A bunch of riboxin and trimetazidine with glutamic acid. Treatment of heart disease

The vast majority of athletes prefer to train in a natural way, namely, without the use of steroids, and in order to improve the quality and speed of recovery after training, they use only some relatively harmless drugs that are not related to doping, including creatine, protein, amino acids, gainers, free sold in specialized sports nutrition stores. For the same purposes, athletes widely use a number of medicines that are available in ordinary pharmacies and dispensed without a prescription.

But, nevertheless, despite the relative harmlessness and availability of such pharmaceutical preparations, it is necessary to strictly adhere to the instructions attached to them and it is advisable to consult a doctor about their use before taking them. This article provides an overview of the main drugs used in bodybuilding, discusses their significance and effect on the athlete's body, contraindications and possible side effects.

The composition also includes magnesium in an easily digestible form for the human body - aspartate. Potassium and magnesium contribute to the normalization of metabolic processes in muscle cells, maintaining their normal osmotic pressure. This is realized through the potassium-sodium pump (the predominant location of potassium inside the cell, and sodium outside the cell space). However, the work of the potassium-sodium pump will be ensured only if a sufficient amount of energy is supplied to the cells, for which magnesium is responsible.

Aspartate facilitates the transport of potassium and magnesium into cells, which has a beneficial effect on the athlete's body. The drug increases efficiency, which contributes to the rate of muscle building. Magnesium, which is involved in protein metabolism and supplies this process energy, allows the athlete to effectively build muscle in the process of strength training.

Asparkam is also used by athletes for the purpose of rapid weight loss, when necessary in case of weight gain due to the fat component or excess fluid. Excess fat is removed "", combining enhanced protein nutrition with active training, and to prevent possible intoxication, they use a lot of fluid, with which the body also removes potassium and magnesium, so asparcam is needed here, as it restores the balance of potassium and magnesium. With fluid retention and edema, diuretics are used simultaneously with asparkam, which helps prevent the body from losing essential minerals and related complications.

The drug helps to fight cramps, and also significantly increases the endurance of an athlete training in high temperatures. environment. Asparkam is produced in the form of tablets. Dosages and method of use are indicated in the attached instructions, as a rule, this is the intake of one or two tablets three times a day. The drug should be taken in the morning and afternoon, since in the evening magnesium and potassium are absorbed by the body worse. The duration of the course of taking asparkam by a bodybuilder is individual and is determined by a sports doctor. It is recommended to take 1-2 tablets 3 times a day, preferably in the morning and afternoon.

Being a stimulant of biochemical processes, it is able to have a beneficial effect on the cardiovascular system of an athlete. The drug increases the strength of heart contractions, increasing stroke volume and coronary blood supply, has anabolic and antiarrhythmic effects. Riboxin improves blood supply to muscle tissues, normalizes energy metabolism, activates metabolic processes in the myocardium, as well as a number of enzymes. In addition to a positive effect on the heart, Riboxin improves the regeneration of muscle tissue. But for effective recovery after heavy loads, riboxin alone is not enough, so it is recommended to take it in combination with potassium orotate.

Riboxin can replace ATP. The drug is effective in combination with potassium orotate. It is taken for 1-3 months according to the scheme 0.2 g 3-4 times a day.

The drug is a stimulator of endogenous biochemical processes, belongs to the metabolism. Produced mainly in tablet form, dispensed in a pharmacy without a prescription. The average dosage for an athlete is 1.5-2 g per day. In fact, potassium orotate is a common mineral salt found in the tissues of any living organism. The drug helps to strengthen the cardiovascular system and has an anabolic effect, allowing the athlete to recover faster after training. The drug enhances diuresis and improves appetite. For a noticeable progress of a bodybuilder, the drug is not particularly effective, but, nevertheless, in general, it is useful for the body, well tolerated by the athlete and has no side effects.

The drug is taken according to the scheme: one hour before meals, 1 tablet 3-4 times a day. The duration of the treatment course is 21-24 days.

Mildronate

Mildronate is classified as a cardioprotector. The drug is designed to increase the athlete's performance, compensating for the manifestations of the syndrome of mental and physical overwork. Mildronate normalizes metabolic processes and regulates cellular immunity. As a rule, mildronate is prescribed at the rate of 15-20 mg per kilogram of weight. The drug is taken according to the doctor's prescription, so it is recommended to consult before you start taking it.

The daily dosage of the drug is determined at the rate of 15-20 mg / kg of body weight, which averages 1-2 g, taken in 4 doses. The duration of the course is 14 days with a repeat in 2-3 weeks.

Agapurin is available in tablet form and is relatively inexpensive. Preparations based on a similar active substance are trental and pentoxifylline. Agapurine is taken separately from other drugs. It increases vascular tone, reduces blood viscosity and increases blood flow velocity, which is important for an athlete who feels the maximum pumping of working muscles. The drug is used mainly by experienced bodybuilders - agapurine should be taken carefully, following the instructions, in order to avoid side effects of the drug.

In bodybuilding, Agapurin is taken according to the scheme:

on training days 3 times 2 tablets;
on rest days 3 times 1 tablet.

Duration of the course Agapurin - 20 days. After a 4-week break, the course is repeated. Tablets are washed down with a large volume of water. To avoid side effects, it is forbidden to take the drug without the consent of the doctor.

The plant grows in the western and eastern parts of Siberia, in the highlands of Altai and in Central Asia. It contains phytoexidons - substances identical to steroid compounds with a pronounced anabolic effect. activates protein synthesis and its accumulation in muscle tissue, heart, liver and kidneys. The drug helps to increase physical endurance and intellectual performance. Long-term use of leuzea strengthens the vascular bed and thereby improves overall blood circulation. The drug reduces the heart rate. Leuzea is part of a dietary supplement called Leuzea-P. One tablet of the supplement contains about 0.85 mg of the active substance - ecdysten, the cost of supplements is sports shops varies between 700-1800 rubles.

The drug is capable of causing hypoglycemia (a drop in blood sugar levels) and is superior in effectiveness to individual RA-adaptogens. Because hypoglycemia causes the release of growth hormone, taking Manchurian aralia contributes to the achievement of a high anabolic effect - the athlete improves his appetite and increases body weight. The drug is classified as an anabolic stimulant. Aralia tincture is sold in every pharmacy. Take it at a dose of 20-30 drops in the morning on an empty stomach and an hour before training.

As for vitamins taken separately:

Thiamine (B1) participates in the activity of the main body systems: cardiovascular, nervous and digestion. Influences growth and energy balance. Lack of vitamin B1 causes irritability, lack of appetite, increased fatigue and related health disorders.

Cyanocobalamin (B12) increases protein synthesis and its accumulation in tissues, is an effective anabolic agent.

Pyridoxine (B6) plays an important role in metabolism and the normal functioning of the nervous system.

Ascorbic acid (C)- antioxidant and reducing agent involved in metabolic processes.

B vitamins are available in injectable form, as a rule, the ampoule contains 1 ml of a substance of 5% concentration. It is unacceptable to administer all vitamins at the same time on one day - each vitamin is administered sequentially on a separate day, adhering to the cycle. Injections are made intramuscularly, the introduction of B1 and B6 can be somewhat painful.

Diabeton MB is a pharmaceutical drug sold freely. One of the strongest anabolics. how medicine used as a pancreatic stimulant in the complex treatment of diabetes mellitus. Bodybuilders use this drug to maintain a high level of anabolism in the offseason. In terms of effectiveness, it is close to insulin injections, and in terms of overall action, to methandrostenolone. The drug allows the athlete to quickly gain weight.

Available in the form of tablets of 30 mg. They start with a dose of 30 mg per day, which, if necessary, can be increased to 60 mg in the next course (the course lasts one and a half to two months). Diabeton MB should not be taken with other drugs. Take it with breakfast once a day. The anabolic effect of diabetone is to stimulate the production of one of the anabolic hormones - insulin. For effective action The drug is recommended at least six meals a day with a small amount of fat and an increased amount of protein. While taking diabetone, low-calorie diets are prohibited in order to avoid the development of side effects of the drug, in particular, hypoglycemia.

Tamoxifen is classified as an antiestrogen. The drug is used by bodybuilders to increase the level of testosterone in the body, blocking estrogen. Tamoxifen is used in combination with other drugs for the most effective exposure to long-term courses, for at least 6-8 weeks. Tamoxifen becomes especially popular with bodybuilders during cutting, as it speeds up and enhances fat burning processes. In cases where an athlete has a tendency to water retention while using anabolic steroids, taking tamoxifen becomes mandatory. The drug in bodybuilding is also valuable in that it allows the bodybuilder to effectively increase muscle density. Like any highly effective drug, tamoxifen has many side effects and contraindications, so it should be taken strictly as directed by a sports doctor.

It is an analogue and belongs to the category of effective fat burners. It is released in a pharmacy without a prescription. The drug provides an increase in body temperature by one degree, which allows you to mobilize fat from the depot and convert it into energy. When taking, side effects are possible - nervousness and trembling of the hands. On average, 3-5 tablets are taken per day in three doses (based on a tablet per 25 kg of an athlete's weight). A course lasting 6 weeks is repeated after 1.5 months.

Indications for taking glycerophosphate as a drug are overwork, dystrophy, rickets. For a bodybuilder, the drug is valuable in that it accelerates the absorption of protein and improves metabolism. Calcium glycerophosphate also helps to increase appetite. While taking the drug in the diet, it is necessary to limit fats, replacing them with proteins. It is recommended to take the drug in courses. There are no analogues of calcium glycerophosphate. The approximate daily dose of the drug is calculated based on the ratio of 100 mg for every 8 kilograms of weight. The daily dosage of Calcium Glycerophosphate is 1000 mg with a weight of 80 kg. It is divided into 5 doses of one tablet (200 mg). Time of taking the drug: morning 2 hours before training. The mass course lasts 1.5-2 months.

In terms of action, trimetazidine is close to the well-known mildronate, but much cheaper than the latter. The drug contributes to a greater delivery of oxygen to the cells, preserves the intracellular potential, counteracts the formation of free radicals, and increases the athlete's endurance. Taking the drug can significantly increase the load and intensity of training. Trimetazidine can be replaced with a similar agent containing, which, however, will not be an equivalent replacement in terms of effectiveness. It is possible to combine the drug with other drugs.

Vinpocetine is a drug that corrects cerebral circulation disorders. The active substance of the drug is apovincaminate. Vinpocetine has a direct effect on metabolic processes in the brain tissue. It has a vasodilating effect and improves the blood supply to the brain tissues. Vinpocetine increases the resistance of tissues to hypoxia, activates the utilization of glucose and the exchange of serotonin and norepinephrine in the brain tissue. The drug prevents platelet aggregation, thereby reducing blood viscosity. Vinpocetine has a positive effect not only on the brain, but also on muscle tissues, contributing to their better supply of oxygen and nutrients. The drug is usually taken in a dose of 5 to 30 mg 30 minutes - an hour before training. Vinpocetine does not have the side effects of classic "energy drinks" in the form of insomnia or hand tremors.

The mechanism of action of metformin is based on its ability to suppress gluconeogenesis in the liver, prevent glucose absorption in the intestine and better utilize it in muscle tissues. Accelerates the process of transition of glucose into glycogen. Reduces appetite, thereby reducing or stabilizing weight. It does not have a hypoglycemic effect. Before use, the athlete should consult a doctor, as the drug has many contraindications and may have side effects.

Rhodiola rosea is also called Golden Root. The places of its growth are Eastern Siberia, the Far East, Altai, Sayan Mountains. Pharmacological properties of the golden root are due to the active substances present in it - rhodiolyside and rhodosin. In pharmacies you can find them in their pure form. The main feature of Rhodiola rosea is the effect on muscle tissue, which is manifested in the improvement of energy metabolism in them. Taking the drug helps to increase endurance and increase muscle strength. At the same time, the activity of contractile proteins - myosin and actin - increases at the cellular level, and mitochondria increase in size. Rhodiola rosea tincture is taken 2-3 times before meals in the amount of 20-25 drops.

In this article, you can read the instructions for using the drug Trimetazidine. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of doctors of specialists on the use of Trimetazidine in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Trimetazidine analogues in the presence of existing structural analogues. Use for the treatment and prevention of angina attacks and vascular disorders in adults, children, as well as during pregnancy and lactation. The composition of the drug.

Trimetazidine - has an antihypoxic effect.

Directly affecting cardiomyocytes and brain neurons, it optimizes their metabolism and function. The cytoprotective effect is due to an increase in energy potential, activation of oxidative decarboxylation and rationalization of oxygen consumption (increased aerobic glycolysis and blockade of fatty acid oxidation).

Supports myocardial contractility, prevents a decrease in the intracellular content of ATP and phosphocreatine. Under conditions of acidosis, it normalizes the functioning of membrane ion channels, prevents the accumulation of calcium and sodium in cardiomyocytes, and normalizes the intracellular content of potassium ions.

Reduces intracellular acidosis and elevated phosphate levels caused by myocardial ischemia and reperfusion. It prevents the damaging effect of free radicals, preserves the integrity of cell membranes, prevents the activation of neutrophils in the ischemic zone, increases the duration of the electrical potential, reduces the release of creatine phosphokinase from cells and the severity of ischemic myocardial damage.

With angina pectoris, it reduces the frequency of attacks (the consumption of nitrates decreases), after 2 weeks of treatment, exercise tolerance increases, and blood pressure drops decrease. Improves hearing and results of vestibular tests in patients with ENT pathology, reduces dizziness and tinnitus. At vascular pathology the eye restores the functional activity of the retina.

Trimetazidine dihydrochloride + excipients.

After administration, trimetazidine is rapidly and almost completely absorbed from the gastrointestinal tract. Bioavailability - 90%. Easily penetrates through histohematic barriers. Excreted by the kidneys (about 60% - unchanged).

Film-coated tablets 20 mg.

Tablets with modified release 35 mg (Biokom MV).

Instructions for use and dosing regimen

skin itching;
headache;
feeling of a strong heartbeat;
weak dyspeptic symptoms (nausea, vomiting, gastralgia).

renal failure (CC below 30 ml / min);
parkinson's disease, symptoms of parkinsonism, tremor, syndrome restless legs and other related movement disorders;
pregnancy;
lactation period;
age up to 18 years (efficacy and safety have not been established);
hypersensitivity to any component of the drug;
due to the presence of lactose in the preparation, it is contraindicated in congenital lactose intolerance, lactase deficiency, and glucose-galactose malabsorption.

Use during pregnancy and lactation

Trimetazidine is contraindicated during pregnancy and lactation.

Contraindicated in children and adolescents under 18 years of age (efficacy and safety not established).

Do not use for the relief of angina attacks!

During treatment with the drug in patients with coronary artery disease, there is a significant decrease daily requirement in nitrates.

Influence on the ability to drive vehicles and control mechanisms

The use of the drug does not affect the ability to drive a car and perform work requiring high speed psychomotor reactions.

