBB-hydroxylase does not act on mildronate, and therefore, when it is introduced into the body, the concentration of carnitine does not increase, but decreases. Due to the fact that Mildronate itself acts as a "mediator" of stress, and also increases the content of GBB, it contributes to the development of the body's response. As a result, the overall metabolic activity also increases in other systems, such as the central nervous system.

results experimental studies

In experiments on anesthetized cats, the effect of mildronate on the performance of the cardiovascular system was studied. It has been established that in a wide range of doses, the drug increases volumetric blood flow, systolic and minute volumes, does not have a significant effect or slightly lowers venous pressure. These data indicate a positive effect of Mildronate on the contractile function of the myocardium.

Mildronate has a protective effect in myocardial hypoxia. In experiments on isolated rabbit atria, it was found that after the cessation of hypoxic exposure, the drug accelerates the restoration of myocardial contractility to a normal level.

In another series of experiments on anesthetized white rats, it was found that the introduction of Mildronate before the start of the experiment eliminates the increase in ischemia (ST segment elevation) after ligation of the left coronary artery, reduces the corresponding focus of infarction and increases the life expectancy of animals. With repeated administration of the drug for 10 days, a pronounced (more than 2 times compared with the control) decrease in the focus of infarction was found.

Mildronate is more effective than nifedipine in preventing the development of disorders heart rate, including ventricular fibrillation, in rats after coronary artery ligation.

In conditions of "facilitated" experimental myocardial infarction (ligation of the left coronary artery for ≤1 h) in dogs, the drug eliminates ischemic ECG changes.

Mildronate protects the myocardium from the damaging effects of catecholamines and alcohol.

In experiments on rats, it was found that the preliminary administration of Mildronate in 50% of animals completely eliminates ECG changes caused by isoproterenol (izadrin) and epinephrine (adrenaline). Histological examination myocardium of rats indicates that in the case of the use of epinephrine, mildronate protects myocardial cells, prevents the development irreversible changes cardiomyocytes and helps to restore the normal structure of the myocardium.

In experimental studies, it was found that toxic concentrations ethyl alcohol caused by myocardial damage in principle do not differ from those caused by ischemia or stress. It can be assumed that this is due to the similarity of the mechanisms of action of factors affecting myocardial tissues. The data that Mildronate reduces myocardial damage caused by ethyl alcohol justifies the use of the drug for the correction of functional and organic disorders of the body in chronic alcohol intoxication.

It has been experimentally established that Mildronate reduces the stimulating effect of ethyl alcohol by about 5 times. Under conditions of "free choice", mildronate reduces the consumption of ethyl alcohol by 80-100% in experimental animals.

In experiments on animals, an antihypoxic and cerebral blood flow-improving effect of the drug was observed. It has been established that Mildronate has a positive effect in ischemia of the brain tissue. The drug optimizes the distribution of cerebral blood flow in favor of ischemic foci, increases the resistance of neurons to hypoxia. So, in experiments on rats, the drug partially or completely eliminated EEG changes after occlusion. carotid artery. Mildronate has an activating effect on the central nervous system: increases physical activity and physical performance, stimulation of motor reactions was noted, as well as an anti-stress effect, manifested in stimulation of the sympathetic nervous system, an increase in the content of catecholamines in the brain and adrenal glands, a protective effect against stress-induced changes in internal organs.

The obtained results of experimental studies indicate the effectiveness of Mildronate and the possibility of its use in cerebrovascular pathology.

Results of clinical studies

Analysis of clinical data on the course treatment of stable angina pectoris with Mildronate indicates that under the influence of the drug the frequency and intensity of attacks are reduced, and the amount of nitroglycerin used is also reduced. The drug has a pronounced antiarrhythmic action in the presence of coronary artery disease and ventricular extrasystoles and is less effective in supraventricular extrasystoles. special attention deserves the ability of the drug to reduce oxygen consumption at rest, which is considered an indicator of the effectiveness of antianginal IHD treatment. Mildronate has a beneficial effect on atherosclerotic processes in the coronary and other peripheral vessels as a result of a decrease in the level total cholesterol in blood plasma and atherogenicity index.

The role of Mildronate in the treatment of chronic heart failure caused by coronary artery disease has been analyzed on the basis of a fairly a large number clinical studies that indicate that the drug increases exercise tolerance and the amount of work performed by patients suffering from heart failure.

In a separate study of the Latvian and Tomsk Institutes of Cardiology, the effectiveness of Mildronate in moderate heart failure (II functional class according to the NYHA classification) was studied. After treatment with Mildronate, 59-78% of patients with an initial diagnosis of heart failure II functional class was assigned to group I of the functional class.

It has been established that Mildronate improves the inotropic function of the myocardium and increases exercise tolerance, improves the quality of life of patients without causing severe side effects. It is noted, however, that Mildronate can cause moderate arterial hypotension, skin allergic reactions, headache, feeling of discomfort under the spoon. In severe heart failure, Mildronate should be administered in combination with traditional means used to treat this disease.

Good clinical effect Mildronate appeared in patients with cardialgia, which developed as a result of menopause and alimentary obesity.

AT clinical setting it was found that the treatment with Mildronate reduces the frequency of relapses of alcoholism. It is shown that Mildronate allows to stop the alcohol withdrawal syndrome.

Mildronate is effective tool complex treatment of acute and chronic disorders cerebral circulation(ischemic stroke, chronic insufficiency cerebral circulation). It has been established that Mildronate normalizes the tone and resistance of capillaries and arterioles of the brain, restores their reactivity.

The effect of Mildronate on the process of rehabilitation of patients with neurological disorders (after past cerebrovascular diseases, brain surgery, tick-borne encephalitis) was studied.

The results of the test of therapeutic efficacy indicate a positive, dose-dependent effect of the drug on recovery. physical performance and functional independence of patients during the recovery period. When analyzing changes in individual and integral intellectual functions, a positive effect of Mildronate on the process of restoring intellectual functions during the rehabilitation period was revealed. It was found that Mildronate improves the quality of life of convalescents (mainly as a result of the restoration of physical functions), and also contributes to the elimination of mental disorders in patients.

During the rehabilitation period, Mildronate has a positive effect on the regression of disorders of the nervous system in patients with neurological deficits. The general neurological condition of patients improves (reduction of brain damage and pathology of reflexes, regression of paresis, improvement of coordination of movements and autonomic functions).

In the clinic and practice of sports medicine, experimental data on the ability of Mildronate to increase efficiency and accelerate the recovery of performance after intense physical exertion have been confirmed. These features of the action of the drug are characterized by an improvement in the tolerance of training loads, the elimination of a feeling of fatigue, a surge of vivacity. In addition, the drug reduces emotional and mental stress (the disappearance of apathy and irritability after stress in training and competitions).

Toxicological characterization

Mildronate has low toxicity. When administered to mice and rats active substance orally, the LD 50 value exceeded 18,000 mg/kg. Repeated administration of mildronate to rats and dogs for 6 months did not cause adverse changes in body weight, blood composition, biochemical parameters animal blood and urine. In high doses, Mildronate caused hemorrhages in the liver and kidneys in dogs, without affecting the functions of these organs.

