TOP 7 analogues of the drug Mildronate: list of cheap substitutes

Mildronate is a drug intended to improve metabolism in cells exposed to ischemia or hypoxia. The medicine improves energy metabolism in the tissues of the heart muscle and other organs. The drug is prescribed to patients with heart and vascular diseases, cerebrovascular accidents, retinopathy, as well as people engaged in heavy physical and mental work. In addition to the original product, which you can read about in detail here, modern pharmaceuticals offer various analogues of Mildronate. Analogues are drugs that are similar in their action and chemical composition.

Compound

• One hard gelatin capsule of Mildronate contains 250 or 500 mg of meldonium in the form of dihydrate as an active component and excipients: potato starch, colloidal silicon dioxide, calcium stearate. Gelatin and titanium dioxide are used to make the gelatin shell.
• One Mildronate tablet contains 500 mg of meldonium in the form of phosphate and auxiliary components: mannitol E421, povidone K-29/32, potato starch, silicon dioxide, microcrystalline cellulose, magnesium stearate.
• One milliliter of Mildronate injection solution contains 100 mg of meldonium and water for injection as an auxiliary component.

Mildronate caps 250 mg in blister pack No. 10x4

Name

Mildronate.

Description

The active substance of the drug Mildronate® is meldonium dihydrate (meldonium). Meldonium is a structural analogue of a substance found in every cell of the body - gamma butyrobetaine. The action of this drug is based on a positive effect on the body’s energy metabolism, as well as a slight activation of the central nervous system. During exercise, Mildronate® restores the balance between oxygen delivery and consumption in cells and activates metabolic processes in them, which require less oxygen consumption to produce energy. Usually, under conditions of increased stress, the body quickly becomes exhausted, but as a result of using the drug Mildronate®, the body gets used to withstanding the load, using oxygen economically and quickly restoring energy reserves in preparation for new loads. Mildronate®, performing the functions of gamma butyrobetaine, can accelerate the transmission of nerve impulses in the body, and therefore all responses are accelerated and the overall metabolism in the body is improved. Therefore, when using the drug Mildronate®, a tonic effect is felt - memory improves, thinking speeds up, dexterity of movements increases, and the body’s resistance to harmful conditions increases.

Main active ingredient

Meldonium

Release form

White hard gelatin capsules. 10 capsules in a blister made of polyvinyl chloride film with polyvinylidene chloride coating and aluminum foil. 2 blisters along with instructions for medical use in a cardboard pack.

Dosage

250 mg

Indications for use

The drug Mildronate® is used as part of complex therapy in the following cases: - with physical and psycho-emotional overload, accompanied by a decrease in performance; - during the recovery period after cerebrovascular diseases, traumatic brain injury and encephalitis (as recommended by a doctor).

Directions for use and doses

Always use the drug in full accordance with the recommendations of your doctor or pharmacist. If in doubt, consult your doctor or pharmacist. Due to the possible stimulating effect, it is advisable to use it in the first half of the day. Recommended dose Adults The daily dose for adults is 500 mg (2 capsules). The entire dose can be taken in the morning in one dose, or divided into 2 doses (1 capsule each). The duration of the course of therapy is determined by the doctor. Special groups of patients Elderly patients For elderly patients with impaired liver and/or kidney function, the dose of Mildronate® may be reduced. Patients with Renal Impairment Since the drug is eliminated from the body through the kidneys, patients with mild to moderate renal impairment should use a lower dose of meldonium. Patients with hepatic impairment Patients with mild to moderate hepatic impairment should use a lower dose of meldonium. Use in children and adolescents There is no data on the safety and effectiveness of Mildronate® in children and adolescents (under 18 years of age), so this drug should not be used in children and adolescents (see Do not use this drug). If you have taken more Mildronate® than you should. There are no data on cases of overdose of Mildronate®. The drug is low-toxic and does not cause severe side effects. In case of low blood pressure, headaches, dizziness, accelerated heart activity (tachycardia), and general weakness are possible. In case of overdose, consult a doctor immediately. If you forgot to take the drug Mildronate® If you forgot to take the next dose of the drug Mildronate® on time, do it immediately. However, if your next dose is approaching, skip the forgotten dose and continue to use the drug as recommended at the usual dosing intervals. Do not use a double dose to replace a forgotten dose. If you stop using the drug Mildronate® When you stop using this drug, no adverse reactions are observed. If you have questions about the use of the drug, contact your doctor or pharmacist.