Analogues of the drug Trimetazidine

Structural analogues for the active substance:

Angiosil retard;
Antisten;
Vero Trimetazidine;
Deprenorm MV;
Carditrim;
Metaguard;
Predizin;
Preductal;
Preductal MV;
Precard;
Rimecore;
Rimecor MV;
Triducard;
Trimectal;
Trimectal MV;
Trimet;
Trimetazid;
Trimetazidine MB;
Trimetazidine Biokom MV;
trimetazidine ratiopharm;
Trimetazidine Teva;
Trimetazidine dihydrochloride;
Trimitard MV.

Which is better: Trimetazidine or Mildronate?

Trimetazidine, also called Preductal, is an antioxidant. The drug regulates metabolism in the heart muscles, has a good effect on homeostasis at the intracellular level. What is better Trimetazidine or Mildronate should be decided by the doctor.

Features of Trimetazidine

This is old drug, which the famous firm "Servier" from France created in the early sixties of the last century. Then he was the first drug from the group of antioxidants with good effect actions. However, the mechanism of action on the body of Trimetazidine, the company that created it, found out only 30 years later, after the creation of Mildronate in Riga.

Common to these drugs is the same effect on the myocardium with the focus of ischemia. Trimetazidine also allows you to increase physical activity on a person. In this capacity, the effect of both drugs is the same. But for patients with angina pectoris, doctors prefer to prescribe Trimetazidine, because of the smaller doses of this drug needed to achieve the same result. Whereas Mildronate is more suitable for healthy people in need of increased physical activity.

The difference between Trimetazidine and Mildronate

Mildronate protects against cell death during oxygen starvation. This is very important during the restoration of blood circulation in the heart muscle. But the methods of influencing the cells of the heart muscle and Mildronate and Trimesidine are different.

The duration of treatment courses for these drugs vary. The course of treatment with Trimetazidine is 6 months, and the usually prescribed course of treatment with Mildronate is 6 weeks. It has been proven that Mildronate increases the life expectancy of people who have had a severe myocardial infarction.

Combination of Trimetazidine and Mildronate

Many medical professionals believe that it is possible to take Trimetazidine and Mildronate in combination. Mildronate affects the rate of metabolic reactions of long-chain fatty acids, and Trimetazidine affects their utilization. Together they give improvement and stability of the course of angina pectoris, and the normalization of the reaction of the body of such a patient to physical activity.

You can also combine the analogue of Mildronate Cardionate with Trimetazidine. Riboxin and Mildronate can be taken simultaneously as drugs that affect the mechanism of metabolism. Drinking Trimetazidine along with Mildronate is advisable and is considered effective, especially in postoperative period in patients undergoing coronary artery bypass grafting. Against the background of such treatment, the protective functions in the cells of the heart muscle rapidly increase. In the same way, these drugs work with other types of angioplasty. Such a remedy results in an improvement in the biochemical parameters of a sick person.

The compatibility of Mildronate and Trimetazidine is based on the fact that each of them acts on different parts of the metabolic process in the heart cells and therefore the dosage of each can be reduced. At the same time, the effect of the overall action of the drugs increases. It should be borne in mind that both drugs belong to the category of low-toxic drugs, and do not give various serious side effects.

Modern cardiologists believe that energy metabolism in cells can be improved through:

decrease in ATP consumption by cells;
improving the efficiency of membranes in mitochondria;
restoration of lost links in the chain of respiratory processes in cells;
decrease in oxygen demand by the cells of the heart muscle.

All this is done by direct-acting cardioprotectors Trimetazidine and Mildronate, if used in combination.

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Preductal MV instructions for use, reviews of cardiologists, analogues

Preductal is a drug that has antianginal and anti-ischemic properties. Instructions for use mb contains a leaflet with detailed information. The drug has a short effect on the body and is quickly absorbed, also quickly excreted from the body. Reviews of cardiologists, which one is better, a recipe in Latin, what is the difference, how long can you take, what is it and how to replace it, we will consider below.

Compound

Preductal has a composition - the active substance is dinidrochloride mn trimetadizine and a number excipients- povidone, magnesium stearate, sodium stearate. Release form - tablets, injections.

The cost and how much a generic drug costs in pharmacies in Minsk, Russia, Odessa, Moscow depends on the country of manufacture. Most often it is France.

What is prescribed, indications for use

The drug helps:

Analogues are cheaper

The analogue of the Russian preductal - trimetazidine, is a synonym for the preductal, and is able to replace it. Expert opinions vary. Preductal has a number of analogues and cheaper substitutes, which are used in different ways.

The substitute for the preductal is able to fully implement the functions assigned to it and cope with the problem. If you have atrial fibrillation, the drug will relieve unwanted symptoms.

Preductal mv or mildronat, which is better?

Mildronate is widely used in sports. Most athletes focus on various supplements that can support heart muscle and increase performance. Preductal is suitable for ordinary people who monitor their health and want to eliminate the causes of arrhythmia or tachycardia.

Preductal instructions for use

After taking the drug, the body quickly removes through the gastrointestinal intestinal tract trimetadizine derivatives. The maximum concentration in the blood is observed after 5 hours after consumption. It is excreted from the body with urine, kidneys. Caution should be taken in patients over 75 years of age, as some older people experience increased concentration trimetadizine in the blood, and as a result, sharp jumps in pressure. The drug should be taken orally 2 tablets 2 times a day after meals. As a rule, it is worth splitting the reception into the morning and evening. Tablets do not chew, drink necessary quantity water. The daily dosage of the drug should be 70 mg.

Tablets are strictly contraindicated for pregnant women and during lactation. breastfeeding. There has not been a sufficient number of studies that would confirm the safety of trimetadizine on the fetus. If there is a need to take the drug, then it is worth canceling the feeding.

Why do athletes choose preductal? The drug is able to actively release free radicals, thereby having a pronounced antioxidant effect. May have the ability to increase metabolism, enhances the oxidation of glucose in the body. For athletes, this is relevant, as efficiency increases and more strength appears. Effective in angina attacks. As a result of clinical studies of athletes who regularly took Preductal, it was revealed by ECG results that a relatively calm heart rhythm.

Preductal mv reviews of cardiologists

According to the numerous reviews of cardiologists who prescribed this drug to patients, one can note a positive trend in the treatment of these patients. Many stopped complaining about the confused heart rate and stabilization of the position.

Contraindications

Preductal has a number of contraindications. Among them:

1. Individual intolerance to the drug.
2. Hypersensitivity to the active components of the product.
3. Pregnancy and lactating mothers.
4. Children's age up to 18 years
5. Elderly people after 80 years of age with caution on the advice of a doctor
6. Kidney failure

1. Constipation, abdominal pain, diarrhea, dyspepsia
2. Unsteadiness of gait, absent-mindedness.
3. Allergic reactions - urticaria, pruritus, dermatitis.

Alcohol compatibility

The drug is compatible with alcohol, alcohol. Simultaneous reception of replacement is undesirable. child, method, most effective method, describe the medication - more detailed information can be found on wikipedia.

Which is better: therapy with Riboxin or Mildronate tablets together - effect

There are drugs that are used as cardioprotective and antihypoxic agents for intensive physical activity. These drugs include Riboxin and Mildornate.

The main purpose of drugs is complex therapy coronary disease hearts. However, athletes often use them to achieve more pronounced sports results.

The drugs are effective separately, but many are interested in whether it is possible to take Riboxin and Mildronate together.

All about the drug Riboxin - brief instructions for use

A modern drug aimed at stabilizing the metabolism in the myocardium, normalizing the state of tissues that have undergone hypoxia - Riboxin. Country of origin - Russia.

The release form of the drug is round tablets with a specialized film shell, the shade varies from yellow to pale orange. The main component of Riboxin is inosine. The drug is available in one dosage - 200 mg.

Additional components included in the preparation: stearic acid, potato starch, microcrystalline cellulose, sucrose monohydrate, talc, iron oxide, yellow dye.

Riboxin is available in cartons containing blisters of either 25 or 10 tablets.

It is important to note that Riboxin is dispensed by prescription.

Indications for the use of the drug Riboxin:

as one of the components of therapy for ischemia of the heart muscle, cardiac arrhythmias, prolonged use of cardiac glycosides, acute myocardial infarction;
for symptomatic treatment of liver dysfunction, hepatitis, cirrhosis, provoked by the use of strong drugs, alcohol abuse.

Riboxin is taken by professional athletes to improve physical performance.

Factors excluding the possibility of prescribing the drug:

allergic reactions, hypersensitivity;
benign prostatic hyperplasia;
fructose intolerance or severe sucrase deficiency.

Riboxin can be taken only under the supervision of a doctor for severe kidney pathologies, diabetes mellitus.

Conducted clinical studies have shown that Riboxin has excellent tolerance. Possible side effects: skin rashes, urticaria, intense itching, increased blood urea, in men - worsening gout.

Mildronate - dosage, indications

A popular drug that increases metabolic processes and energy supply to body tissues. The drug has scandalous popularity in the field of sports, some time ago a “mildronate explosion” was widespread. During this period of time, many professional athletes used the drug in the process of training to improve results.

Mildronate has two dosage forms: capsules for oral administration and ampoules with a solution for injection. The main component of the drug is meldonium dihydrate, the amount of active substance in the capsule is 5 g.

Additional substances included in the medicinal product: colloidal silicon dioxide, potato starch, gelatin, titanium and silicon dioxide.

Mildronate is sold in cardboard packs containing 6 contour cells of 10 tablets.

This medication is considered a doping drug. The main purpose of Mildronate:

in a therapeutic complex against chronic heart failure, ischemic pathology, various forms of angina pectoris, myocardial infarction, arrhythmias;
to improve concentration, increase activity, treat chronic fatigue syndrome;
as one of the drugs complex therapy circulatory disorders in the brain;
reduction of psycho-emotional, physical and mental overstrain in professional athletes;
symptomatic therapy for withdrawal caused by a chronic form of alcoholism.

The list of contraindications for taking Mildronate includes:

deficiency of potassium in the blood plasma;
systematically elevated blood pressure;
the period of breastfeeding and pregnancy;
minor age;
increased susceptibility to components, allergic manifestations.

The drug should be taken with extreme caution if there is a history of severe kidney pathologies. Mildronate is well tolerated, side effects include dermatological reactions, general malaise, and weakness.

How to take Riboxin and Mildronate correctly

One of the important topics is the way drugs are used, because if you take a powerful drug incorrectly, then there is high risk development of life-threatening complications.

Riboxin and Mildronate are potent drugs, so the frequency, duration and effective dosage of administration is prescribed by a doctor.

It is recommended to drink the drug 15-30 minutes before meals. Take the whole tablet without chewing and drinking water.
The therapeutic course varies from 1 to 3 months. In the treatment process, Riboxin is used daily.
The initial dose is 600 - 800 mg. The maximum value is 2400 mg. The daily dose must necessarily be divided into several doses.

The occurrence of side effects or intolerance to the components suggests the abolition of the use of Riboxin.

Professional athletes (running, athletics, bodybuilding) should take 50-100 mg twice a day immediately before the training process.
For ischemia and chronic heart failure, disorders of cerebral circulation, take 50 - 100 mg, the duration of the course is 1 - 1.5 months.
Ppri increased physical and psycho-emotional stress. Dosage 5 g twice a day. Therapy should not last more than 2 weeks.

It is important to emphasize that in order to achieve the maximum effect, the characteristics of the reception must be selected individually.

The difference between drugs, and what is best for the heart

Quite a popular question about the simultaneous intake and compatibility of these drugs. But before you understand this topic, you need to understand how Riboxin and Mildronate differ.

In sports, Mildronate is considered more effective and popular. In this regard, the drug is widely distributed among professional and novice athletes. In addition, the drug is actively used in the training of the military.

When ingested, meldonium solves several problems at once:

increases endurance;
participates in increasing the rate of glucose breakdown;
several times reduces the breakdown of lipids;
increases the efficiency of muscle contractions.

It is recommended to take Mildronate in the morning to achieve maximum effects.

In turn, the use of Riboxin gives best results in the treatment of pathologies of the cardiovascular system. The drug has a less pronounced effect, but it helps to fight dangerous pathologies. The main properties of the drug Riboxin:

improvement of wall elasticity and vasodilatation;
normalization of blood pressure;
increasing the immune activity of the body;
beneficial effect on the structure of muscle tissue;
increase in the rate of regeneration of cells subject to hypoxia;
increased effect when taken simultaneously with other drugs.

If you take these medicines together, then Mildronate takes the leading role in achieving the result.

Compatibility of Riboxin and Mildronate

The main effect of these medicines is identical - the normalization of metabolism. Simultaneous administration of drugs leads to a mutual increase in efficiency. The leading role in this complex is assigned to Mildronate.

The combined use of drugs that affect metabolism and heart muscle can be dangerous. In this regard, before starting use, it is necessary to visit a doctor, undergo a comprehensive diagnostic study.

Important! Taking both drugs on your own is dangerous not only for health, but also for life.

Analogues of these drugs

In addition to Riboxin and Mildronate in cardiology and professional sports substitute drugs are used. Popular analogues include:

Synonymous drugs also have a strong effect on the body, so they are used only after the appointment of a cardiologist, the attending therapist.

Mildronate and Riboxin are popular medicines used in the treatment of cardiological diseases and professional sports. The use of drugs can be harmful, a doctor's prescription is necessary.

Actions of cardioprotectors

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3. Trimetazidine and its effect on the myocardium

Cardiovascular diseases are one of the main non-communicable causes of death in the population. In recent years, preventive and medical measures led to a decrease in mortality from coronary artery disease, mainly among people young age. However, based on the data epidemiological studies it is concluded that the prevalence of angina pectoris in the elderly will increase. In this regard, the search for new ways to treat diseases of the cardiovascular system, especially in the elderly, remains an urgent problem in clinical cardiology and pharmacology.

The word "protection" in Latin literally means cover or figuratively - support, protection, patronage, protection.

The concept of cardioprotection includes all mechanisms and methods of protecting the heart by preventing or reducing the degree of myocardial damage. Interventions aimed at cardioprotection can be divided into acute and chronic. In both cases, a number of physiological adaptive or compensatory mechanisms develop, and in both cases, surgical or pharmacological correction of the disorders that have arisen is possible.

One of the most common types of myocardial damage is its ischemia, which develops as a result of a discrepancy between myocardial oxygen demand and its delivery with blood through the coronary arteries. In this case, a decrease in the energy supply of cells, a violation of contractility and death of the myocardium occur. It is known that with acutely developing thrombosis and sharp decline oxygen supply to cardiomyocytes, the protective effect is achieved by restoring coronary blood flow through surgical or pharmacological correction. In addition, the pharmacological correction of acute and, especially, chronic ischemic conditions follows three main directions:

1. Increased coronary blood flow (nitrates, calcium antagonists)

2. Reducing the work of the heart (decrease in heart rate, decrease in after- and preload) with the use of beta-blockers, calcium antagonists, nitrates.