When studying the specific toxicity of Mildronate, teratogenic and embryotoxic effects were not observed. The drug has no mutagenic and carcinogenic properties. In experiments on animals, an allergenic effect was not detected.

Indications for use

- in the composition complex therapy IHD (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy;

- as part of the complex therapy of acute and chronic disorders of cerebral circulation (strokes and cerebrovascular insufficiency);

- hemophthalmos, retinal hemorrhage various etiologies;

- thrombosis of the central retinal vein and its branches;

- retinopathy of various etiologies (diabetic, hypertensive);

- withdrawal syndrome chronic alcoholism(in combination with specific alcoholism therapy);

- reduced performance;

- physical overstrain (including athletes).

drug interaction

With simultaneous use enhances the effect of coronary dilators, antihypertensive drugs, cardiac glycosides.

Mildronate can be combined with antianginal agents, anticoagulants, antiplatelet agents, antiarrhythmic drugs, diuretics, bronchodilators.

In view of possible development moderate tachycardia and arterial hypotension, caution should be exercised when combined with nitroglycerin, nifedipine, alpha-blockers, antihypertensives and peripheral vasodilators.

Dosing regimen

In connection with the possibility of developing an exciting effect, the drug is recommended to be used in the morning.

At cardiovascular diseases as part of complex therapy, the drug is prescribed at 0.5-1 g / day orally or intravenously (5-10 ml of injection solution with a concentration of 500 mg / 5 ml), the frequency of use is 1-2 times / day. The duration of the course of treatment is from 4 to 6 weeks.

At cardialgia on the background of dyshormonal myocardial dystrophy Mildronate is administered orally at 250 mg 2 times / day. The duration of the course of treatment is 12 days.

At cerebrovascular accident in the acute phase, the drug is prescribed intravenously at 500 mg 1 time / day for 10 days, then they switch to taking the drug orally at 0.5-1 g / day (taking the entire dose at once or dividing into 2 doses). Duration general course therapy is 4 to 6 weeks.

At chronic disorders cerebral circulation, the drug is taken orally at a dose of 0.5-1 g / day. The duration of the general course of therapy is from 4 to 6 weeks. Repeated courses are prescribed individually after consulting a doctor 2-3 times a year.

At vascular pathology and degenerative diseases of the retina Mildronate is administered parabulbarno in 0.5 ml injection solution at a concentration of 500 mg/5 ml for 10 days.

When Mildronate is administered orally at 250 mg 4 times / day or intravenously at 0.5 g 1 time / day. The duration of the course of treatment is from 10 to 14 days. If necessary, therapy is repeated after 2-3 weeks.

At chronic alcoholism the drug is prescribed orally at 500 mg 4 times / day, in / in - 500 mg 2 times / day. The duration of the course of treatment is from 7 to 10 days.

Indications for pregnancy

The safety of Mildronate during pregnancy has not been proven. To avoid possible adverse influence the drug should not be administered to the fetus during pregnancy.

It is not known if the drug is excreted from breast milk. If it is necessary to use Mildronate during lactation, the issue of stopping breastfeeding should be resolved.

special instructions

Use with caution over a long period of time in patients with chronic diseases liver and kidneys.

Years of experience in treatment acute infarction myocardial infarction and unstable angina in cardiology departments shows that Mildronate is not a first-line drug in acute coronary syndrome.

Pediatric use

Data on the use of Mildronate in children is not enough.

Influence on the ability to drive vehicles and control mechanisms

There are no data on the adverse effects of Mildronate on the speed of psychomotor reactions.

Mildronate instructions for use for humans, dogs and cats. Meldonium effect and pharmacology. Mildronate side effects, composition, form of release, analogues
Instructions for use of the drug Mildronate for humans, dogs, cats

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

Brief description of the medicinal product

• Name of the drug - Mildronate


• Method of application - intravenously, orally, retrobulbarno, intramuscularly


• Active pharmaceutical ingredient: meldonium, trimethylhydrazinium propionate dihydrate


• Release form: ampoules of 5 ml (500 mg), capsules of 500 mg and 250 mg.


• Analogues (synonyms)


• Gross formula - C6H14N2O2


• Pharmacological group: metabolic, antihypoxant, cardioprotector, adaptogen


• Object of application of mildronate: humans, dogs, cats and other species of mammals and birds


• Where to buy? AT medical pharmacies without recipe

Release form and composition of the drug "Mildronate"

1. Mildronate 10% 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.


2. Mildronate capsules 250 mg and 500 mg, which contain the active 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 (caps. 500 mg) or 4 blisters (caps. 250 mg), in each blister 10 capsules. The contents of the capsule are powder, white in color, in the form of small crystals, with a slight odor, hygroscopic.

Characteristics of the medicinal substance "Mildronate"

Meldonium, the active pharmaceutical ingredient in 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 to restore balance in relation to the need for cells in oxygen and its delivery, eliminates the accumulation of toxic metabolic products in cells, and provides a cytoprotective effect. For long term appointment meldonium preparations the body of a person, animals and birds is able to quickly restore spent energy reserves, as well as withstand great physical and psycho-emotional overload. Thanks to the above pharmacological properties mildronate is used for therapy various violations blood supply to the brain, the functional state of the heart and blood vessels, as well as to increase mental, mental and physical performance, endurance, tolerance to physical stress. It should be noted that with a decrease in the content of carnitine in cells, gamma-butyrobetaine is intensively produced, which has a vasodilatory 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 ventricles, the tolerance of the human body, dogs, cats and birds to physical activity increases, in people with angina pectoris, the frequency of attacks is significantly reduced. In persons with chronic and acute ischemic disorders of cerebral circulation, meldonium improves blood microcirculation in the ischemic focus, has the ability to redistribute blood circulation in favor of the area of ​​tissues in a state of ischemia. The drug "Mildronate" has clinical efficacy in ophthalmology regarding dystrophic and vascular pathology of the fundus. Meldonium contributes to the elimination of functional disorders of the central nervous system in people suffering from chronic forms of alcoholism, especially those complicated by withdrawal syndrome.

Meldonium pharmacokinetics

According to the instructions for the use of mildronate for humans, dogs, cats, birds, it was found that when taken orally, the drug is well absorbed. The bioavailability of meldonium is about 80%. Cmax of the active pharmaceutical ingredient is reached in 60-120 minutes. Mildronate in the body of humans, cats, dogs, birds lends itself to biotransformation, with 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 the use of the drug mildronat in medicine and veterinary medicine

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

• dishormonal and peripartum cardiomyopathy


• chronic circulatory failure


• cerebral circulatory disorders, chronic and acute dyscirculatory encephalopathies (cerebrovascular insufficiency, cerebral strokes and other types of cerebrovascular accidents)


• complex therapy of people, patients ischemic disease heart (acute myocardial infarction, rest and exertion angina pectoris)


• withdrawal syndrome in people with chronic forms of alcoholism (as part of a specific combined treatment)


• reduced exercise tolerance and performance, physical and emotional overstrain, in particular in athletes (mildronate and other meldonium preparations are not doping)


• retinopathy various genesis(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 appointment are defined:

• Raise 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. For the period of therapy, it is recommended to stop breastfeeding.

Side effects of the drug "Mildronate"

When using mildronate and other meldonium preparations, side effects develop very rarely. In the rarest cases, allergic reactions (rashes, swelling, redness, itching), dyspeptic phenomena, as well as tachycardia, changes in the level of blood pressure blood, excitement.

Compatibility of mildronate with other drugs

• Mildronate is compatible with antianginal and anticoagulant medicines, bronchodilators, antiarrhythmic drugs, antiplatelet agents, diuretics.


• Care must be taken when combining meldonium preparations with nifedipine, nitroglycerin, antihypertensive drugs, peripheral vasodilators and alpha-blockers, which is explained by the hypothetical risk of arterial hypotension and moderate tachycardia.


• Meldonium potentiates the action of cardiac glycosides, agents that expand coronary vessels, a number of antihypertensive drugs.


• Mildronate goes well with actovegin, and there is an additive effect on their cardioprotective and cerebroprotective properties. Mexidol is compatible with mildronate, Riboxin - yes, L-carnitine - no.

Method of administration of mildronate and its dose to a person

Capsules "Mildronate" administered orally, the solution for injection is used in the first half of the day strictly intravenously.

Adults at 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 preparations is 4-6 weeks.

In patients with cardialgia, which has developed against the background of dyshormonal dystrophy of the heart muscle (cardiomyopathy), mildronate capsules are used orally at 0.25 g 2 times a day. The course of therapy is 12-14 days.

In persons with impaired cerebral circulation:

• 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 administered orally in capsules of 500–1000 mg per day. The course of meldonium therapy is 4-6 weeks


• in persons with chronic disorders of cerebral circulation, mildronate capsules are prescribed orally at a dose of 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)

Degenerative diseases of the retina and vascular pathology of the fundus: I inject mildronate parabulbarno at a dose of 0.5 ml of injection solution 1 time per day for 10 days.

With physical and mental overload, in particular in athletes: optimal daily dose meldonium - 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 prescribed again after 2-3 weeks. In sports medicine, meldonium preparations are used orally in capsules, 500-1000 mg 2 times a day immediately before training. The duration of the 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 agent have not yet been proven.

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

Method of application of mildronate in veterinary medicine and its doses for dogs, cats and birds

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

Brief description of the medicinal product

• Name of the drug - Mildronate
• Method of application - intravenously, orally, retrobulbarno, intramuscularly
• Active pharmaceutical ingredient: meldonium, trimethylhydrazinium propionate dihydrate
• Release form: ampoules of 5 ml (500 mg), capsules of 500 mg and 250 mg.
• Analogues (synonyms)
• Gross formula - C6H14N2O2
• Pharmacological group: metabolic, antihypoxant, cardioprotector, adaptogen
• Object 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 "Mildronate"

1. Mildronate 10% 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.
2. Mildronate capsules 250 mg and 500 mg, which contain the active 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 (caps. 500 mg) or 4 blisters (caps. 250 mg), in each blister 10 capsules. The contents of the capsule are powder, white in color, in the form of small crystals, with a slight odor, hygroscopic.

Characteristics of the medicinal substance "Mildronate"

Meldonium, the active pharmaceutical ingredient in 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 exertion and psycho-emotional stress, mildronate has a general tonic and adaptogenic effect on the body of humans, cats, dogs, birds, helps to restore balance in relation to the need for cells in oxygen and its delivery, eliminates the accumulation of toxic metabolic products in cells, and provides a cytoprotective effect. For long term appointment meldonium preparations the body of a person, animals and birds is able to quickly restore spent energy reserves, as well as withstand great physical and psycho-emotional overload. Due to the above pharmacological properties, mildronate is used to treat various disorders of the blood supply to the brain, the functional state of the heart and blood vessels, as well as to increase mental, mental and physical performance, endurance, tolerance to physical stress. It should be noted that with a decrease in the content of carnitine in cells, gamma-butyrobetaine is intensively produced, which has a vasodilatory 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 ventricles, the tolerance of the human body, dogs, cats and birds to physical activity increases, in people with angina pectoris, the frequency of attacks is significantly reduced. In persons with chronic and acute ischemic disorders of cerebral circulation, meldonium improves blood microcirculation in the ischemic focus, has the ability to redistribute blood circulation in favor of the area of ​​tissues in a state of ischemia. The drug "Mildronate" has clinical efficacy in ophthalmology regarding dystrophic and vascular pathology of the fundus. Meldonium contributes to the elimination of functional disorders of the central nervous system in people suffering from chronic forms of alcoholism, especially those complicated by withdrawal syndrome.

Meldonium pharmacokinetics

According to the instructions for the use of mildronate for humans, dogs, cats, birds, it was found that when taken orally, the drug is well absorbed. The bioavailability of meldonium is about 80%. Cmax of the active pharmaceutical ingredient is reached in 60-120 minutes. Mildronate in the body of humans, cats, dogs, birds lends itself to biotransformation, with 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.

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

• dishormonal and peripartum cardiomyopathy
• chronic circulatory failure
• cerebral circulatory disorders, chronic and acute dyscirculatory 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 exertion)
• withdrawal syndrome in people with chronic forms of alcoholism (as part of a specific combined treatment)
• reduced exercise tolerance and performance, physical and emotional overstrain, 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 appointment are defined:

• 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. For the period of therapy, it is recommended to stop breastfeeding.

Side effects of the drug "Mildronate"

When using mildronate and other meldonium preparations, side effects develop very rarely. In the rarest cases, allergic reactions (rashes, swelling, redness, itching), dyspeptic phenomena, as well as tachycardia, changes in the level of blood pressure, agitation are described in the rarest cases.

Compatibility of mildronate with other drugs

• Mildronate is compatible with antianginal and anticoagulant drugs, bronchodilators, antiarrhythmics, antiplatelet agents, diuretics.
• Care must be taken when combining meldonium preparations with nifedipine, nitroglycerin, antihypertensive drugs, peripheral vasodilators and alpha-blockers, which is explained by the hypothetical risk of arterial hypotension and moderate tachycardia.
• Meldonium potentiates the action of cardiac glycosides, agents that dilate coronary vessels, and a number of antihypertensive drugs.
• Mildronate goes well with actovegin, and there is an additive effect on their cardioprotective and cerebroprotective properties. Mexidol is compatible with mildronate, Riboxin - yes, L-carnitine - no.

Method of administration of mildronate and its dose to a person

Capsules "Mildronate" administered orally, the solution for injection is used in the first half of the day strictly intravenously.

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 preparations is 4-6 weeks.

In persons with impaired cerebral circulation:

• 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 administered orally in capsules of 500–1000 mg per day. The course of meldonium therapy is 4-6 weeks
• in persons with chronic disorders of cerebral circulation, mildronate capsules are prescribed orally at a dose of 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)

Degenerative diseases of the retina and vascular pathology of the fundus: I inject mildronate parabulbarno at a dose of 0.5 ml of injection solution 1 time per day for 10 days.

With physical and mental overload, in particular in 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 prescribed again after 2-3 weeks. In sports medicine, meldonium preparations are used orally in capsules, 500-1000 mg 2 times a day immediately before training. The duration of the 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 agent have not yet been proven.