3. Improve myocardial metabolism.

The last direction of therapy should be considered no less important than the first two ways of treating ischemia. This is due to the fact that acute myocardial ischemia often leads to such significant changes that even the restoration of blood flow and oxygen delivery in many cases does not allow maintaining the functional activity of the heart. At the same time, chronic or recurrent episodes of ischemia can lead to adaptation of the myocardium to subsequent ischemic damage, which is manifested by inhibition of metabolism and the development of myocardial "hibernation", which is a chronic, but reversible, ischemic dysfunction of the left ventricle. During ischemia, there is a decrease in the delivery of exogenous substrates and oxygen, a decrease in the rate of glucose utilization, the rate of absorption of free fatty acids, as mitochondrial oxidation is inhibited. In conditions of insufficient oxygen supply, the oxidation of fatty acids proceeds incompletely, acyl-CoA and medium-chain fatty acids accumulate. In addition, as a result of lipolysis of phospholipids of the sarcolemma and other membranes, toxic products accumulate, which increase membrane damage and aggravate the severity of ischemia. Drugs that are able to interrupt the cascade of adverse reactions caused by ischemia, or reduce their manifestations, have a protective effect and have undoubted prospects in clinical practice. One of these drugs is Riboxin.

1. Mechanism of action of Riboxin

Despite the widespread use of riboxin in the treatment of coronary heart disease, there are still no generally accepted ideas about the mechanism of action of this drug. Riboxin is a derivative of purine. Considered as a precursor of adenosine triphosphoric acid. According to the type of action refers to anabolic substances. In experiments conducted in 1989 by the Department of Pharmacology of the Zaporozhye Medical Institute on rats in which myocardial infarction was experimentally induced, an attempt is made to reveal the mechanism of action of Riboxin. The nature of the change in carbohydrate-energy metabolism after a single administration of riboxin indicated the activation of anaerobic glycolysis, which was manifested by an increase in lactate concentration. Oxygen-free energy production was carried out mainly with the use of glucose, which, probably, was the reason for the decrease in its content in the heart muscle. The effect of riboxin on the metabolism of proteins and free amino acids was manifested in a decrease in the content of urea in the blood serum. Riboxin, used in the acute period of experimental myocardial infarction, had a pronounced cardioprotective effect, manifested by a lower activity of lactate dehydrogenase and a lesser severity of ischemia signs on the ECG. At the same time, a protective effect was noted in the heart muscle in relation to the depletion of carbohydrate reserves (glycogen) and inhibition of lactate production, which is apparently associated with the suppression of glycolysis. Attention is drawn to the fact that Riboxin retained the ability to stimulate the biosynthesis of nucleotides and proteins under conditions of ischemic myocardium. Thus, the study confirms the fact that the effects of riboxin are realized through its impact on the energy balance and nucleotide synthesis. In addition, it was found that the effect of riboxin, which stimulates anaerobic glycolysis, is accompanied by a deficiency of glucose. A very important characteristic of the drug is the ability to stimulate protein biosynthesis on the piloribosomes of cardiomyocytes. Apparently, the leading mechanism of the cardioprotective action of riboxin is the activation of an adaptive reaction - a targeted synthesis of enzyme proteins that provide bioenergetics of cardiomyocytes under hypoxic conditions. The decrease in fermentemia, the severity of electrocardiographic and pathobiochemical manifestations of myocardial ischemia with riboxin determines the advisability of using the drug in the acute period of myocardial infarction. One of the most likely ways of "metabolic potentiation" of the cardioprotective action of riboxin is its combined use with glucose (glucose-insulin-potassium mixture) and aspartic acid (panangin, asparkam) preparations. Thus, riboxin increases the activity of anaerobic glycolytic processes with hyperproduction of lactate and the formation of glucose deficiency in the heart muscle, accelerates the biosynthesis of proteins in the myocardium in normal conditions and during ischemia, and causes a pronounced cardioprotective effect in experimental myocardial infarction. Currently, Riboxin is used in the complex therapy of coronary artery disease, with cardiomyopathies, cardiac arrhythmias associated with the use of cardiac glycosides, as well as with liver diseases (cirrhosis, hepatitis). Usually the drug is well tolerated. However, itching, flushing of the skin is possible; in rare cases, there is an increase in the concentration of uric acid in the blood and exacerbation of gout.

2. Mildronate is an analogue of carnitine

In recent years, it has been established that in the case of ischemia (insufficient oxygen supply), the cells accumulate the active form of non-oxidized fatty acids - acylcarnitine, which is dangerous for the body, as it destroys cell membranes and blocks the delivery of ATP to cell organelles. As a result, cells die, even if the ATP reserves are sufficient for their functioning for some time. To prevent cell death, it is necessary either to improve their blood supply (which is not always possible in conditions of circulatory failure), or to limit the synthesis of carnitine. MILDRONATE is a structural analogue of the precursor of carnitine, which reversibly partially blocks the enzyme responsible for the synthesis of carnitine and the activation of fatty acids. MILDRONATE prevents the accumulation of toxic metabolic products, activates an alternative energy supply mechanism (anaerobic glycolysis), ensures the delivery of the resulting ATP to the cell organelles and adapts the metabolism to cell functioning under ischemia conditions. As a result of experimental studies, it has been proven that the use of MILDRONATE helps to reduce the content of carnitine and acylcarnitine, which have a damaging effect on the membrane, by 5 times. At the same time, the oxidation of free fatty acids in the myocardium is halved. Less free fatty acids enter the mitochondria, they accumulate in the blood serum. At the same time, the content of free fatty acids in the cytoplasm of myocardiocytes does not increase. This is very important for the survival of the cell. The drug has a pronounced cardioprotective (protecting heart tissue) effect. In the case of acute ischemic damage to the myocardium (heart muscle), mildronate slows down the formation of a necrotic zone (tissue necrosis), shortens rehabilitation period(period of restoration of disturbed body functions). In heart failure improves myocardial contractility, increases tolerance (tolerance) to physical activity. When not stable angina the drug reduces the likelihood of developing myocardial infarction in patients, and with stable angina pectoris II and III of functional classes, it increases the physical performance of patients and reduces the frequency of angina attacks. In addition, the drug has antiarrhythmic properties. According to the manufacturer's instructions and literature data, indications for the use of the drug are: stable and unstable angina, myocardial infarction, chronic heart failure and myocardial dystrophy. The drug is also used for acute and chronic cerebrovascular accidents (HNMK). According to research conducted in 1991 at the Department of Nervous Diseases of the Kyiv National medical university them. A.A. Bogomolets by Professor S.M. Vinichuk, the use of MILDRONATE in CNMC is pathogenetically justified, since the drug has an antioxidant, anti-ischemic and cardiotonic effect. In addition, MILDRONAT is prescribed to increase physical performance in case of psycho-emotional overload, including athletes in the recovery period. Now let's talk about preductal or trimetazidine.

What is better riboxin or trimetazidine

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Topic: Severe metabolic changes

About your tachycardia. It could very well be just emotional reaction for a medical examination or in general the result of physical activity before the study.

But I'm confused by your metabolic changes. You probably made a little mistake when reading the conclusion (most likely this was facilitated by the doctor's handwriting). Think, we are talking about metabolic changes.

Perhaps there is myocardial dystrophy. Of course, it is difficult to make a diagnosis based on the ECG findings alone.

Therefore, in any case, you need to see a doctor again, preferably a cardiologist. Also, perhaps, consultation of the endocrinologist is necessary for you.

73 is not tachycardia. Tachycardia is more than 90. Sinus is the norm, because. The basic human rhythm is sinus.

Metabolic or metabolic changes are nonsense that is sometimes written in Russia when something needs to be written. There are no metabolic disorders, these are fantasies of inventors.

If you have the ECG in your hands (the film itself), you can scan it and post it on this forum (up to 100 kb) or send it to me by E-mail: .

I think that I will reassure you.

Unique person, what is myocardial dystrophy? How is she treated? How does it manifest itself? Don't you think that this concept is equivalent to the phrase "something with a heart"? Modern cardiology is a concrete science, not an illusory one.

Tell me, is there such a disease - fatty hepatosis? Couldn't some organ be affected due to some metabolic disorder in the body? Is hemochromatosis of the heart, for example, not one of the causes of myocardial dystrophy?

In my opinion, myocardial dystrophy is a structural change in the myocardium due to metabolic disorders.

And the clinic can really be reflected in the expression "something with the heart", because. with myocardial dystrophy with heart function, anything can happen. Another thing is that there are still signs of damage to other organs and systems.

And it is necessary to treat metabolic disorders at the level of the whole organism.

Alexander Ivanovich, do not take it for work, comment.

Sincerely, physician-therapist Maxim Sosnin.

[B] Dear Alexander Ivanovich!

I will not argue with you. You are a specialist with experience, I - (hopefully temporarily) no.

I will just express my point of view (of course, based on what we have been taught at the university for the last 6 years).

Tell me, is there such a disease - fatty hepatosis? Can't

In general, it would really be nice to check out the ECG, so as not to argue pointlessly

3. Climacteric (dyshormonal).

Clinical manifestations of myocardial dystrophy proper are EXTREMELY VARIOUS!

ECG signs of myocardial dystrophy: various arrhythmias, various changes in T (+, -, 0).

Treatment: ONLY ELIMINATION OF THE CAUSE OF MYOCARDIODISTROPHY! There is NO specific treatment!

To metabolic disorders, except for the indicated myocardial dystrophies, ONLY changes can be added electrolyte metabolism(K, Ca). The general phrases “something with the metabolism” or “malnutrition of the heart” speak only of the low qualification of the doctor and his ignorance of cardiology. I put twos for the phrase in the conclusion of the ECG: "moderate metabolic disorders"! From this phrase, it is impossible to even imagine what is actually on the ECG (depression / ST elevation, +, -, 0 T wave or lengthening / shortening of QT).

If you wish, you can download my lecture on ECG decoding (Power Point file) here.

Can't find a husband/wife

Husband / wife is an alcoholic or a businessman,

Divorce, adultery, etc.

Sometimes the patient himself blocks the tip of the iceberg of his problems from himself. Having collected an anamnesis, you, even pointing out the MAIN problem of the patient, can help him start searching for its solution.

Mildronate or trimetazidine

In the Beauty and Health section, to the question Is it possible to combine Trimectal and Mildronate together? What action are they? The best answer given by the author Lelka is that mildronate, using a number of different mechanisms, is able to regulate the amount of available carnitine in cells and, at the same time, the rate of oxidation of long-chain fatty acids, which is a necessary tool for regulating energy metabolism under conditions of oxygen deficiency.

The beneficial effects of mildronate were noted not only in the pathology of the cardiovascular system (IHD, heart failure, myocardial infarction, etc.), but also in diseases of the central nervous system, as well as other pathologies, in the etiology of which ischemia and tissue hypoxia play an important role.

Trimectal, Trimetazidin-Ratiopharm) - a drug that prevents the utilization of FFA as an energy substrate and the accumulation active forms FFAs in the cytosol due to their use for the formation of membrane phospholipids. A number of clinical studies have shown the anti-ischemic effect of Trimetazidine, comparable to the effect of nifedipine and propranolol. This effect was manifested by a significant improvement in the clinical course and an increase in exercise tolerance in patients with stable angina pectoris, with ischemic cardiomyopathy, during revascularization interventions.

Which is better: Trimetazidine or Mildronate?

Features of Trimetazidine

This is an old drug that the famous Servier company from France created back in the early sixties of the last century. Then he was the first drug from the group of antioxidants with a good effect. However, the mechanism of action on the body of Trimetazidine, the company that created it, found out only 30 years later, after the creation of Mildronate in Riga.

The difference between Trimetazidine and Mildronate

Combination of Trimetazidine and Mildronate

You can also combine the analogue of Mildronate Cardionate with Trimetazidine. Riboxin and Mildronate can be taken simultaneously as drugs that affect the mechanism of metabolism. Drinking Trimetazidine together with Mildronate is advisable and is considered effective, especially in the postoperative period in patients undergoing coronary bypass surgery. Against the background of such treatment, the protective functions in the cells of the heart muscle rapidly increase. In the same way, these drugs work with other types of angioplasty. Such a remedy results in an improvement in the biochemical parameters of a sick person.

Modern cardiologists believe that energy metabolism in cells can be improved through:

decrease in ATP consumption by cells;
improving the efficiency of membranes in mitochondria;
restoration of lost links in the chain of respiratory processes in cells;
decrease in oxygen demand by the cells of the heart muscle.

All this is done by direct-acting cardioprotectors Trimetazidine and Mildronate, if used in combination.

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Mildronate or trimetazidine

Trimetazidine (preductal) has its own rather narrow niche, but, it seems to me, not in your case.

Trimetazidine (preductal) has its own rather narrow niche, but, it seems to me, not in your case. In which case will he help? Thank you doctor for the answer, please tell me what could help me in my case?

Thank you for your reply. Sincerely, Vera.

in my understanding, none. the fact is that the indication for the appointment was (according to the results of some studies that I personally doubt) the situation in which surgical intervention is indicated, otherwise there is no need for it, especially considering that there is no positive effect either on life expectancy or on its quality, nor on the risk of developing complications of the disease.

indication for the appointment of preductal (according to the results of some studies that I personally doubt) the situation in which surgery is indicated[\QUOTE]

From myself I will add - and there is no way to fulfill it.

You asked a question - they explained to you that it makes no sense to take either one or the other drug. And in what - your case? You are not the first time on the forum and, for sure, you know how best to formulate questions in order to get an exhaustive answer, right?

2. How do you handle physical activity and what worries you?

Which is better: therapy with Riboxin or Mildronate tablets together - effect

There are drugs that are used as cardioprotective and antihypoxic agents for intense physical exertion. These drugs include Riboxin and Mildornate.

The main purpose of the drugs is the complex therapy of coronary heart disease. However, athletes often use them to achieve more pronounced sports results.

The drugs are effective separately, but many are interested in whether it is possible to take Riboxin and Mildronate together.

All about the drug Riboxin - brief instructions for use

A modern drug aimed at stabilizing the metabolism in the myocardium, normalizing the state of tissues that have undergone hypoxia - Riboxin. Country of origin - Russia.

Additional components included in the preparation: stearic acid, potato starch, microcrystalline cellulose, sucrose monohydrate, talc, iron oxide, yellow dye.

Riboxin is available in cartons containing blisters of either 25 or 10 tablets.

It is important to note that Riboxin is dispensed by prescription.

Indications for the use of the drug Riboxin:

as one of the components of therapy for ischemia of the heart muscle, cardiac arrhythmias, prolonged use of cardiac glycosides, acute myocardial infarction;
for symptomatic treatment of liver dysfunction, hepatitis, cirrhosis, provoked by the use of strong drugs, alcohol abuse.

Riboxin is taken by professional athletes to improve physical performance.

Factors excluding the possibility of prescribing the drug:

allergic reactions, hypersensitivity;
benign prostatic hyperplasia;
fructose intolerance or severe sucrase deficiency.

Riboxin can be taken only under the supervision of a doctor for severe kidney pathologies, diabetes mellitus.

Conducted clinical studies have shown that Riboxin has excellent tolerance. Possible side effects: skin rashes, urticaria, intense itching, increased blood urea, in men - worsening gout.