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

Method of application of mildronate in veterinary medicine and its doses for dogs, cats and birds

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

Table 1 - Recommended parenteral doses of mildronate for dogs and cats (ampoules 500 mg 10% 5.0 ml)

Table 2 - Recommended oral doses of mildronate for dogs and cats (500 mg and 250 mg capsules)

Dosage of mildronate for birds 1-2 ml per 1 kg of body weight intramuscularly or 100-200 mg/kg orally once a day for 5-10 days.

Overdose of meldonium (Mildronate)

Cases of overdose with mildronate and other meldonium preparations have not been described.

Precautions when using the drug "Mildronate"

Persons with chronic hepatopathy and nephropathy with long-term use medicines, meldonium derivatives, care must be taken. In patients with myocardial infarction, meldonium is not the drug of choice, but only an additive therapy.

There are no reliable data on the effectiveness of the appointment of mildronate in children, so special care should be taken.

Special instructions regarding the use of meldonium preparations

Mildronate does not adversely affect the speed of reflexes and reactions.

Manufacturer

PJSC Grindeks (“Grindex”), Latvia.

Storage conditions for meldonium preparations

Meldonium preparations are stored out of the reach of children, at a temperature environment not higher than 25 °C.

Shelf life of the drug mildronate

The drug remains stable for 4 years. Mildronate should not be used after the expiration date indicated on the package.

Synonyms, generics, analogues of mildronate

Meldonium list of analogues, generics, synonyms:

1. Cardionate
2. Idrinol
3. Medatern
4. Meldonium Organic
5. Meldonium-Eskom
6. Meldonium-Bynergia
7. Melfor
8. Midolat
9. Midroxin
10. Trimethylhydrazinium propionate dihydrate

Summary. The article provides information regarding instructions for the use of mildronate in medicine and veterinary medicine. Range of application - human, cats and dogs. The drug has a cardioprotective, cytoprotective, anti-ischemic effect. Ways of introducing the drug mildronate into the body - intravenously, orally, intramuscularly. Compatible with riboxin, actovegin, mexidol and other drugs. Given meldonium analogues and its preparations, dosage forms.

Brief description of the medicinal product

• Name of the drug - Mildronate
• Method of application - intravenously, orally, retrobulbarno, intramuscularly
• Active pharmaceutical ingredient: meldonium, trimethylhydrazinium propionate dihydrate
• Release form: ampoules of 5 ml (500 mg), capsules of 500 mg and 250 mg.
• Analogues (synonyms)
• Gross formula - C6H14N2O2
• Pharmacological group: metabolic, antihypoxant, cardioprotector, adaptogen
• Object 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 "Mildronate"

1. 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.
2. 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 (caps. 500 mg) or 4 blisters (caps. 250 mg), in each blister 10 capsules. The contents of the capsule are powder, white in color, in the form of small crystals, with a slight odor, hygroscopic.

Characteristics of the medicinal substance "Mildronate"

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 exertion and psycho-emotional stress, mildronate has a general tonic and adaptogenic effect on the body of humans, cats, dogs, birds, helps to restore balance in relation to the need for cells in 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 body of a person, animals and birds is able to quickly restore spent energy reserves, as well as withstand great physical and psycho-emotional overload. Due to the above pharmacological properties, mildronate is used to treat various disorders of the blood supply to the brain, the functional state of the heart and blood vessels, as well as to increase mental, mental and physical performance, endurance, tolerance to physical stress. It should be noted that with a decrease in the content of carnitine in cells, gamma-butyrobetaine is intensively produced, which has a vasodilatory 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 ventricles, the tolerance of the human body, dogs, cats and birds to physical activity increases, in people with angina pectoris, the frequency of attacks is significantly reduced. In persons with chronic and acute ischemic disorders of cerebral circulation, meldonium improves blood microcirculation in the ischemic focus, has the ability to redistribute blood circulation in favor of the area of ​​tissues in a state of ischemia. The drug "Mildronate" has clinical efficacy in ophthalmology regarding dystrophic and vascular pathology of the fundus. Meldonium contributes to the elimination of functional disorders of the central nervous system in people suffering from chronic forms of alcoholism, especially those complicated by withdrawal syndrome.

Meldonium pharmacokinetics

According to the instructions for the use of mildronate for humans, dogs, cats, birds, it was found that the drug is well absorbed when taken orally. The bioavailability of meldonium is about 80%. Cmax of the active pharmaceutical ingredient is achieved in minutes. Mildronate in the body of humans, cats, dogs, birds lends itself to biotransformation, with 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 the use of the drug mildronat in medicine and veterinary medicine

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

• dishormonal and peripartum cardiomyopathy
• chronic circulatory failure
• cerebral circulatory disorders, chronic and acute dyscirculatory 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 exertion)
• withdrawal syndrome in people with chronic forms of alcoholism (as part of a specific combined treatment)
• reduced exercise tolerance and performance, physical and emotional overstrain, 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 defined:

• 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. For the period of therapy, it is recommended to stop breastfeeding.

Side effects of the drug "Mildronate"

When using mildronate and other meldonium preparations, side effects develop very rarely. In the rarest cases, allergic reactions (rashes, swelling, redness, itching), dyspeptic phenomena, as well as tachycardia, changes in the level of blood pressure, agitation are described in the rarest cases.

Compatibility of mildronate with other drugs

• Mildronate is compatible with antianginal and anticoagulant drugs, bronchodilators, antiarrhythmics, antiplatelet agents, diuretics.
• Care must be taken when combining meldonium preparations with nifedipine, nitroglycerin, antihypertensive drugs, peripheral vasodilators and alpha-blockers, which is explained by the hypothetical risk of arterial hypotension and moderate tachycardia.
• Meldonium potentiates the action of cardiac glycosides, agents that dilate coronary vessels, and a number of antihypertensive drugs.
• Mildronate is well combined with actovegin, and an additive effect is observed in relation to their cardioprotective and cerebroprotective properties. Mexidol is compatible with mildronate, Riboxin - yes, L-carnitine - no.

Method of administration of mildronate and its dose to a person

Capsules "Mildronate" 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 preparations is 4-6 weeks.

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

In persons with impaired cerebral circulation:

• 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 administered orally in capsules of 500–1000 mg per day. The course of meldonium therapy is 4-6 weeks
• in persons with chronic disorders of cerebral circulation, mildronate capsules are prescribed orally at a dose of 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)

Degenerative diseases of the retina and vascular pathology of the fundus: I inject mildronate parabulbarno at a dose of 0.5 ml of injection solution 1 time per day for 10 days.

With physical and mental overload, in particular in 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 prescribed again after 2-3 weeks. In sports medicine, meldonium preparations are used orally in capsules, 500-1000 mg 2 times a day immediately before training. The duration of the 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 agent have not yet been proven.

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

Method of application of mildronate in veterinary medicine and its doses for dogs, cats and birds

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

Veterinary Forum

Everyone chalked it up to the fact that the dog was in a collar and could have strangled it by accident, and plus they met a girl, like he was overexcited. A week later, during a walk, the same thing happened. But this time he was in a harness (nothing choked him), walked calmly, did not communicate with dogs. And suddenly almost the exact same picture. By the time they got to the clinic, the tongue began to turn pink on its own. The doctor injected him with drugs (caffeine, riboxin, prednisolone, furosemide, piracetam). She made a diagnosis: depression of cardiac activity, bradycardia, congestion in the lungs. Ten minutes later, the pug was rushing around the office like a scalded one (this is his usual behavior), and the doctor said that she did not understand at all what had happened to him. Has registered riboxin and mildronat. Now the dog is too excited. He does not sit in one place and is very alert, barking at every rustle. 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 also not for long. On the third day after the attack, he lost his appetite. He turned his face away even from tasty things. Hurricane in the belly. True, later all the same, he dug out meat from rice.

Perhaps these are also symptoms:

During one of the "attacks of joy", meeting the owner, he coughed, as if he had choked on something. But that was only once.

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

She sneezes constantly while walking.

When he rejoices, he begins to lick the air, as it were.

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

Drinks little water (always)

Very picky about food. Never eat raw meat. When fed dry food, he could starve for weeks. Weighed less than 7 kg. Now on naturalka weighs 9.5 kg.

Mildronate for a dog

Relatives live in a deep village, to the nearest large settlement. about 100 km, a dog fell ill, local "collective farm" veterinarians do not even bother trying to treat it, it is not possible to take a dog to the regional center for examination (most likely it will not endure the road).

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

They turned to me, told me the symptoms on the phone, went to the veterinary clinic, where they said with great reluctance that most likely the dog had CHF was advised to give the dog mildronate to drink and glycine during fainting and after corvalol. Followed this advice for a couple of days - no improvement.

I went to a doctor I knew, he advised me to pierce a course (20 days) of sulfocamphocaine 2 ml 2 r / d read an article on your website http://www.vet.ru/node/130 advised Digoxin (dose according to the instructions) + Enalopril under his own responsibility (dose according to the instructions) + Furosemide, limit drinking. After a week or two, the dog's condition was already satisfactory, the dog began to eat (albeit a little), shortness of breath, although it remained, decreased, the dog's physical activity slightly increased, although it still lies down every 10 meters on the street.

Yesterday, the course (20 days) of sulfocamphocaine ended, today the relatives called and said that the dog, after the injections were canceled, became noticeably harder, they could barely take him outside, he stops to rest every 2 meters, his appetite is weak but there.

I understand that it is very difficult to make a diagnosis and even more so to prescribe some kind of treatment without having 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 one is more correct.

Help with advice if possible.

Here she (still able) Dog lived a decent life, once saved even a child from certain death (feral dogs attacked), she deserved the last worries about herself!

Mildronate for a dog

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

calcium gluconate, calcium glycerophosphate (I think it sounds like this),

activated charcoal and brewer's yeast. Now we bought vitamins "Vitabon" (for medium dogs). We do not know if we can (should) continue to give

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? Thanks..

stool and urine samples were taken. The diagnosis is as follows: feces - severe insufficiency of pancreatic enzymes, moderate insufficiency of bile secretion, malabsorption, dysbacteriosis; urine - chronic pylonephritis, urogenital chlamydia. What can you recommend? It's all serious. Signs of the disease are not visible, only a little pee for yourself. Tell me how to treat.

gave vitamin complex"bone".

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

The dog is alive.

In the 20th of April, the ears ached in the veterinary clinic, they were cleaned and prescribed "Ciprinol", the heart to continue, the ears returned to normal,

but on the 5th day of taking the dog lay down on a morning walk, they noticed that their legs were swollen.

We turned to the veterinary clinic, they said that it was the joints, they did X-ray of the hind limbs,

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

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

sculphocamphocaine 2 ml 2 times a day

mildronate 5 ml 1 time per day

asparkam 1 tab 3 times a day

Let's give milk thistle ( food supplement) 1 teaspoon 1 or 2 times a day (she sometimes does not eat it).

and something antihistamine (pressed pipolfen 0.5 tab at night, switched 0.5 loratodina)

Mildronate pricked 7 days then switched to capsules 1 cap 3 times a day.

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

because the taste was distorted, so they switched (on the advice of a doctor) to cordiamin 2 ml 2 times a day.

The dog felt much better, she began to play with the dogs for walks, but climbing to the 3rd floor was still difficult,

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

Do not prick furasemide for 4 days, the dog's legs are swollen again! it's on the 14th day.

Kolem furasemide day 15, day 17, we also give all other medicines, the dog is better.

The veterinarian said you should try celanid, but it is only available by prescription, but will it help?

but she began to itch and there are not big wounds on her chest - she combs it.

He walks with difficulty, but the world is interested in a living look,

breathes heavily at the slightest exertion,

coughing in the evenings and in the morning

yawns on a walk, walks, stops, stands, yawns and went on.

with food and toilet as usual. She was never put in a rigid framework,

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

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

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

In the intervals between the main feeding we give black (rye) bread and occasionally (the teeth are no longer the same) beef bones.

Only furasemide really helps, expels water and trace elements, if it is pricked for a long time, this in itself can cause death.

doctor says old dog, What would you like. In essence, he refuses us.

We are desperate 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 actions.

If possible, tell me what your opinion is, what can happen to the dog and what is the prognosis.

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 advice about the "hair ball" in cats. Our kitten, about 5 months old, often tried to vomit something, but then swallowed back. My husband said it was a hairball and the kitten would vomit it for sure. But weeks after weeks pass, and he still suffers. Can you advise what should I do: go to the vet to help remove this hairball or can it be helped with home remedies? And how to determine if the hair ball is tormenting him? Thank you in advance.

How to support the immunity of an elderly dog: vitamins and drugs

Features of metabolism in old dogs

You need to understand that the metabolism of old dogs is slowed down - with this in mind, you need to develop a diet and vitamin-mineral complexes depending on the season. Older dogs need to be sure to increase the content of vitamins A, B1, B6, B12 and E in food or dressings - now they are more needed than in more young age.

Also, an elderly organism and immune system zinc is needed.

You should limit your intake of salty foods. If at a young age salt could be consumed in small quantities, then in the elderly its use is undesirable.

In order not to burden the kidneys, older dogs should receive less phosphorus. For the same purpose, reduce the amount of protein foods and control carbohydrate intake in order to old dog did not gain weight.

Preparations for older dogs

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

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

"Glycine" is a metabolic agent that regulates metabolism.

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

"Cocarboxylase" - a tool that regulates metabolic processes, playing important role in carbohydrate metabolism.

"L-carnitine" is an amino acid synthesized in the body from the amino acids lysine and methionine. Older dogs are prescribed it for the prevention of diseases of the muscles, liver, diabetes, kidneys. Amino acid promotes growth muscle mass, increases the tone and activity of the heart muscle.

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

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

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

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

Less commonly, dogs become deaf or lose their sight as they age. Basically, this happens with representatives of the so-called "problem" breeds.

Mildronate for a dog

A drug that improves metabolism. It is a structural analogue of the carnitine precursor gamma-butyrobetaine (GBB), in which one hydrogen atom is replaced by a nitrogen atom.