Mildronate - dosage, indications

Additional substances included in the medicinal product: colloidal silicon dioxide, potato starch, gelatin, titanium and silicon dioxide.

Mildronate is sold in cardboard packs containing 6 contour cells of 10 tablets.

This medication is considered a doping drug. The main purpose of Mildronate:

in a therapeutic complex against chronic heart failure, ischemic pathology, various forms of angina pectoris, myocardial infarction, arrhythmias;
to improve concentration, increase activity, treat chronic fatigue syndrome;
as one of the drugs in the complex therapy of circulatory disorders in the brain;
reduction of psycho-emotional, physical and mental overstrain in professional athletes;
symptomatic therapy for withdrawal caused by a chronic form of alcoholism.

The list of contraindications for taking Mildronate includes:

deficiency of potassium in the blood plasma;
systematically elevated blood pressure;
the period of breastfeeding and pregnancy;
minor age;
increased susceptibility to components, allergic manifestations.

How to take Riboxin and Mildronate correctly

One of the important topics is the way drugs are used, because if a powerful drug is not taken correctly, there is a high risk of developing life-threatening complications.

Riboxin and Mildronate are potent drugs, so the frequency, duration and effective dosage of administration is prescribed by a doctor.

It is recommended to drink the drug 15-30 minutes before meals. Take the whole tablet without chewing and drinking water.
The therapeutic course varies from 1 to 3 months. In the treatment process, Riboxin is used daily.
The initial dose is 600 - 800 mg. The maximum value is 2400 mg. The daily dose must necessarily be divided into several doses.

The occurrence of side effects or intolerance to the components suggests the abolition of the use of Riboxin.

Professional athletes (running, athletics, bodybuilding) should take 50-100 mg twice a day immediately before the training process.
For ischemia and chronic heart failure, disorders of cerebral circulation, take 50 - 100 mg, the duration of the course is 1 - 1.5 months.
Ppri increased physical and psycho-emotional stress. Dosage 5 g twice a day. Therapy should not last more than 2 weeks.

It is important to emphasize that in order to achieve the maximum effect, the characteristics of the reception must be selected individually.

The difference between drugs, and what is best for the heart

Quite a popular question about the simultaneous intake and compatibility of these drugs. But before you understand this topic, you need to understand how Riboxin and Mildronate differ.

When ingested, meldonium solves several problems at once:

increases endurance;
participates in increasing the rate of glucose breakdown;
several times reduces the breakdown of lipids;
increases the efficiency of muscle contractions.

It is recommended to take Mildronate in the morning to achieve maximum effects.

In turn, the use of Riboxin gives the best results in the treatment of pathologies of the cardiovascular system. The drug has a less pronounced effect, but it helps to fight dangerous pathologies. The main properties of the drug Riboxin:

improvement of wall elasticity and vasodilatation;
normalization of blood pressure;
increasing the immune activity of the body;
beneficial effect on the structure of muscle tissue;
increase in the rate of regeneration of cells subject to hypoxia;
increased effect when taken simultaneously with other drugs.

If you take these medicines together, then Mildronate takes the leading role in achieving the result.

Compatibility of Riboxin and Mildronate

The combined use of drugs that affect metabolism and heart muscle can be dangerous. In this regard, before starting use, it is necessary to visit a doctor, undergo a comprehensive diagnostic study.

Important! Taking both drugs on your own is dangerous not only for health, but also for life.

Analogues of these drugs

In addition to Riboxin and Mildronate, substitute drugs are used in cardiology and professional sports. Popular analogues include:

Synonymous drugs also have a strong effect on the body, so they are used only after the appointment of a cardiologist, the attending therapist.

Mildronate and Riboxin are popular medicines used in the treatment of cardiological diseases and professional sports. The use of drugs can be harmful, a doctor's prescription is necessary.

Mildronate or trimetazidine

We also provide you with annotations of these drugs:

Mildronate is an original drug for optimizing the use of oxygen in the heart muscle, brain and other tissues of both sick and healthy people and athletes under conditions of increased physical and emotional stress, as well as during the recovery period after various diseases.

MILDRONATE - a competitive inhibitor of gamma-butyrobetaine hydroxylase, causes a decrease in the content of free carnitine, reduces carnitine-dependent oxidation of fatty acids. Improves metabolic processes, increases efficiency, reduces symptoms of mental and physical overstrain; has a cardioprotective effect. Regulates cellular immunity.

Eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome. Mildronate promotes the redistribution of blood flow to ischemic areas, in particular, in the brain. Renders positive influence on degenerative changes in retinal vessels.

After oral administration, the drug is rapidly absorbed from the gastrointestinal tract.

Bioavailability is 78%. The maximum plasma concentration is reached 1-2 hours after ingestion. In the human body, Mildronate is metabolized and excreted mainly by the kidneys. The half-life is 3-6 hours.

Skin itching, dyspepsia, tachycardia, agitation, various changes in blood pressure are possible.

There are no sufficient data on the use of Mildronate in children, pregnant and lactating women.

INDICATIONS FOR USE AND DOSES:

Stable angina: 0.25 x 3 r / day per day; 0.25 x 3 r / day per os, 5 months (2 days a week).

Unstable angina pectoris, myocardial infarction: 0.5-1.0 IV - once; 25 x 2 r / day; 0.25 x 3 r / day (2 days a week), 5 months;

Chronic heart failure: 0.5-1.0 x 1-2 r / day, 5 months;

Cardialgia, myocardial dystrophy: 0.25 x 2 r / day per os - 2 weeks;

Acute circulatory disorders of the brain: 0.5 x 1 r / day - 10 days, then 0.25 x 2 r / day of the week;

Chronic circulatory disorders of the brain: 0.5 x 1 r / day i.v. or 0.25 x 1-3 r / day per os 2-3 weeks.

Chronic ischemic heart disease, cerebrovascular accident: 0.5-1.0 IV or per os in 1-2 doses for 1-2 months (2 courses per year).

Separate nosological units:

Bronchial asthma: 0.25 x 1 r / day per os for 3 weeks;

Chronic alcoholism: 0.5 x 2 r/day IV or 0.5 x 4 r/day per day;

Vascular pathology of the eye, retinal dystrophy: 0.5 ml of 10% solution, retrobulbar or subconjunctival - 10 days.

Practically healthy contingent:

Mental and physical overload: 0.25 x 4 r / day per os or 0.5 x 1 r / day / day (repeatedly);

Athletes: 0.5-1.0 x 2 r / day per day (10-14 days);

Reduced performance: 0.25-0.5 in / in or per os in 1-2 doses of a month (2 courses per year).

INTERACTION WITH OTHER DRUGS:

Mildronate can be combined with antianginal agents, anticoagulants and antiplatelet agents, antiarrhythmic drugs, cardiac glycosides, diuretics and other drugs.

It should be noted that Mildronate can enhance the effect of nitroglycerin, nifedipine, beta-blockers, antihypertensive agents and peripheral vasodilators.

Data on an overdose of Mildronate are not available.

Active ingredient: Trimetazidine (Trimetazidine)

Pharmacological group: Antihypoxants and antioxidants

Composition and form of release: 1 coated tablet contains trimetazidine dihydrochloride a 20 mg; 30 pcs in a blister, 2 blisters in a box.

Pharmacological action: Antianginal. Prevents a decrease in intracellular ATP concentration, supporting the energy metabolism of myocardial cells subjected to hypoxia or ischemia, ensures the functioning of ion channels, maintains normal transmembrane transport of potassium and sodium ions, and maintains intracellular homeostasis.

Pharmacokinetics: Well absorbed from the gastrointestinal tract. T1 / 2 - from 4 h 30 min to 5 h 10 min. It is excreted mainly by the kidneys.

Pharmacodynamics: Preserves the energy metabolism of myocardial cells and provides their protection during hypoxia or ischemia.

Clinical pharmacology: In patients with angina pectoris, from the 15th day of treatment, the coronary reserve increases (the time before the onset of ischemic disorders during exercise increases), the frequency of angina attacks decreases, and the consumption of nitrates decreases.

Side effects: Gastrointestinal Disorders(rarely).

Dosage and administration: Inside, during meals - 20 mg 3 times a day.

Mildronate and trimetazidine: similarities and differences in their action

Ivars Kalvins, Academician of the Latvian Academy of Sciences, Professor

Latvian Institute of Organic Synthesis, Riga

What to do if any part of the body lacks oxygen, but a significant improvement in blood circulation is physically impossible (blood vessels are clogged and sclerotized, heart function is impaired - heart attack, coronary heart disease, etc.)?

It was this question that was and remains relevant for everyone who has ever had to deal with hypoxia and ischemia in any form of its manifestation. Traditionally, for the treatment of coronary heart disease, antianginal drugs are used, which either reduce the work of the heart or increase coronary blood flow. These include nitrates, beta-blockers, calcium antagonists (“dipins”), angiotensin-converting enzyme (“prila”) or angiotensin receptor blockers (“sartans”), vasopeptidase inhibitors (“patrilates”). These drugs are relatively effective in maintaining the hemodynamic parameters of the heart (strength and frequency of heart contractions, coronary blood flow, workload on the heart, etc.), but they are not able to change the efficiency of oxygen use by the heart muscle. That is why the above medicines often cannot provide a sufficiently effective treatment for cardiovascular diseases and significantly slow them down. further development. In addition, the use of these drugs is largely limited by contraindications and the accumulation of unwanted side effects during treatment (Macor J.E., 2000).

Today it seems logical that, in addition to this treatment, the use of oxygen for energy production in the myocardium should be optimized. (Lewandowski E.D., 2000). But how can this be done? Scientists around the world have been looking for substances, the so-called. cytoprotectors that could prevent harmful effect oxygen starvation on cell viability. The use of antioxidants seemed promising, which, it was believed, could capture and neutralize harmful radicals that arise in the body under conditions of oxygen deficiency, but especially when blood circulation is restored after prolonged ischemia (at the stage of reperfusion).

Whatever has been tested, however, none of the antioxidants has proven to be sufficiently effective in the treatment of diseases of the cardiovascular system. And only in 1961, the French company Servier patented trimetazidine as the world's first antioxidant with clinically significant efficacy.

Ironically, the reason why this drug was effective in the treatment of coronary heart disease, the whole world and even the manufacturer itself learned only 27 years later (Lopaschuk G.D., 2001), when in Riga it had long been created, researched and tested in clinic second-generation trimetazidine - mildronate (Simkhovich B.Z., 1988).

Although completely different mechanisms of action were initially postulated for both drugs, the attention of scientists was increasingly attracted by the striking similarity in the action of both drugs on the ischemic myocardium. This suggested that perhaps the mechanism of cytoprotective action of trimetazidine was not initially properly understood, and its positive effects are not associated with antioxidant properties.

The fact that the use of trimetazidine, for example, as an antioxidant for the treatment of myocardial infarction (short-term, in the acute phase of myocardial infarction) does not make sense, was later confirmed by studies of EMIP-FR (European project for the treatment of myocardial infarction: free radicals) in patients with acute myocardial infarction of which the patient received preductal as a 48-hour infusion. This study, conducted in 1996, showed that when used in this mode - as an antioxidant - trimetazidine is comparable in effectiveness to placebo.

At the same time, mildronate has already been clearly identified and proven to influence the processes of fatty acid oxidation in cells. Experiments carried out at IOS, the Japanese company Taiho, US universities and the American concern Marion-Merell-Dow, as well as the Servier company confirmed the initial hypothesis of mildronate authors: restriction of the flow of fatty acids through mitochondrial membranes protects the cell from death under conditions of oxygen starvation.

Intensive studies have shown that trimetazidine also inhibits beta-oxidation of fatty acids in mitochondria. However, mildronate and trimetazidine affect various sections chains of fatty acid metabolism, which creates significant advantages for mildronate. Trimetazidine has been shown to block the last reaction of the four-step fatty acid oxidation process (3-ketoacyl-CoA thiolase). This, in turn, means that trimetazidine inhibits the oxidation of all fatty acids in the mitochondria - both long-chain (the number of carbon atoms is more than 8) and short-chain (the number of carbon atoms is less than 8), however, it does not in any way interfere with the accumulation of activated fatty acids in mitochondria (Lopaschuk G.D., 2001).

Mildronate works differently. The drug limits the transport through the mitochondrial membranes only of long-chain fatty acids, while short-chain fatty acids can freely penetrate into mitochondria and be oxidized there.

What is the significance of these differences in protecting cells from oxygen starvation-induced changes in cellular metabolism and, consequently, in the treatment of pathological conditions associated with ischemia?

On the one hand, trimetazidine, which blocks the oxidation of all fatty acids, should be used in smaller doses than mildronate, because. complete exclusion of fatty acids from energy metabolism, at least theoretically, creates a potential threat to the functioning of the myocardium. At the same time, trimetazidine is not able to delay the flow of fatty acids into mitochondria and, therefore, cannot prevent the accumulation of their activated forms, acyl-CoA and acylcarnitine, in mitochondria, as well as the harmful effects of these metabolites on ATP transport and cell membranes. On the other hand, a decrease in the rate of fatty acid oxidation in the case of preductal undoubtedly has a positive effect on the metabolism of ischemic myocardium, because an alternative energy production system is switched on - glucose oxidation, which uses oxygen much more efficiently (by 12%) for ATP synthesis. This circumstance, as well as the fact that glucose is not converted into lactate, determines mainly the cytoprotective effect of preductal on ischemic cells.

And how does this happen in the case of mildronate? Mildronate reversibly limits the rate of carnitine biosynthesis from its precursor, α-β utirobetaine. And since it is with the help of carnitine that long-chain fatty acids are transported through mitochondrial membranes, it is clear that mildronate, leading to a decrease in carnitine concentration, reduces the influx of fatty acids and their accumulation in mitochondria, but in no way inhibits the metabolism of short-chain fatty acids. This means that mildronate is practically unable to provide toxic action on mitochondrial respiration, as it cannot completely block the oxidation of all fatty acids.

It has been suggested that by inhibiting the transport of fatty acids and, consequently, their oxidation, it is possible to adapt (precondition) the cells of the heart muscle, brain, and others to oxygen deficiency (Sisdossis L.S., 1998). This hypothesis was confirmed by experiments carried out in many countries of the world on isolated organs, as well as experiments aimed at reducing the size of myocardial infarction and the resulting heart failure. As has been shown, after a 10-day course Mildronate perfectly protects the ischemic zone of the myocardium from death both under conditions of oxygen starvation and after restoration of blood circulation in the organ. Mildronate also has a cytoprotective effect in the case of myocardial damage caused by adrenaline and norepinephrine (Hanaki Y., 1989).

How is this possible? - many experimenters shrugged their shoulders in bewilderment. After all, coronary blood flow under the influence of mildronate increases only slightly! And the heart muscle mainly uses fatty acids for energy production, but mildronate limits their transport! And yet - it is known that carnitine definitely has a positive effect on the myocardium, but mildronate inhibits the biosynthesis of this vitamin!