It is assumed that there are 2 mechanisms of action of Mildronate on the body

1. Effect on carnitine synthesis

As a result of the inhibition of the activity of butyrobetaine hydroxylase, Mildronate reduces the biosynthesis of carnitine and inhibits the transport of long-chain fatty acids through the cell membrane, preventing the accumulation in cells of activated derivatives of unoxidized fatty acids - acylcarnitine and acylcoenzyme A, which have pronounced detergent properties. Under conditions of ischemia, Mildronate restores the balance between the delivery and consumption of oxygen in cells, eliminates ATP transport disorders, while activating an alternative energy source - glycolysis, which is carried out without additional oxygen consumption.

With an increased load as a result of intensive energy consumption in the cells of a healthy body, a temporary decrease in the content of fatty acids, mainly carnitine, occurs. It is known that the biosynthesis of carnitine is regulated by its level in blood plasma and stress, but does not depend on the concentration of carnitine precursors in the cell. Since Mildronate inhibits the conversion of GBB to carnitine, this leads to a decrease in the level of carnitine in the blood, which in turn activates the synthesis of the carnitine precursor - GBB.

With a decrease in the concentration of Mildronate, the process of carnitine biosynthesis is restored and the concentration of fatty acids in the cell is normalized. Thus, cells undergo regular training, which contributes to their survival in conditions of increased stress, in which the content of fatty acids in them regularly decreases, and when the load decreases, the content of fatty acids is quickly restored. Under conditions of real overload, cells "trained" with Mildronate survive in those conditions when "untrained" cells die.

2. Function of the mediator of the hypothetical GBB-ergic system

It is hypothesized that there is a previously undescribed system of transmission of nerve impulses in the body - the GBB-ergic system, which ensures the transmission of nerve impulses to somatic cells. The mediator of this system is the immediate precursor of carnitine, the GBB ester. As a result of the action of esterase, this neurotransmitter gives up an electron to the cell, thus transferring an electrical impulse, and itself turns into GBB.

Synthesis of GBB is possible in any somatic cell of the body. Its speed is regulated by the intensity of the stimulus and energy expenditure, which in turn depend on the concentration of carnitine. Therefore, with a decrease in the concentration of carnitine, the synthesis of GBB is stimulated. With an increase in the concentration of the mediator (HBB ester) in any place in the body, with the participation of the central nervous system, regulatory mechanisms are activated that are “responsible” specifically for it.

Thus, there is an economical chain of reactions in the body that provides an adequate response to irritation or stress: it begins with the receipt of a signal from nerve fibers (in the form of an electron), followed by the synthesis of GBB and its ester, which, in turn, carries the signal on somatic cell membranes. Somatic cells, in response to irritation, synthesize new molecules, ensuring signal propagation. After that, the hydrolyzed form of GBB, with the participation of active transport, enters the liver, kidneys and testes, where it turns into carnitine.

As mentioned earlier, Mildronate is a structural analogue of GBB, in which one hydrogen atom is replaced by a nitrogen atom. Since Mildronate can be exposed to GBB-esterase, it can act as a hypothetical "mediator". However, GBB-hydroxylase does not act on mildronate, and therefore, when it is introduced into the body, the concentration of carnitine does not increase, but decreases. Due to the fact that Mildronate itself acts as a "mediator" of stress, and also increases the content of GBB, it contributes to the development of the body's response. As a result, the overall metabolic activity also increases in other systems, such as the central nervous system.

Results of experimental studies

In experiments on anesthetized cats, the effect of mildronate on the performance of the cardiovascular system was studied. It has been established that in a wide range of doses, the drug increases volumetric blood flow, systolic and minute volumes, does not have a significant effect or slightly lowers venous pressure. These data indicate a positive effect of Mildronate on the contractile function of the myocardium.

Mildronate has a protective effect in myocardial hypoxia. In experiments on isolated rabbit atria, it was found that after the cessation of hypoxic exposure, the drug accelerates the restoration of myocardial contractility to a normal level.

In another series of experiments on anesthetized white rats, it was found that the introduction of Mildronate before the start of the experiment eliminates the increase in ischemia (ST segment elevation) after ligation of the left coronary artery, reduces the corresponding focus of infarction and increases the life expectancy of animals. With repeated administration of the drug for 10 days, a pronounced (more than 2 times compared with the control) decrease in the focus of infarction was found.

Mildronate is more effective than nifedipine in preventing the development of cardiac arrhythmias, including ventricular fibrillation, in rats after coronary artery ligation.

In conditions of "facilitated" experimental myocardial infarction (ligation of the left coronary artery for ≤1 h) in dogs, the drug eliminates ischemic ECG changes.

Mildronate protects the myocardium from the damaging effects of catecholamines and alcohol.

In experiments on rats, it was found that the preliminary administration of Mildronate in 50% of animals completely eliminates ECG changes caused by isoproterenol (izadrin) and epinephrine (adrenaline). Histological examination of the myocardium of rats indicates that in the case of the use of epinephrine, mildronate protects myocardial cells, prevents the development of irreversible changes in cardiomyocytes and helps restore the normal structure of the myocardium.

In experimental studies, it was found that toxic concentrations of ethyl alcohol caused by myocardial damage do not differ in principle from those caused by ischemia or stress. It can be assumed that this is due to the similarity of the mechanisms of action of factors affecting myocardial tissues. The data that Mildronate reduces myocardial damage caused by ethyl alcohol justifies the use of the drug for the correction of functional and organic disorders of the body in chronic alcohol intoxication.

It has been experimentally established that Mildronate reduces the stimulating effect of ethyl alcohol by about 5 times. Under conditions of "free choice", mildronate reduces the consumption of ethyl alcohol by % in experimental animals.

In experiments on animals, an antihypoxic and cerebral blood flow-improving effect of the drug was observed. It has been established that Mildronate has a positive effect in ischemia of the brain tissue. The drug optimizes the distribution of cerebral blood flow in favor of ischemic foci, increases the resistance of neurons to hypoxia. Thus, in experiments on rats, the drug partially or completely eliminated EEG changes after occlusion of the carotid artery. Mildronate has an activating effect on the central nervous system: motor activity and physical performance increase, stimulation of motor reactions is noted, as well as an anti-stress effect, manifested in stimulation of the sympathetic nervous system, an increase in the content of catecholamines in the brain and adrenal glands, and a protective effect against stress-induced changes in internal organs.

The obtained results of experimental studies indicate the effectiveness of Mildronate and the possibility of its use in cerebrovascular pathology.

Results of clinical studies

Analysis of clinical data on the course treatment of stable angina pectoris with Mildronate indicates that under the influence of the drug the frequency and intensity of attacks are reduced, and the amount of nitroglycerin used is also reduced. The drug has a pronounced antiarrhythmic effect in the presence of coronary artery disease and ventricular extrasystoles and is less effective in supraventricular extrasystoles. The ability of the drug to reduce oxygen consumption at rest deserves special attention, which is considered an indicator of the effectiveness of antianginal treatment of coronary artery disease. Mildronate has a beneficial effect on atherosclerotic processes in the coronary and other peripheral vessels as a result of lowering the level of total cholesterol in the blood plasma and the atherogenic index.

The role of Mildronate in the treatment of chronic heart failure due to coronary artery disease has been analyzed on the basis of a fairly large number of clinical studies that indicate that the drug increases exercise tolerance and the amount of work performed by patients suffering from heart failure.