However, it turned out that these contradictions are only apparent. An explanation for the action of mildronate was found as a result of a study of a well-known phenomenon, when people exposed to regular, not too strong stress exposure, suffer from heart disease much less frequently than those who experienced stress once, but in a large dose. This phenomenon has been called the preconditioning effect, and the reason for it is simple: stress in small doses trains those enzyme systems of the cell that use sugars for energy production. This is due to the fact that the oxidation of glucose, compared with the burning of fatty acids, saves about 12% of oxygen! And therefore, the heart muscle responds to adrenergic irritation (stress!) Not at all by increasing the rate of fatty acid oxidation, as was thought so far, but receives all the additional energy from the oxidation of sugars, which requires less oxygen. Those who have these enzyme systems are more trained endure, respectively, higher loads. This is typical for athletes and other trained (adapted) people.

It turned out that this is where the secret of the effectiveness of mildronate lies: the drug causes the effect of preconditioning in cells, inducing the expression (biosynthesis) of the enzymes necessary for the oxidation of sugars and an increase in their activity. In other words, mildronate acts as a pharmacological training agent, helping cells optimize oxygen consumption to the maximum extent for energy and prepare for ischemia.

But the flow of surprises did not end there! It turned out that it is not enough to produce energy (this happens in mitochondria). It still needs to be delivered to the place of consumption - to the ion pumps of organelles in the cytosol, so that they can function and maintain the vital activity of the cell. But it is activated fatty acids that, accumulating in mitochondria, block this ATP transport and at the same time act as surfactants that mechanically injure cell membranes and cause their destruction. Mildronate, by reducing the penetration of fatty acids into mitochondria, restores ATP transport and helps cells survive.

And what about the antioxidant properties, the positive effect of which, at least at the postischemic stage of reperfusion, has been experimentally proven in many studies?

True, there are completely opposite observations, convincingly proving that the feasibility of using antioxidants to prevent reperfusion-induced damage is at least debatable. However, preductal has antioxidant properties, and mildronate?

It was found that mildronate, which itself does not have antioxidant properties, increases the concentration of gamma-butyrobetaine (GBB) in the body, since under the influence of mildronate it oxidizes more slowly than usual to carnitine. In turn, GBB is able to induce the formation of NO, which acts as one of the most effective natural agents that scavenge free radicals in the body. It is the increase in the concentration of GBB under the influence of mildronate that explains the very unexpected effects of mildronate: a decrease in peripheral vascular resistance, a decrease in blood vessel spasms caused by norepinephrine or angiotensin, inhibition of platelet aggregation and an increase in the elasticity of erythrocyte membranes. Unexpected, because it is well known that preductal has no effect on hemodynamics. Mildronate, by increasing the concentration of gamma-butyrobetaine, is also able to protect cells from the effects of free radicals (Akahira M., 1997), but its mechanism of action is completely different from that of trimetazidine, because it is realized through the induction of NO biosynthesis.

Thus, mildronate promotes the biosynthesis of a physiologically regulated amount of NO, which allows the body to determine the necessary level of protection against radicals. As a result, mildronate has a selective effect on the ischemic zone of various tissues, including the myocardium, with virtually no effect on areas not affected by ischemia (counteracting the steal effect) (Kirimoto T., 1996).

Perhaps it is this mechanism that can explain the experimental observations obtained by the electron microscopic method, namely, that in the myocardium in the case of increased training loads under the influence of mildronate, the number of functioning capillaries (vascularization) increases by 2-3 times, the number and size of mitochondria increase (hyperplasia and hypertrophy) and significantly (by 180%) the number of cristae in them increases. The number of ribosomes and polysomes also increases, which indicates the ability of mildronate to activate the synthesis of proteins (enzymes), as well as to increase the respiratory capacity of the myocardium (Bobkov Yu.G., 1983). Subsequent studies have shown that mildronate induces the biosynthesis and activity of Ca? +-ATPase, hexokinase and pyruvate dehydrogenase of the sarcoplasmic reticulum (Yonekura K., 2000, Hayashi Y., 2000).

The ability to control the rate of fatty acid oxidation in the ischemic myocardium, of course, has a positive effect on the antianginal action of both mildronate and trimetazidine. It has been experimentally proven that both of these drugs are well combined with other antianginal drugs, while the dose of other drugs in this case can be reduced (Sisetsky A.P., 1992). As clinical practice shows, metabolic cytoprotective therapy in the case of, for example, trimetazidine is equivalent in antianginal effect to the action of propranolol or nifedipine, in addition, the drug can be combined with diltiazem. Both mildronate and trimetazidine in the case of stable angina reduce the frequency of angina attacks, increase patients' exercise tolerance and reduce the average daily intake of nitroglycerin.

Both drugs, but especially mildronate, have low toxicity and do not cause significant side effects. However, due to the blocking effect of trimetazidine on the oxidation of all fatty acids, it should be used in smaller doses, more often and for longer (3 tablets of 20 mg per day for at least 6 months) than mildronate, therapeutic effect which, thanks to the greater allowable dose(2-4 capsules of 250 mg per day), appears faster, and the course of treatment usually does not exceed six weeks. Of course, treatment courses of both drugs can be repeated if necessary. Due to the physiological, regulating and training effects of mildronate on the body, the drug is approved for use by healthy people and athletes to improve physical and mental performance. Since it is no secret that it is overloads that most often contribute to the occurrence of ischemic episodes in a healthy myocardium and muscle tissues, from which the body should be protected.

Does this mean that mildronat is a panacea? In no case! Like any drug that affects metabolism, mildronate needs time to affect cell viability through the mechanisms described above in conditions of oxygen deficiency, i.e. train them. Therefore, as a result of the action of mildronate, there is no pronounced rapid effect, the drug acts gently, without sudden changes in pressure or other parameters of cardiac activity. However, the importance of its long-term effect on the body can hardly be overestimated. Mildronate optimizes oxygen consumption and increases ATP production not only in the myocardium, but also in muscle tissue and other cells. This means that the saturation of red blood cells with oxygen under the influence of mildronate increases, and more oxygen enters the ischemic tissues than usual (Sakharchuk II, 1992).

Experiments by Japanese scientists have shown that mildronate significantly (by 30% or more) increases life expectancy in heart failure caused by severe myocardial infarction. (Hayashi Y., 2000). Mildronate perfectly combines with ACE inhibitors (captopril, lisinopril, etc.), and also enhances the effect of many other cardiac drugs. But mildronate is especially effective on the so-called. cor pulmonale model associated with general oxygen deficiency in the body and disorders in the pulmonary circulation.

These newly discovered properties of mildronate are an excellent addition to the well-known effects associated with the inhibition of fatty acid oxidation, which have been well studied as a result of many years of use of trimetazidine.

Despite the fact that trimetazidine (preductal) appeared in pharmacies later than mildronate, it was created 15 years earlier. Trimetazidine and mildronate are undoubtedly drugs of the same pharmacological group, a similar cytoprotective anti-ischemic effect of which is based on switching the energy supply of the myocardium from fatty acids to aerobic glycolysis and limiting acidosis - this ensures the similarity of the clinical effects of drugs in the treatment of stable angina pectoris. However, mildronate is distinguished by the presence of additional positive effects, which are provided by the induction of NO biosynthesis, as well as optimization in cells of the activity and amount of enzymes involved in the transport of energy and ions. These properties open up broader opportunities for the use of mildronate in the prevention of severe cases of heart disease (precondition), in the treatment of heart failure and to limit cardiac hypertrophy (remodeling) in the post-infarction period.

If trimetazidine as a cytoprotective anti-ischemic agent is recommended for use by all patients with coronary heart disease, then mildronate is used with good results to treat other diseases associated with circulatory pathology, for example, disorders of cerebral and peripheral circulation and microcirculation (Karpov R.S., 1991 , Vinichuk S.M., 1991). The cytoprotective effect of mildronate opens up wide possibilities for its use in combination therapy. lung diseases, especially asthma, for the relief of alcohol withdrawal syndrome, as well as in the treatment of many other pathological conditions, the pathophysiological mechanism of which is associated with a limitation in the supply of tissues and organs with oxygen.

To date, there are few clinical observations in which the effectiveness of mildronate and trimetazidine would be directly compared. However, in one of the first clinical studies in which a comparative evaluation of the effectiveness of 12 different antihypoxants in intensive care of 620 patients with acute myocardial infarction was carried out, mildronate was found to be more effective than trimetazidine (Semigolovsky N.I., 1998).

Another round of the search for new anti-ischemic drugs has ended!

In the treatment of coronary heart disease, cytoprotective anti-ischemic drugs are not opposed to other antianginal drugs, they are considered to be medicines that provide a significant improvement in the quality of life of patients. It remains only to wish success to our doctors: a deep understanding of the mechanism of action of mildronate is the basis for the successful use of this promising drug for the treatment of patients suffering from impaired blood supply to any tissues. The use of mildronate in combination with standard therapy (Nedoshivin A.O., 1999) is undoubtedly the key to achieving the maximum effect in the treatment of coronary heart disease, peripheral and cerebral circulation disorders, as well as other ischemic conditions.

Mildronate: why are there so many victims in Russian sports?

This entry is perhaps the longest in the history of my blog. It is not about whether mildronate is doping. It is about arrogance, stupidity, and for the most part - about the spit on those for whom sport is a profession. It is, in essence, about the fact that any person who was related to the sports world and a couple of convolutions in his head should have foreseen this catastrophe.

Yes, and I'm not a doctor or a pharmacologist. All the information presented below, I found in open sources.

In February 2014, at the Sochi Olympics, Ukrainian skier Marina Lisogor failed a doping test for a substance added to the WADA blacklist earlier that year. In her testimony, Lisogor explained that ten years earlier she had undergone an operation for typhoid fever, after which the cardiologist recommended that she use the drug "Preductal" - to "maintain physical condition." Lisogor claimed that before using Preductal, she made sure that it did not contain prohibited substances.

Ten years have passed, and Lisogor, according to her, used Preductal again during the 2014 Olympics, not knowing that since January 1, 2014, its use by athletes during the competitive period was prohibited. “This is my personal fault, I am very sorry that I let this happen,” Lisogor said. - I want to assure you that I made this mistake unintentionally. I am telling the truth".

For violating anti-doping rules, Marina Lisogor was suspended for two years.

In February 2015, Nikolai Vedekhin, the Estonian 1500m champion, failed an out-of-competition doping test at a training camp in Eldoret, Kenya. The Estonian Anti-Doping Agency reported that Vedekhin was taking Preductal, a drug recommended, in particular, for angina pectoris and for the prevention of ischemia. However, Vedekhin did not take into account (more precisely, he pretended that he did not take into account) that from January 1, 2015, the use of this medicine was also prohibited outside the competition period.

Nikolai Vedekhin was disqualified for a period of four years - not only for the use of a prohibited drug, but also for an attempt to replace a doping sample.

"Preductal" is one of trade names the drug trimetazidine (trimetazidine), its manufacturer is the French company Les Laboratoires Servier, operating in the markets of many countries in Asia and Central and Eastern Europe.

Manufacturers of trimetazidine claim that it has antianginal, coronary dilating, antihypoxic and hypotensive effects, serves as a cardioprotector, reduces blood pressure drops, reduces dizziness and tinnitus. It is especially recommended to protect the heart during increased physical exertion. Doesn't it remind you of anything?

Meldonium and trimetazidine: find ten differences

Back in 2010, in No. 3 of the Kursk scientific and practical bulletin "Man and his health" (this is not the Guardian or The Times hostile to Russia), an article was published by employees of the Department of Pharmacology of the Kursk State Medical University under the frightening title "Endothelio- and cardioprotective effects of meldonium and trimetazidine in L-name-induced endothelial dysfunction in experiment”. Due to my ignorance in this area, I cannot go into the details of this experiment, which, by the way, was carried out on rats. I will only say that the essence was to compare the mechanism of the protective effect of these two drugs on the heart.

Meldonium apologists call it a "harmless vitamin" and almost a dummy, medicinal effect which, not to mention doping, is not at all obvious. It is precisely because of the lack of evidence of its medical properties that Mildronate, for example, is not certified in the USA - poor Sharapova had to arrange its traffic across the ocean.

What about trimetazidine? Back in 2007, the Formulary Committee of the Russian Academy of Medical Sciences ranked it among “obsolete drugs with unproven effectiveness” (along with, among other things, validol, valocordin and arbidol).

The epithet "obsolete" is no less important here than "unproven". The inventor of Mildronate claims to have invented the drug back in the mid-1970s. Publications about the possible cardiac effects of trimetazidine appeared even earlier - in the 1960s. However, there is still no convincing evidence of its clinical value. The European Medical Agency also joined the opinion of the Russian Academy of Medical Sciences, recommending in 2012 to limit the use of trimetazidine-containing drugs.

In turn, a dubious company similar to the promoters of Herbalife is unsuccessfully trying to make the inhabitants of the United States happy with this drug. But the all-powerful FDA tends to agree with its Russian and European counterparts.

We have two drugs - meldonium and trimetazidine - which are not actually (and in many cases legally) recognized by the medical authorities of developed countries. Both are quite old and have been used for a long time in the markets of developing countries. Both declare protection of the heart during increased physical exertion. Both are used by athletes. At the same time, the manufacturer of one of the drugs is quite a French company - and it was he who was the first to be banned two years ago. Moreover, the head of the medical and research committee of WADA, which selects experts to evaluate potentially doping drugs, is the former Minister of Sports of France, Valerie Fourneron. How unpatriotic of her to play against French business!

The astonishing story of the successive banning of two twin drugs prompts me to ask some far from rhetorical questions. But first, a little note.

How drugs get on the WADA Prohibited List

According to a popular conspiracy theory, WADA (that is, Obama personally) deliberately did not conduct a study on how long it takes to remove meldonium from the body. I hasten to inform you that WADA did not conduct such a study, and banned trimetazidine, and a bunch of other drugs. It is amazing that this was news to the Russian sports medical community at all.

The procedure for including a drug on the WADA stop list is, in fact, outrageously bureaucratic, standard and monotonous, and, therefore, easily predictable and predictable. Every year the same thing happens. And exactly the same thing happened with meldonium as before with trimetazidine, namely:

In January, the List Expert Group meets for the first meeting to "identify new and key areas of action and assign tasks";

In April, at the second meeting of this group, a draft (draft) of the list of prohibited drugs for the next year is prepared;

In June-July, this draft is sent to representatives of governments and sports movements of countries that recognize the authority of WADA for consultation and gathering opinions;

In August, the collected comments and opinions are summarized and added to the previously proposed list, which is again sent to WADA experts;

In September, the group of experts meets for the third time, evaluating all the comments received and making its final opinion on the new list; The WADA Medical and Research Committee also makes its recommendations, after which the list is submitted for discussion and voting by the WADA Executive Committee;

In this case, a doping violation is not the fact of taking a prohibited drug after January 1, but the fact of its discovery.

10 questions to the Russian Ministry of Sports, sports federations, sports doctors and the athletes themselves

Were they not alerted by the inclusion in 2014 of trimetazidine on the list of prohibited drugs, which, in terms of its supposed effects, is not much different from meldonium?

Have they questioned - publicly or at least at the level of private conversations with representatives of WADA - the validity of the inclusion of trimetazidine in the list?

Why, in their opinion, the ban on trimetazidine, whose elimination time from the body even according to the manufacturers' claims is twice as long as that of meldonium, did not cause such an avalanche of positive doping tests as the ban on meldonium?

Trimetazidine has been widely used by athletes in countries east of Germany. So, in 2014, a study by Polish authors was published on the prevalence of trimetazidine use in Polish sports, in particular, in cycling, athletics and triathlon.

Did they see the trimetazidine ban as politically or commercially (depending on which conspiracy theory they liked) motivated as the meldonium ban?

Did the inclusion of meldonium on WADA's list of “observed” drugs in 2015 alert them?

How aware were they of the prevalence of meldonium use in Russian sports? Were they aware of the consequences of his ban?

Have they questioned - publicly or at least at the level of private conversations with representatives of WADA - the validity of the listing of meldonium?

What feedback and opinions did representatives of the Russian government and the sports movement send to WADA after receiving the draft 2016 Prohibited List?

Why did Russian doctors and athletes continue to use meldonium in November and even December 2015, if, according to the statements of the doctors, athletes and sports officials themselves, there were no studies on the timing of the elimination of meldonium from the body?

Do Russian athletes, doctors and sports officials understand that a doping violation is not the fact of using a prohibited substance after it is listed, but the fact of a positive doping test? In the case of meldonium, did they understand that the detection of meldonium in a doping sample after January 1, and not the use of meldonium after January 1, would be considered a doping violation?

Comrades in misfortune. Instead of an afterword

Indeed, there were almost no doping scandals related to the ban on trimetazidine. Almost. Because one case was extremely remarkable and quite in the Russian spirit, but not Russian at the same time.

In the late summer of 2014, the International Swimming Federation (FINA) announced that Chinese swimmer Sun Yang, Olympic champion, world champion and record holder, was suspended for three months for using trimetazidine. The piquancy of the situation was that by the time the disqualification was announced, it (the disqualification) had already expired.

The fact is that Sun Yang failed the doping test on May 17, 2014 at the Chinese domestic championship. But the Chinese Anti-Doping Agency (CHINADA) did not inform anyone about this (more precisely, there is a suspicion that it secretly informed FINA about this), and the Chinese Swimming Federation quietly issued a three-month ban to the athlete.

Why only three months? Because Sun Yang "provided convincing evidence that he did not intend to deceive anyone." The champion, you guessed it, turned out to be a core and had been taking a life-saving medicine for six years, but did not notice that it was now banned. The doctor who inadvertently prescribed him trimetazidine was suspended for a year.

Why did the news of the disqualification come with such a delay? Because poor CHINADA was too busy processing other doping tests and in general it publishes its decisions once a quarter. In addition, as the Deputy Director of CHINADA stated, “Sun Yang is the most famous athlete in China and is known all over the world, so we had to treat his case very carefully. But we didn't try to cover it up!"

WADA, to put it mildly, was not happy with this scrupulousness. The World Agency, whose rules require disqualification decisions to be published no later than 20 days after they are issued, expressed "deep concern at the lack of necessary communication from CHINADA and FINA."

The role of FINA, whose leadership is not unreasonably accused of pandering to dopingists, is extremely cloudy in this story. If the head of FINA, Cornel Marculescu, did not know about the secret disqualification of the swimmer, this is an indicator of his unprofessionalism. If he knew and hid, then he should make claims of a completely different kind. In any event, FINA took no action to investigate the story after it surfaced. Sun Yang kept the medals of the Asian Games, received immediately after the expiration of his parody of disqualification, and calmly went to the 2015 World Cup in Kazan.

And here, in Kazan, having won yet another world championship gold, Sun Yang made a policy statement, which Russian athletes caught doping regularly make. Just replace the country name.

“I don't understand why, when it comes to the Chinese, the media pays such attention to it,” Sun Yang protested. - When China performs well, people all over the world are sure to think something bad. There is nothing questionable in our performances. Doping exists in other countries as well. As athletes, we work hard and sometimes get injured and take substances we don't know about. Sometimes we make mistakes. But don't make enemies of us!"

After winning two gold and a silver medal at the 2015 World Championships, Sun Yang withdrew from the 1500m final, citing ... sudden heart problems that he "never had before" during the competition. The next international start, after a long winter break, for the Chinese swimmer was to be the Aquatic Super Series tournament, scheduled for February 2016 in Perth, Australia. However, Sun Yang unexpectedly withdrew from these competitions, now due to an injury to his right foot. However, he still assures that he will perform at the Olympics in Rio.

What is better Trimetazidine or Mildronate should be decided by the doctor.

Features of Trimetazidine

The difference between Trimetazidine and Mildronate

Combination of Trimetazidine and Mildronate

You can also combine the analogue of Mildronate Cardionate with Trimetazidine. Riboxin and Mildronate can be taken simultaneously as drugs that affect the mechanism of metabolism. Drinking Trimetazidine together with Mildronate is advisable and is considered effective, especially in the postoperative period in patients undergoing coronary bypass surgery. Against the background of such treatment, the protective functions in the cells of the heart muscle rapidly increase. In the same way, these drugs work with other types of angioplasty. Such a remedy results in an improvement in the biochemical parameters of a sick person.

Modern cardiologists believe that energy metabolism in cells can be improved through:

decrease in ATP consumption by cells;
improving the efficiency of membranes in mitochondria;
restoration of lost links in the chain of respiratory processes in cells;
decrease in oxygen demand by the cells of the heart muscle.

All this is done by direct-acting cardioprotectors Trimetazidine and Mildronate, if used in combination.

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Medical reference center "InfoDoctor"

Can you please tell me if these medicines are compatible?:

Pentoxifylline, Tamoxifen, Riboxin, Potassium Orotate,

Saltos, Trimetazidine, Leuzea safflower.

steroids or growth hormone, if I understand correctly, I should not take (because I had LASIK eye surgery - and these drugs can impair vision), and the drugs listed above greatly help to achieve good success in bodybuilding.

however, I don’t know if they can all be taken together and if there are any serious side effects?

I therefore turn to you with this question.

Even regardless of medication, people involved in sports should take general analysis blood and do an ECG every six months.

Igar82 › Blog › It's time to lose weight - Pharmacy anabolics. Part 1 (cardioprotectors)

I am starting a series of videos on the topic of pharmaceutical preparations that I take to help my body cope better with physical exertion and also recover faster after them.

And today I will talk about two drugs such as Mildronate and Riboxin.

In short, xy is xy:

Cardioprotectors - Pharmacological preparations used to correct the functional state of the myocardium.

Myocardium (literally from other Greek. The heart muscle) - if in your own words, then this is our heart, that is, the myocardium is the heart muscle that makes up most of our heart. It is she who contracts, twitches, jerks, knocks, and so on. :)))

Mildronate (aka Meldonium - yes, yes, the same one!) Is a metabolic agent that normalizes the energy metabolism of cells that have undergone hypoxia or ischemia.

This drug improves metabolism and energy supply of tissues.

Prevents the accumulation of activated forms of non-oxidized fatty acids in cells.

Under conditions of ischemia, it restores the balance of the processes of oxygen delivery and its consumption in cells, prevents the violation of ATP transport.

Activates glycolysis, which proceeds without additional oxygen consumption.

Improves muscle nutrition.

Increases the effectiveness of training.

Protects the heart and increases myocardial contractility.

In rare cases, itching, dyspepsia, tachycardia, agitation, various changes in blood pressure.

Contraindications for use:

Use the drug with caution for a long time in people with chronic diseases liver and kidneys.

Riboxin (aka Inosine) is a metabolic agent, a stimulator of biochemical processes, a precursor of ATP.

Increases energy balance, improves coronary circulation and metabolic processes in the myocardium. Has antihypoxic action.

Inosine is generally well tolerated; in some cases, bradycardia, itching, skin flushing are possible; in cases allergic reaction the drug is cancelled. In rare cases, there is an increase in the concentration of uric acid in the blood.

Hypersensitivity to inosine, gout, severe renal failure.

ATP (Adenosine triphosphate - you can break your tongue) is a molecule that serves as an energy source for all processes in the body, including movement. The contraction of the muscle fiber occurs with the simultaneous splitting of the ATP molecule, as a result of which energy is released, which goes to the implementation of the contraction.

Joint reception of Riboxin and Mildronate.

Riboxin is a natural compound that is also found in the human body. It is a metabolic agent, a precursor of ATP; It has antihypoxic, metabolic and antiarrhythmic effects. Increases the energy balance of the myocardium, improves coronary circulation, prevents the consequences of intraoperative renal ischemia. It is directly involved in the metabolism of glucose and contributes to the activation of metabolism in conditions of hypoxia and in the absence of ATP. Activates metabolism pyruvic acid to ensure the normal process of tissue respiration, and also contributes to the activation of xanthine dehydrogenase. Stimulates the synthesis of nucleotides, enhances the activity of some enzymes of the Krebs cycle. Penetrating into the cells, it increases the energy level, has a positive effect on the metabolic processes in the myocardium, increases the strength of the contractions of the heart and contributes to a more complete relaxation of the myocardium in diastole, resulting in an increase in cardiac output. Reduces platelet aggregation, activates tissue regeneration (especially myocardium and gastrointestinal mucosa).

Mildronate acts in a similar way, but unlike riboxin, it is not itself used for the synthesis of any substances. At the same time, mildronate regulates the activity and biosynthesis of those enzymes that are involved in energy production, that is, it corrects metabolic disorders.

Thus, mildronate is a metabolic corrector, while riboxin is one of the participants in biochemical reactions, the so-called metabolic agent (metabolite).

Therefore, Mildronate will improve the use of riboxin by the body and their joint application will reinforce each other.

Which is better: therapy with Riboxin or Mildronate tablets together - effect

There are drugs that are used as cardioprotective and antihypoxic agents for intense physical exertion. These drugs include Riboxin and Mildornate.

The main purpose of the drugs is the complex therapy of coronary heart disease. However, athletes often use them to achieve more pronounced sports results.

The drugs are effective separately, but many are interested in whether it is possible to take Riboxin and Mildronate together.

All about the drug Riboxin - brief instructions for use

A modern drug aimed at stabilizing the metabolism in the myocardium, normalizing the state of tissues that have undergone hypoxia - Riboxin. Country of origin - Russia.

Additional components included in the preparation: stearic acid, potato starch, microcrystalline cellulose, sucrose monohydrate, talc, iron oxide, yellow dye.

Riboxin is available in cartons containing blisters of either 25 or 10 tablets.

It is important to note that Riboxin is dispensed by prescription.

Indications for the use of the drug Riboxin:

as one of the components of therapy for ischemia of the heart muscle, cardiac arrhythmias, prolonged use of cardiac glycosides, acute myocardial infarction;
for symptomatic treatment of liver dysfunction, hepatitis, cirrhosis, provoked by the use of strong drugs, alcohol abuse.

Riboxin is taken by professional athletes to improve physical performance.

Factors excluding the possibility of prescribing the drug:

allergic reactions, hypersensitivity;
benign prostatic hyperplasia;
fructose intolerance or severe sucrase deficiency.

Riboxin can be taken only under the supervision of a doctor for severe kidney pathologies, diabetes mellitus.

Conducted clinical studies have shown that Riboxin has excellent tolerance. Possible side effects: skin rashes, urticaria, intense itching, increased blood urea, in men - worsening gout.

Mildronate - dosage, indications

Additional substances included in the medicinal product: colloidal silicon dioxide, potato starch, gelatin, titanium and silicon dioxide.

Mildronate is sold in cardboard packs containing 6 contour cells of 10 tablets.

This medication is considered a doping drug. The main purpose of Mildronate:

in a therapeutic complex against chronic heart failure, ischemic pathology, various forms of angina pectoris, myocardial infarction, arrhythmias;
to improve concentration, increase activity, treat chronic fatigue syndrome;
as one of the drugs in the complex therapy of circulatory disorders in the brain;
reduction of psycho-emotional, physical and mental overstrain in professional athletes;
symptomatic therapy for withdrawal caused by a chronic form of alcoholism.

The list of contraindications for taking Mildronate includes:

deficiency of potassium in the blood plasma;
systematically elevated blood pressure;
the period of breastfeeding and pregnancy;
minor age;
increased susceptibility to components, allergic manifestations.

How to take Riboxin and Mildronate correctly

One of the important topics is the way drugs are used, because if a powerful drug is not taken correctly, there is a high risk of developing life-threatening complications.

Riboxin and Mildronate are potent drugs, so the frequency, duration and effective dosage of administration is prescribed by a doctor.

It is recommended to drink the drug 15-30 minutes before meals. Take the whole tablet without chewing and drinking water.
The therapeutic course varies from 1 to 3 months. In the treatment process, Riboxin is used daily.
The initial dose is 600 - 800 mg. The maximum value is 2400 mg. The daily dose must necessarily be divided into several doses.

The occurrence of side effects or intolerance to the components suggests the abolition of the use of Riboxin.

Professional athletes (running, athletics, bodybuilding) should take 50-100 mg twice a day immediately before the training process.
For ischemia and chronic heart failure, disorders of cerebral circulation, take 50 - 100 mg, the duration of the course is 1 - 1.5 months.
Ppri increased physical and psycho-emotional stress. Dosage 5 g twice a day. Therapy should not last more than 2 weeks.

It is important to emphasize that in order to achieve the maximum effect, the characteristics of the reception must be selected individually.

The difference between drugs, and what is best for the heart

Quite a popular question about the simultaneous intake and compatibility of these drugs. But before you understand this topic, you need to understand how Riboxin and Mildronate differ.

When ingested, meldonium solves several problems at once:

increases endurance;
participates in increasing the rate of glucose breakdown;
several times reduces the breakdown of lipids;
increases the efficiency of muscle contractions.

It is recommended to take Mildronate in the morning to achieve maximum effects.

improvement of wall elasticity and vasodilatation;
normalization of blood pressure;
increasing the immune activity of the body;
beneficial effect on the structure of muscle tissue;
increase in the rate of regeneration of cells subject to hypoxia;
increased effect when taken simultaneously with other drugs.

If you take these medicines together, then Mildronate takes the leading role in achieving the result.

Compatibility of Riboxin and Mildronate

The combined use of drugs that affect metabolism and heart muscle can be dangerous. In this regard, before starting use, it is necessary to visit a doctor, undergo a comprehensive diagnostic study.

Important! Taking both drugs on your own is dangerous not only for health, but also for life.

Analogues of these drugs

In addition to Riboxin and Mildronate, substitute drugs are used in cardiology and professional sports. Popular analogues include:

Synonymous drugs also have a strong effect on the body, so they are used only after the appointment of a cardiologist, the attending therapist.

Mildronate and Riboxin are popular medicines used in the treatment of cardiological diseases and professional sports. The use of drugs can be harmful, a doctor's prescription is necessary.