In a separate study of the Latvian and Tomsk Institutes of Cardiology, the effectiveness of Mildronate in moderate heart failure (II functional class according to the NYHA classification) was studied. After treatment with Mildronate, 59-78% of patients with an initial diagnosis of heart failure of functional class II were assigned to group I of functional class.

It has been established that Mildronate improves the inotropic function of the myocardium and increases exercise tolerance, improves the quality of life of patients without causing severe side effects. It is noted, however, that Mildronate can cause moderate arterial hypotension, allergic skin reactions, headache, discomfort in the stomach. In severe heart failure, Mildronate should be prescribed in combination with traditional remedies used to treat this disease.

A good clinical effect of Mildronate was manifested in patients with cardialgia, which developed as a result of menopause and alimentary obesity.

In clinical conditions, it has been established that the treatment with Mildronate reduces the frequency of relapses of alcoholism. It is shown that Mildronate allows to stop the alcohol withdrawal syndrome.

Mildronate is an effective means of complex treatment of acute and chronic disorders of cerebral circulation (ischemic stroke, chronic cerebrovascular insufficiency). It has been established that Mildronate normalizes the tone and resistance of capillaries and arterioles of the brain, restores their reactivity.

The effect of Mildronate on the process of rehabilitation of patients with neurological disorders (after past cerebrovascular diseases, brain surgery, tick-borne encephalitis) was studied.

The results of testing the therapeutic efficacy indicate a positive, dose-dependent effect of the drug on the restoration of physical performance and functional independence of patients during the recovery period. When analyzing changes in individual and integral intellectual functions, a positive effect of Mildronate on the process of restoring intellectual functions during the rehabilitation period was revealed. It was found that Mildronate improves the quality of life of convalescents (mainly as a result of the restoration of physical functions), and also contributes to the elimination of mental disorders in patients.

During the rehabilitation period, Mildronate has a positive effect on the regression of disorders of the nervous system in patients with neurological deficits. The general neurological condition of patients improves (reduction of brain damage and pathology of reflexes, regression of paresis, improvement of coordination of movements and autonomic functions).

In the clinic and practice of sports medicine, experimental data on the ability of Mildronate to increase efficiency and accelerate the recovery of performance after intense physical exertion have been confirmed. These features of the action of the drug are characterized by an improvement in the tolerance of training loads, the elimination of a feeling of fatigue, a surge of vivacity. In addition, the drug reduces emotional and mental stress (the disappearance of apathy and irritability after stress in training and competitions).

Mildronate has low toxicity. When administered to mice and rats of the active substance through the mouth, the LD 50 value exceeded lamg/kg. Repeated administration of mildronate to rats and dogs for 6 months did not cause adverse changes in body weight, blood composition, biochemical parameters of blood and urine of animals. In high doses, Mildronate caused hemorrhages in the liver and kidneys in dogs, without affecting the functions of these organs.

When studying the specific toxicity of Mildronate, teratogenic and embryotoxic effects were not observed. The drug has no mutagenic and carcinogenic properties. In experiments on animals, an allergenic effect was not detected.

Indications for use

As part of the complex therapy of IHD (angina pectoris, myocardial infarction), chronic heart failure, dyshormonal cardiomyopathy;

As part of the complex therapy of acute and chronic disorders of cerebral circulation (strokes and cerebrovascular insufficiency);

Hemophthalmos, retinal hemorrhages of various etiologies;

Thrombosis of the central retinal vein and its branches;

Retinopathy of various etiologies (diabetic, hypertensive);

Withdrawal syndrome in chronic alcoholism (in combination with specific alcoholism therapy);

Physical overstrain (including in athletes).

drug interaction

With simultaneous use enhances the effect of coronary dilators, antihypertensive drugs, cardiac glycosides.

Mildronate can be combined with antianginal agents, anticoagulants, antiplatelet agents, antiarrhythmic agents, diuretics, bronchodilators.

In view of the possible development of moderate tachycardia and arterial hypotension, caution should be exercised when combined with nitroglycerin, nifedipine, alpha-blockers, antihypertensives and peripheral vasodilators.

Dosing regimen

In connection with the possibility of developing an exciting effect, the drug is recommended to be used in the morning.

At cardiovascular diseases as part of complex therapy, the drug is prescribed at 0.5-1 g / day orally or intravenously (5-10 ml of injection solution with a concentration of 500 mg / 5 ml), the frequency of use is 1-2 times / day. The duration of the course of treatment is from 4 to 6 weeks.

At cardialgia on the background of dyshormonal myocardial dystrophy Mildronate is administered orally at 250 mg 2 times / day. The duration of the course of treatment is 12 days.

At cerebrovascular accident in the acute phase, the drug is prescribed intravenously at 500 mg 1 time / day for 10 days, then they switch to taking the drug orally at 0.5-1 g / day (taking the entire dose at once or dividing into 2 doses). The duration of the general course of therapy is from 4 to 6 weeks.

At chronic disorders cerebral circulation, the drug is taken orally at a dose of 0.5-1 g / day. The duration of the general course of therapy is from 4 to 6 weeks. Repeated courses are prescribed individually after consulting a doctor 2-3 times a year.

At vascular pathology and degenerative diseases of the retina Mildronate is administered parabulbarno in 0.5 ml injection solution at a concentration of 500 mg/5 ml for 10 days.

When Mildronate is administered orally at 250 mg 4 times / day or intravenously at 0.5 g 1 time / day. The duration of the course of treatment is from 10 to 14 days. If necessary, therapy is repeated after 2-3 weeks.

At chronic alcoholism the drug is prescribed orally at 500 mg 4 times / day, in / in - 500 mg 2 times / day. The duration of the course of treatment is from 7 to 10 days.

Indications for pregnancy

The safety of Mildronate during pregnancy has not been proven. To avoid possible adverse effects on the fetus, the drug should not be administered during pregnancy.

It is not known whether the drug is excreted in breast milk. If it is necessary to use Mildronate during lactation, the issue of stopping breastfeeding should be resolved.

special instructions

Use with caution for a long time in patients with chronic liver and kidney disease.

Many years of experience in the treatment of acute myocardial infarction and unstable angina in cardiology departments shows that Mildronate is not a first-line drug for acute coronary syndrome.

Pediatric use

Data on the use of Mildronate in children is not enough.

Influence on the ability to drive vehicles and control mechanisms

There are no data on the adverse effects of Mildronate on the speed of psychomotor reactions.

Mildronate

Instructions for use:

Prices in online pharmacies:

Mildronate is a drug that improves the metabolism and energy supply of tissues.

Release form and composition

Mildronate is produced in the following dosage forms:

• Capsules: white, hard gelatin, size No. 1 (250 mg each) or No. 00 (500 mg each); the contents of the capsules are a hygroscopic crystalline white powder with a slight odor (in blisters of 10 pcs., 2, 4 or 6 blisters in a cardboard box);
• Solution for injection: colorless, transparent (in ampoules of 5 ml, 5 ampoules in blister packs, 2 packs in a carton box).

The composition of 1 capsule includes:

• Active substance: meldonium dihydrate - 250 or 500 mg;
• Auxiliary components: potato starch - 13.6 / 27.2 mg; colloidal silicon dioxide - 5.4 / 10.8 mg; calcium stearate - 2.7 / 5.4 mg.

The composition of the capsule shell: E171 (titanium dioxide) - 2%; gelatin - up to 100%.

The composition of 1 ml of solution includes:

• Active substance: meldonium - 100 mg (as trimethylhydrazinium propionate);
• Auxiliary component: water for injections.

Indications for use

• Reduced performance, physical overstrain (including athletes);
• Withdrawal syndrome in chronic alcoholism (simultaneously with specific therapy for alcoholism);
• Ischemic heart disease (myocardial infarction, angina pectoris), chronic heart failure (as part of complex treatment);
• Acute and chronic disorders of cerebral circulation, including strokes and cerebrovascular insufficiency (as part of complex treatment).

Additionally for Mildronate in the form of a solution for injection:

• Thrombosis of the central retinal vein and its branches;
• Hemophthalmos, retinal hemorrhages of various etiologies;
• Retinopathy of various etiologies (hypertensive, diabetic).

Contraindications

• Increased intracranial pressure (including with intracranial tumors, impaired venous outflow);
• Hypersensitivity to the components of the drug.

It is not recommended to prescribe the drug to children under 18 years of age, as well as lactating and pregnant women due to the lack of clinical data confirming the safety and efficacy of Mildronate in these groups of patients.

Mildronate should be used with caution in patients with kidney and / or liver disease (especially for a long time).

Method of application and dosage

Due to the possible development of an exciting effect, Mildronate is recommended to be used in the first half of the day, when taken several times a day - no later than 17.00.

Inside Mildronate in the form of capsules is usually prescribed as follows:

• Ischemic heart disease (myocardial infarction, angina pectoris), chronic heart failure: daily dose - mg; frequency of reception - 1-2 times a day. The duration of the therapeutic course is 1-1.5 months (simultaneously with other drugs);
• Dishormonal cardiomyopathy: daily dose - 500 mg. The duration of the therapeutic course is 12 days (simultaneously with other drugs);
• Subacute disorders of cerebral circulation (cerebrovascular insufficiency and stroke): daily dose - mg; frequency of reception - 1-2 times a day. The duration of the therapeutic course is 1-1.5 months (the drug is taken orally simultaneously with other medicines after the end of the course of injection therapy with Mildronate);
• Chronic disorders of cerebral circulation: daily dose - 500 mg. The duration of the therapeutic course is 1-1.5 months (simultaneously with other drugs). It is possible to conduct repeated courses (usually 2-3 times a year) after a medical consultation;
• Reduced performance, mental and physical overstrain (including athletes): daily dose - 1000 mg; frequency of reception - 2 times a day. The duration of the therapeutic course is days. After 2-3 weeks, a second course is possible;
• Withdrawal syndrome in chronic alcoholism: daily dose - 2000 mg; multiplicity of reception - 4 times a day. The duration of the therapeutic course is 7-10 days (simultaneously with specific treatment alcoholism).

Mildronate in the form of a solution for injection is administered intravenously and parabulbarno.

As a rule, intravenous drug is prescribed:

• Cardiovascular diseases: daily dose - mg (5-10 ml of injection solution, concentration - 500 mg / 5 ml); frequency of use 1-2 times a day. The duration of the treatment course is 1-1.5 months (simultaneously with other drugs);
• cerebrovascular accident ( acute phase): daily dose - 500 mg; frequency of use - 1 time per day. The solution is administered for 10 days, after which they switch to taking Mildronate inside (mg per day). The total duration of the treatment course is 1-1.5 months;
• Physical and mental stress: daily dose - 500 mg; frequency of use - 1 time per day. The duration of the treatment course is days. After 2-3 weeks, a second course is possible;
• Chronic alcoholism: daily dose - 1000 mg; frequency of use - 2 times a day. The duration of the treatment course is days.

At vascular pathologies and dystrophic diseases of the retina Mildronate should be administered parabulbarno at a dose of 0.5 ml of injection with a concentration of 500 mg / 5 ml for 10 days.

Side effects

In rare cases, when using Mildronate in all dosage forms, side effects such as: allergic reactions (itching, redness of the skin, urticaria, skin rash, angioedema), dyspeptic symptoms, tachycardia, increase or decrease in blood pressure, irritability.

In very rare cases, eosinophilia and general weakness may develop.

special instructions

Many years of experience in the use of Mildronate in the treatment of unstable angina and acute myocardial infarction in cardiology departments has shown that Mildronate is not a first-line drug for acute coronary syndrome.

drug interaction

With the simultaneous use of Mildronate with certain drugs, the following undesirable effects may occur:

• coronary dilators, some antihypertensive drugs, cardiac glycosides: enhancing their action;
• Nitroglycerin, nifedipine, alpha-blockers, antihypertensives and peripheral vasodilators: the development of arterial hypotension, moderate tachycardia (when using such combinations, care must be taken).

Mildronate can be administered simultaneously with prolonged forms of nitrates, other antianginal drugs, antiplatelet agents and anticoagulants, antiarrhythmic, bronchodilator and diuretic drugs.

Terms and conditions of storage

Store in a dry place out of the reach of children at temperatures up to 25 ° C (do not freeze the injection solution).

Shelf life - 4 years.

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Mildronate for children

"Mildronate" is considered a drug that has a positive effect on metabolism and performance. This tool used to be 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 violations of the blood supply to the brain. Not everyone knows if such a medicine is allowed for children, than if necessary, it can be replaced.

Release form and composition

"Mildronate" is presented in a pharmacy in two forms:

• Capsules. They have White color and thick gelatin shell. These capsules are available in two different dosages and are sold in packs of 20, 40 or 60 pieces.
• Ampoules with solution for intravenous administration. It is colorless and transparent, poured into each 5 ml ampoule. Such a medicine is also administered parabulbarno. 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 an injectable drug with a dosage of 100 mg (one ampoule contains 500 mg), and in one capsule it can be either 250 or 500 mg. Additionally, only sterile water is present in the ampoules, and the capsules include Ca stearate, silicon dioxide, gelatin, titanium dioxide and potato starch.

Operating principle

Meldonium provides many positive effects. This connection:

• Increases the viability of heart cells and provides them with protection from adverse effects.
• Reduces the oxygen demand of heart cells and reduces bad influence lack of oxygen to the tissue.
• Protects and maintains the integrity of blood vessels, and also promotes their expansion.
• It has a tonic effect on the body.
• Supports cellular immunity by helping the body resist viral attacks.
• Helps to eliminate ischemia in the retina, myocardium or brain, improving the blood supply to these organs.
• Stimulates the removal of toxic compounds from cells, protecting them from damage.
• Helps to transfer physical activity and quickly restore their own reserves.
• Helps to eliminate the symptoms of mental stress.

Indications

• With heart failure, myocardial dystrophy, functional disorders in the work of the heart, myocardial infarction, angina pectoris and other problems with the cardiovascular system.
• At chronic bronchitis or bronchial asthma.
• With circulatory disorders in the retina of the eye or in the brain.
• With overwork, strong physical exertion, decreased performance, as well as after surgical treatment.