Antiarrhythmic drug Riboxin - principles of action and instructions for use

The drug Riboxin is an effective stimulator of energy metabolism in the cells of the human body.

This drug is indispensable for many pathologies, including diseases of the heart, liver, gastrointestinal tract.

It strengthens the myocardium, restores metabolism, improves the blood supply to the coronary vessels and, in general, has a beneficial effect on health.

Today we will analyze in detail what Riboxin treats, instructions for use and at what pressure this drug is effective.

Riboxin: what is it prescribed for?

First of all, let's figure out whether Riboxin is a vitamin or a medicine. The basis of the drug - the active substance inosine (the precursor of adenosine triphosphate acid) is a nucleoside, an element that is part of human cells. This compound is the main source of energy for all tissues of the human body. Indeed, without its action, oxygen deficiency occurs and the heart stops.

When inosine (0.2 g in one tablet) enters the body in the form of a medicine, it fills its cells with vitamins and minerals necessary for full life. And yet, why is Riboxin prescribed?

The drug is prescribed to patients who are diagnosed with such ailments as:

coronary artery disease;
coronary atherosclerosis;
myocardial dystrophy;
cirrhosis of the liver;
hepatitis (acute, chronic);
diseases of the visual organs;
uroporphyria (metabolic disorder);
stomach ulcer;
liver intoxication.

Riboxin raises or lowers blood pressure? The drug lowers blood pressure and, often, Riboxim is simply irreplaceable for hypertension. But is it worth taking it at low pressure? A condition such as hypotension requires additional consultation with the attending physician.

The drug significantly reduces the body's reactions during the period of radiation therapy used to get rid of oncological diseases. This drug is also used by athletes with serious physical exertion that can undermine the body.

Application rules

Can Riboxin be administered intramuscularly? Can. Moreover, as a rule, the drug is administered intramuscularly, as this is the most rational route of administration.

In addition to intravenous administration, it is used in the form of tablets or capsules.

Orally for adults and older than 12 years of age, children are prescribed 1 tablet or capsule 3-4 times a day, which is 0.6-0.8 g. If the drug is well tolerated, then its dosage is gradually increased.

Initially, take 2 tablets 3 times a day, then go to 4 tablets 3 times a day. An exception is the impaired metabolism of an innate nature (urocoproporphyria). So, in the presence of such an ailment, the optimal dose is 1 tablet 4 times throughout the day. This drug requires long-term use: 1-3 months.

Riboxin tablets

With drip or jet in / in the introduction to initial stage treatment, the patient is supposed to administer 200 mg of Riboxin 1 time per day. Then, subject to good tolerance of the drug, the dosage is raised to 400 mg 1-2 times a day. The course of treatment is generally 10 days.

If drip intravenous administration is necessary, then in order to avoid attacks of tachycardia, the drug is administered slowly (approximately 50 drops per minute).

The liquid form of Riboxin is produced in ampoules (for 20 m) such pharmaceutical companies such as, JSC Biosintez, JSC Novosibkhimfarm, Arterium and others.

In the form of capsules and tablets (200 ml) Riboxin is also produced different firms, including Darnitsa, Vero, Ferein. Tablets are taken half an hour before meals with plain water.

Riboxin: contraindications and side effects

A significant advantage of the drug is the minimum number of side effects.

Allergic manifestations are quite rare, expressed in the form of urticaria and an itchy rash.

At the same time, in a more severe form, allergy manifests itself if the drug is administered intravenously. But even with minimal signs of allergy, the drug must be canceled.

Also, long-term courses of taking Riboxin can provoke an attack of gout. This ailment, accompanied severe pain, characterized by the accumulation of uric acid salts in the joints. One of the elements of the drug, purine, is just involved in the exchange of uric acid. Therefore, its significant accumulation in the body, as a rule, leads to gout.

In some cases, the use of Riboxin is simply unacceptable. So, contraindications to taking the medicine are:

some kidney diseases;
leukemia in the last stages;
late pregnancy;
lactation;
gout;
excessive levels of uric acid in the blood;
increased disposition to the components of the drug.

Use during pregnancy

Many years of medical experience shows that taking the drug during pregnancy helps to avoid many unpleasant situations.

So, often expectant mothers have heart problems. Therefore, for the coordinated work of the heart muscle, women in position are prescribed Riboxin, and if necessary, the medicine is also administered during childbirth.

Riboxin is also an excellent remedy for combating gastritis and liver problems. And importantly, the drug is recommended to be taken for normal formation fetus. Indeed, in the case of hypoxia, the baby suffers from a lack of oxygen, and it is precisely such a drug that can cope with the current problem.

Treatment of heart disease

Virtually all cardiac disorders are caused by myocardial dysfunction.

There are also metabolic changes in the myocardium with failures in the blood supply to the heart and blood flow. Such disorders, as a rule, lead to arrhythmia, angina pectoris, heart attack, hypertension, myocardial dystrophy and other diseases.

And if the heart lacks energy for perfect work, then the intake of the components of the drug Riboxin into the myocardial muscle compensates for this deficiency. They prescribe medication for many heart ailments, but it is of great importance for angina pectoris (a type of coronary artery disease).

Use in diseases of the liver and stomach

The drug leads to the appropriate state of the cells of the walls of the stomach.

Therefore, this drug accelerates recovery and prevents exacerbation of gastric and duodenal ulcers.

Also, the drug restores liver cells (hepatocytes). This means that this drug is indispensable for acute and chronic liver diseases (hepatitis, alcohol damage ...). In general, a non-toxic drug is able to improve the patient's condition in these and many other diseases.

Compatibility with other drugs

Also, without fear, you can take Riboxin with drugs such as Nitroglycerin, Nifedipine, Furosemide. It is unacceptable to use the drug with vitamin B6.

It is worth noting that many patients are interested in whether Riboxin and Concor drugs can be taken together. They have good compatibility and are often prescribed together for people with diseases of the cardiovascular system.

IRON FACTOR

replacement of steroids with pharmaceutical preparations - p.

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Good day to all.

unfortunately in the "chemistry" section - there is no right to create topics, so I'll create it here, and the moderator will already throw it where he sees fit. For that I apologize in advance!

I am stuck in the mass at 76 kg. No matter what I do, I just can't get more.

I wanted to try steroids or growth hormone - however, the Ophthalmologist said that my vision might fall (I really don’t want this, because I had LASIK eye surgery only 2 years ago)

Here are the drugs described in the article:

1) Leuzea tablets;

in general, I'm interested in whether they can be combined and are there any serious side effects from them?

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Zoomik Sep 27, 2014

On the forum somewhere there is a separate topic about pharmaceutical preparations, look. And so: 1,3 and 4 are fairly harmless drugs and you can combine them, but No. 2 is a peculiar thing, the reviews on it are contradictory, and you need to think hard before you start using this drug at all.

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TII Sep 27, 2014

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AnatolyR 27 Sep 2014

I found an article on the net that you can buy drugs in a pharmacy - similar in their properties to some steroids.

no legal drug can compare in effect with the action of steroids

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terminalX Sep 27, 2014

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Oleg K 27 Sep 2014

Forgot about spinach

Miniatures

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Rostik Sep 27, 2014

lok888, in the pharmacy you can buy retabolil, omnadren, testosterone propionate and growth hormone)

however, the optometrist said that vision may fall

ask the shark specialist, explain to me why eyesight will fall Or what reasons can fall?

I think it's hard for him to do

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TII Sep 27, 2014

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Rostik Sep 27, 2014

study Pharmacy preparations for athletes, which can be bought at a small price at any pharmacy

Asparkam contains potassium and magnesium in a form that allows them to be absorbed by the body easily and painlessly. These substances contribute to the effective regulation of metabolic processes. Basically, asparkam is used by athletes who want to quickly lose weight. In addition, asparkam helps prevent cramps and facilitates training in hot conditions. As a rule, this drug is produced in the form of tablets, the order of use and dosage can be found in the instructions. Taking pills should be planned for the morning and afternoon, as in the evening the body does not absorb magnesium and calcium well.

Riboxin is a stimulant of biochemical processes, it has a positive effect on the athlete's heart. This drug has antiarrhythmic, anabolic and other beneficial effects. By increasing the force of heart contractions, it helps to increase stroke volume. Riboxin generally improves tissue blood supply, as well as coronary blood supply. With the use of riboxin, one can observe an improvement in energy metabolism, the activity of many enzymes and metabolic processes in the myocardium. Another positive effect of taking this drug is the improvement of muscle tissue regeneration. But despite all their positive traits, riboxin is bad as a reducing agent, for this reason it is recommended to take it in combination with potassium orate, which acts as a kind of amplifier.

This tool belongs to the category of metabolic. Potassium orotate stimulates endogenous biochemical processes. You can buy it at the pharmacy without a prescription, most often it comes in the form of tablets. The dosage for a bodybuilder is in the range of 1.5-2 grams per day. In principle, potassium orotate is a common mineral salt found in the cells of any living organism. The positive effects of the reception include the strengthening of the cardiovascular athlete and the general anabolic effect, which makes it possible fast recovery after training. In addition, there is an increase in diuresis (fluid excretion from the body) and an improvement in appetite. But do not overestimate the positive effect of potassium orotate for bodybuilders, the effect is not so strong. On the other hand, an athlete taking this drug will not experience problems with poor tolerance and side effects.

Everything is extremely simple here - the tool is designed to increase the bodybuilder's performance and compensate for the manifestations of mental and physical overstrain. Mildronate corrects metabolism, regulates cellular immunity and acts as a cardioprotector. Mildronate should be taken at doses per kg of body weight, but it is highly recommended to seek the advice of a doctor before doing so.

The names "Pentoxifylline" and "Trental" are also possible. Produced in the form of tablets and has a low cost. This drug should be taken separately, since its main task is to increase vascular tone, reduce blood viscosity and increase blood flow. This is a great way to train when there is a feeling of maximum pumping of the working muscles. Agapurine is mainly used by experienced bodybuilders, and it should be taken with caution, since this remedy, in addition to a positive effect, if the instructions are violated, can cause various negative aspects.

This plant, which grows in Eastern and Western Siberia, in Central Asia and in the Altai mountains, contains phytoexidons - steroid compounds with pronounced anabolic properties. In the body of an athlete, Leuzea enhances the processes of protein synthesis and their accumulation in muscles, heart, liver and kidneys. Using this drug, you can significantly increase physical endurance and intellectual performance. Long-term use of Leuzea leads to an expansion of the vascular bed and, in turn, to an improvement in general blood circulation. The heart rate decreases. On the basis of Leuzea, a food supplement such as Levzeya-P is produced. One tablet of "Levzeya-P" contains about 0.85 mg of Ekdisten, supplements with which are in sports stores from 700 to 1800 rubles.

This drug has the ability to cause a noticeable decrease in blood sugar (hypoglycemia), which is greater than the hypoglycemia caused by other RA-adaptogens. Since the result of hypoglycemia in this case is the release of growth hormone, the use of Manchurian aralia allows you to achieve a significant overall anabolic effect with weight gain and increased appetite. Aralia has stimulating properties and enhances anabolism. Aralia tincture can be purchased from any pharmacy. Take it should be 20-30 drops, in the morning and an hour before the start of training.

Vitamins should be used in combination or each vitamin separately. Among the complexes, the most popular is Complevit, which is taken 3 times a day for this tablet after meals. If you take vitamins separately, then first of all you need to pay attention to such as:

B vitamins are injectable, they are sold in ampoules of 1 ml with a concentration of 5%. You can not enter vitamins together, on the first day the body should receive one vitamin, on the next - the second, on the third day - the third with a repetition of the cycle. Injections are made using 2 or 5 cc syringes intramuscularly, in addition, B1 and B6 are quite painful, so you need to be prepared for discomfort.

Of the freely sold drugs, Diabeton MB is perhaps the most powerful in terms of anabolic properties. In medicine, this tool is used to stimulate the pancreas in the treatment of diabetes. In bodybuilding, Diabeton MB is used to maintain a high level of anabolism in the off-season. The strength of the effect is equal to the strength of insulin injections, and the overall effect can be compared to that of methandrostenolone. Also, the tool is great for those who want to quickly gain weight. Diabeton MV is produced in tablets of 30 mg. At the beginning, no more than 30 grams per day should be taken, if tolerance is normal, in the next course (on average, the course lasts 4-6 weeks), the allowable dosage may be 60 grams per day. Diabeton MB is incompatible with other drugs.

In bodybuilding, tamoxifen is used to increase testosterone levels in the body, and in fact it is an antiestrogen. That is, the rise in testosterone levels is carried out by blocking estrogen. For maximum effect, this drug is best combined with others. Considering that tamoxifen takes a long time to start working, the course should be at least 6-8 weeks.

In medicine, calcium glycerophosphate is used in the treatment of rickets, dystrophy and overwork. This drug speeds up the absorption of protein and metabolism. When taking this remedy, the appetite increases significantly, so the consumption of fatty foods should be limited. Instead, include as many protein-rich foods as possible in your diet. Glycerophosphate is well suited for compiling courses, while there are no analogues in sports nutrition stores. For this drug, the dosage is approximately 100 mg per 8 kg of body weight.

Great for burning fat (similar to clenbuterol). You can buy it at a pharmacy without a prescription. The effect of saltos is as follows: it raises body temperature by 1 degree with a dosage of 3-5 tablets per day for 3 doses. An increase of 1 degree is due to the combustion of fats. This may have a small side effect in the form of trembling hands and nervousness. With its fat-burning effect, saltos is significantly superior to most sports preparations for burning fat.

Trimetazidine in its properties is very similar to the popular drug Mildronate, only the cost of the first is much lower. This drug contributes to a better supply of cells with oxygen, preserves intracellular energy, prevents the action and formation of free radicals, and also increases resistance to physical stress. Taking Trimetazidine makes training more powerful and intense. This tool can be replaced with drugs containing creatine, but this replacement will be unequal. In addition, Trimetazidine is well combined with other drugs.

Vinpocetine is a drug that corrects various circulatory disorders of the brain. The active ingredient here is apovincaminate. This drug has a direct effect on the metabolism in brain tissues. The vessels in the brain expand, which contributes to a better blood supply to its tissues. Taking vinpocetine increases resistance to hypoxia (oxygen starvation), activates the processes of glucose utilization, and also increases the level of metabolism of serotonin and norepinephrine in brain tissues. The use of this agent leads to a decrease in platelet aggregation (clumping), which means a decrease in blood viscosity.

The mechanism of action of metmorphine is based on its ability to suppress glucogenesis, the formation of free fatty acids and fat oxidation. This drug has no effect on insulin levels, but is able to change its dynamics by reducing the ratio of free insulin to bound and increasing the ratio of proinsulin to insulin. An important role here is played by the stimulation of glucose uptake by muscle cells. By taking metmorphine, you can increase blood circulation in the liver and speed up the process of converting glucose into glycogen.

Rhodiola rosea grows in the Sayans, Altai, Far East and in Eastern Siberia. Pharmacological effects of this drug are due to the presence of substances such as rhodiolyside and rhodosin. In some countries they are released in pure form. The main feature of Rhodiola rosea is a strong effect on muscle tissue. When taking Rhodiola, strength endurance and muscle strength increase. At the cellular level, the level of activity of such contractile proteins as myosin and actin increases. Mitochondria increase in size.

Riboxin's analogs

If necessary, activate and normalize metabolic processes in the heart muscle, as well as to better provide tissues with oxygen, Riboxin is prescribed.

The drug was also found wide application among athletes, since its use leads to the restoration of carbohydrate, protein and fat metabolism, which increases the body's defenses and increases the effectiveness of training.

The drug is produced in the form of capsules, tablets and solution for injection and is produced by enterprises in the territory of the former Soviet Union and foreign countries(Great Britain, China, Switzerland).

The modern pharmaceutical industry presents numerous analogues of Riboxin, which have an almost identical effect, but differ in manufacturer, and in some cases in composition and form of release.

Structural analogs of Riboxin

Riboxin and its complete analogues are produced on the basis of inosine, a nucleoside, the chemical precursor of adenosine triphosphate (ATP), a universal energy source in every cell of the body.

Replacing Riboxin with structural analogues, as a rule, is not advisable due to their identical effect and occurs only in case of individual intolerance to additional components of the drug or inappropriate price.

The active substance gives drugs the following effects:

anabolic,
antiarrhythmic,
antihypoxic,
coronary dilating.

Riboxin and its analogues are used as part of complex therapy for:

normalization of the heart rhythm;
elimination of manifestations of poisoning caused by cardiac glycosides;
getting rid of cardiomyopathy, ischemia, myocarditis due to physical overload;
recovery of the body after a heart attack;
relief of symptoms caused by angina pectoris;
therapeutic treatment of liver pathologies ( fatty degeneration, cirrhosis, hepatitis);
normalization of vision in open-angle glaucoma without impairment intraocular pressure and etc.

Uncontrolled use of drugs can lead to:

lowering blood pressure;
increased heart rate;
allergic reactions in the form skin itching, urticaria, reddening of the skin, exacerbation of gouty arthritis.

Structural analogues of Riboxin include:

inosine,
Riboxin Vial,
Inosin-Eskom,
Riboxin Bufus,
Riboxin-Lect,
Riboxin-Ferein,
Inosie-F,
Ribonosin,
Vero-Riboxin,
Riboxin-PNITIA,
Riboxin-UVI,
Riboxin-Darnitsa.

All of the above drugs are prescribed for the treatment of the same pathologies, but depending on the manufacturer, they can vary significantly in price.

Other substitutes

There are also drugs that contain active ingredients different from Riboxin, but have the same functional focus as it. Some of them belong to the new generation of drugs and have a much better effect.

Mildronate

The drug is produced on the basis of meldonium, which gives the drug angioprotective, angioprotective, antihypoxic and cardioprotective effects. Designated for:

normalization of metabolism in cells;
improvement of blood microcirculation;
slowing down necrotic processes;
cuts recovery period after surgical interventions;
improving the contractility of the heart muscle;
raise defensive forces organism;
increasing endurance during physical and mental stress;
treatment of certain eye diseases.

Mildronate is a Latvian drug intended for oral, intramuscular, intravenous and parabulbar administration.

The use of Mildronate can cause:

manifestations of allergies;
dyspeptic symptoms (belching, nausea, vomiting, heartburn);
tachycardia;
increased arousal;
lowering blood pressure.

Contraindications to the use of the drug are individual intolerance to its components and intracranial hypertension.

Unlike Riboxin, Mildronate does not participate in the production of any substances in the body, with its help only metabolic processes are corrected.

Cavinton

Produced on the basis of vinpocetine with the addition of excipients.

Cavinton - Hungarian drug, produced in the form of tablets and injection solution

Cavinton has a positive effect on metabolic processes in the brain. Recommended for:

transistor ischemia;
ischemic stroke;
atherosclerosis;
post-traumatic or hypertensive encephalopathy;
neurological and mental failures (memory disorders, headaches, movement disorders), etc.

Side effects appear as:

lowering blood pressure;
dyspeptic disorders;
headaches;
dizziness;
feelings of weakness;
allergies.

The drug is contraindicated in severe forms arrhythmia, expressed by ischemic heart disease, during pregnancy and breastfeeding.

Cytoflavin

The drug is made on the basis of:

succinic acid, which is involved in the synthesis of ATP and has a direct effect on glycolysis, which improves cellular metabolism;
inosine - the main ingredient of Riboxin;
Riboflavin (vitamin B 2), which is a direct participant in the Krebs cycle, which is of particular importance for the body and acts as an antioxidant;
nicotinamide, which improves cellular respiration and ATP synthesis.

Cytoflavin - Russian medicinal product, dosage form - tablets and injection solution

The expediency of prescribing Cytoflavin occurs when:

impaired cerebral circulation (after a stroke);
prolonged mental or physical stress;
insufficient blood supply to the brain in a newborn child;
the use of artificial circulation in the postoperative period;
cerebral atherosclerosis.

The drug is not used in case of allergy to its components, in case of kidney disease and in patients under 18 years of age.

In rare cases, the use of Cytoflavin can provoke headaches, tachycardia, arrhythmia, nausea, vomiting, allergies and other unpleasant symptoms.

Mexicor

The drug contains hydroxymethylethylpyridine succinate as the main component.

Mexicor is produced in the form of capsules and solution for injection by the Russian company EcoPharmInvest

Thanks to antihypoxic, neuroprotective, nootropic, anxiolytic and antioxidant effects, Mexicor, in combination with other methods of treatment, eliminates:

cardiac ischemia;
ischemic stroke;
mild and moderate cognitive disorders;
dyscirculatory encephalopathy.

The use of the drug is prohibited when:

hepatic and renal pathologies in the acute stage;
hypersensitivity to the components of the drug.

Actovegin

It is produced on the basis of deproteinized hemoderivate from calf blood, which promotes the activation of metabolic and regenerative processes and improves trophism. The use of the drug leads to an increase in the resistance of tissues to a lack of oxygen and the activation of energy metabolism.

Actovegin is produced by the Austrian manufacturer of medicines "Nycomed Austria GmbH" in the form of a solution for injection and infusion, tablets, cream, gel and ointment

Actovegin together with other drugs fights against:

vascular and metabolic disorders in the brain (ischemic stroke, dementia, etc.);
diabetic polyneuropathy;
arterial and venous disorders and their consequences (trophic ulcers, angiopathy).

The use of Actovegino is contraindicated in:

oliguria;
pulmonary edema;
anuria;
individual intolerance;
decompensated heart failure (if necessary, droppers).

Therapy with Actovegin can lead to:

allergic manifestations (edema, increased sweating and etc.)
dyspeptic disorders (vomiting, nausea, diarrhea);
tychycardia, heart pain, blanching of the skin, shortness of breath;
feeling of weakness, headaches, dizziness, tremor;
rapid breathing.

Undesirable manifestations occur very rarely and are eliminated by symptomatic treatment.

If it is necessary or desired to replace Riboxin with its analogue, it is necessary to consult the attending physician, who will select the most effective and safe remedy for the patient's health.

There are drugs that are used as cardioprotective and antihypoxic agents for intense physical exertion. These drugs include Riboxin and Mildornate.

The main purpose of the drugs is the complex therapy of coronary heart disease. However, athletes often use them to achieve more pronounced sports results.

The drugs are effective separately, but many are interested in whether it is possible to take Riboxin and Mildronate together.

All about the drug Riboxin - brief instructions for use

A modern drug aimed at stabilizing the metabolism in the myocardium, normalizing the state of tissues that have undergone hypoxia - Riboxin. Country of origin - Russia.

Additional components included in the preparation: stearic acid, potato starch, microcrystalline cellulose, sucrose monohydrate, talc, iron oxide, yellow dye.

Riboxin is available in cartons containing blisters of either 25 or 10 tablets.

Riboxin

It is important to note that Riboxin is dispensed by prescription.

Indications for the use of the drug Riboxin:

as one of the components of therapy for ischemia of the heart muscle, cardiac arrhythmias, prolonged use of cardiac glycosides, acute myocardial infarction;
for symptomatic treatment of liver dysfunction, hepatitis, cirrhosis, provoked by the use of strong drugs, alcohol abuse.

Riboxin is taken by professional athletes to improve physical performance.

Factors excluding the possibility of prescribing the drug:

allergic reactions, hypersensitivity;
benign prostatic hyperplasia;
fructose intolerance or severe sucrase deficiency.

Riboxin can be taken only under the supervision of a doctor for severe kidney pathologies, diabetes mellitus.

Conducted clinical studies have shown that Riboxin has excellent tolerance. Possible side effects: skin rashes, urticaria, intense itching, increased blood urea, in men - worsening gout.

PayAttention! Self-administration is not recommended, a doctor's consultation is necessary before use.

Mildronate - dosage, indications

Additional substances included in the medicinal product: colloidal silicon dioxide, potato starch, gelatin, titanium and silicon dioxide.

Mildronate is sold in cardboard packs containing 6 contour cells of 10 tablets.

Mildronate

This medication is considered a doping drug. The main purpose of Mildronate:

in a therapeutic complex against chronic heart failure, ischemic pathology, various forms of angina pectoris, myocardial infarction, arrhythmias;
to improve concentration, increase activity, treat chronic fatigue syndrome;
as one of the drugs in the complex therapy of circulatory disorders in the brain;
reduction of psycho-emotional, physical and mental overstrain in professional athletes;
symptomatic therapy for withdrawal caused by a chronic form of alcoholism.

The list of contraindications for taking Mildronate includes:

deficiency of potassium in the blood plasma;
systematically elevated blood pressure;
the period of breastfeeding and pregnancy;
minor age;
increased susceptibility to components, allergic manifestations.

How to take Riboxin and Mildronate correctly

One of the important topics is the way drugs are used, because if a powerful drug is not taken correctly, there is a high risk of developing life-threatening complications.

Riboxin and Mildronate are potent drugs, so the frequency, duration and effective dosage of administration is prescribed by a doctor.

It is recommended to drink the drug 15-30 minutes before meals. Take the whole tablet without chewing and drinking water.
The therapeutic course varies from 1 to 3 months. In the treatment process, Riboxin is used daily.
The initial dose is 600 - 800 mg. The maximum value is 2400 mg. The daily dose must necessarily be divided into several doses.

The occurrence of side effects or intolerance to the components suggests the abolition of the use of Riboxin.

Professional athletes (running, athletics, bodybuilding) should take 50-100 mg twice a day immediately before the training process.
For ischemia and chronic heart failure, disorders of cerebral circulation, take 50 - 100 mg, the duration of the course is 1 - 1.5 months.
Ppri increased physical and psycho-emotional stress. Dosage 5 g twice a day. Therapy should not last more than 2 weeks.

Taking medications

It is important to emphasize that in order to achieve the maximum effect, the characteristics of the reception must be selected individually.

The difference between drugs, and what is best for the heart

Quite a popular question about the simultaneous intake and compatibility of these drugs. But before you understand this topic, you need to understand how Riboxin and Mildronate differ.

When ingested, meldonium solves several problems at once:

increases endurance;
participates in increasing the rate of glucose breakdown;
several times reduces the breakdown of lipids;
increases the efficiency of muscle contractions.

Endurance Improvement

It is recommended to take Mildronate in the morning to achieve maximum effects.

improvement of wall elasticity and vasodilatation;
normalization of blood pressure;
increasing the immune activity of the body;
beneficial effect on the structure of muscle tissue;
increase in the rate of regeneration of cells subject to hypoxia;
increased effect when taken simultaneously with other drugs.

If you take these medicines together, then Mildronate takes the leading role in achieving the result.

Compatibility of Riboxin and Mildronate

The combined use of drugs that affect metabolism and heart muscle can be dangerous. In this regard, before starting use, it is necessary to visit a doctor, undergo a comprehensive diagnostic study.

Compatibility

Important! Taking both drugs on your own is dangerous not only for health, but also for life.

Analogues of these drugs

In addition to Riboxin and Mildronate, substitute drugs are used in cardiology and professional sports. Popular analogues include:

Actovegin;
Asparkam;
Trimetazidine;
Panangin.

Synonymous drugs also have a strong effect on the body, so they are used only after the appointment of a cardiologist, the attending therapist.

Mildronate and Riboxin are popular medicines used in the treatment of cardiological diseases and professional sports. The use of drugs can be harmful, a doctor's prescription is necessary.

A bunch of riboxin and trimetazidine with glutamic acid. Treatment of heart disease

Mildronate

Which is better: Trimetazidine or Mildronate?

Features of Trimetazidine

The difference between Trimetazidine and Mildronate

Combination of Trimetazidine and Mildronate

Preductal MV instructions for use, reviews of cardiologists, analogues

Compound

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Analogues are cheaper

Preductal instructions for use

Preductal mv reviews of cardiologists

Contraindications

Alcohol compatibility

Which is better: therapy with Riboxin or Mildronate tablets together - effect

All about the drug Riboxin - brief instructions for use

Mildronate - dosage, indications

How to take Riboxin and Mildronate correctly

The difference between drugs, and what is best for the heart

Compatibility of Riboxin and Mildronate

Analogues of these drugs

Actions of cardioprotectors

What is better riboxin or trimetazidine

Topic: Severe metabolic changes

Mildronate or trimetazidine

Which is better: Trimetazidine or Mildronate?

Features of Trimetazidine

The difference between Trimetazidine and Mildronate

Combination of Trimetazidine and Mildronate

Mildronate or trimetazidine

Which is better: therapy with Riboxin or Mildronate tablets together - effect

All about the drug Riboxin - brief instructions for use

Mildronate - dosage, indications

How to take Riboxin and Mildronate correctly

The difference between drugs, and what is best for the heart

Compatibility of Riboxin and Mildronate

Analogues of these drugs

Mildronate or trimetazidine

Mildronate and trimetazidine: similarities and differences in their action

Mildronate: why are there so many victims in Russian sports?

Features of Trimetazidine

The difference between Trimetazidine and Mildronate

Combination of Trimetazidine and Mildronate

Medical reference center "InfoDoctor"

Igar82 › Blog › It's time to lose weight - Pharmacy anabolics. Part 1 (cardioprotectors)

Which is better: therapy with Riboxin or Mildronate tablets together - effect

All about the drug Riboxin - brief instructions for use

Mildronate - dosage, indications

How to take Riboxin and Mildronate correctly

The difference between drugs, and what is best for the heart

Compatibility of Riboxin and Mildronate

Analogues of these drugs

Antiarrhythmic drug Riboxin - principles of action and instructions for use

Riboxin: what is it prescribed for?

Application rules

Riboxin: contraindications and side effects

Use during pregnancy

Treatment of heart disease

Use in diseases of the liver and stomach

Compatibility with other drugs

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IRON FACTOR

replacement of steroids with pharmaceutical preparations - p.

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Miniatures

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Riboxin's analogs

Structural analogs of Riboxin

Other substitutes

Mildronate

Cavinton

Cytoflavin

Mexicor

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