Use during pregnancy and lactation

If you are pregnant or breastfeeding, think you may be pregnant, or are planning a pregnancy, consult your doctor or pharmacist before using this medicine. Animal studies are insufficient to assess the effect of Mildronate® on pregnancy, embryo/fetal development, childbirth and postpartum development. The potential risk for humans is unknown, therefore Mildronate® should not be used during pregnancy (see Do not use the drug). It is unknown whether the drug is excreted into human breast milk. A risk to newborns/infants cannot be excluded and this drug should not be used while breastfeeding (see Do not use this drug).

Precautionary measures

Before using Mildronate®, consult your doctor or pharmacist. Tell your doctor if you have had liver and/or kidney failure, as liver and/or kidney function tests may need to be monitored. Children and adolescents This drug should not be used in children and adolescents under 18 years of age, as there is no data on the safety and effectiveness of meldonium in these age groups. There is no data on the effect on the ability to drive vehicles and operate machinery.

Interaction with other drugs

Tell your doctor or pharmacist if you are using, have recently used, or may start using any other medications. — Mildronate® can be used together with drugs against angina, cardiac glycosides and diuretics (promote the formation and excretion of urine from the body). — Mildronate® can be combined with anticoagulants (delay blood clotting), antiplatelet agents (prevent the formation of blood clots in blood vessels), drugs that eliminate heart rhythm disturbances and other drugs that improve microcirculation (blood circulation in small blood vessels). — Mildronate® can enhance the effect of drugs containing glyceryl trinitrate, nifedipine, beta-blockers, and other drugs that lower blood pressure and dilate blood vessels. — With the simultaneous use of meldonium with lisinopril, a positive effect of combination therapy is observed. -Additional effects are observed when meldonium is used in combination with orotic acid to reverse damage caused by ischemia/reflow. — As a result of the simultaneous use of Sorbifer and meldonium in patients with anemia caused by iron deficiency, the composition of fatty acids in red blood cells improves. — For patients with acquired immunodeficiency syndrome (AIDS), in addition to azidothymidine or other drugs for its treatment, the doctor may prescribe meldonium, since the combined use of these drugs has a positive effect on the treatment of AIDS. — An overdose of meldonium can increase the toxic effect of cyclophosphamide on the heart. — Carnitine deficiency resulting from the use of D-carnitine (an inactive isomer of carnitine)-meldonium may increase the toxic effects of ifosfamide on the heart. — Meldonium exhibits protective effects against indinavir cardiac toxicity and efavirenz-induced neurotoxicity. Do not use this drug with other drugs that contain meldonium because the risk of side effects may increase.

Contraindications

- if you are allergic to meldonium dihydrate or any other components of the drug; - with increased intracranial pressure (in case of impaired venous outflow, intracranial tumors); - if you have severe liver and/or kidney failure (there is insufficient data on the safety of use); - during pregnancy and lactation; - children and adolescents under 18 years of age (safety of use has not been verified).

Compound

— active substance – meldonium dihydrate. One capsule contains 250 mg of meldonium dihydrate, - excipients: dried potato starch, hydrated silicon dioxide (Siloid 244 FP), calcium stearate. Capsule (body and cap): titanium dioxide (E 171), gelatin.

Side effect

Like all medicines, Mildronate® can cause side effects, although not everyone gets them. If you experience any unwanted reactions, consult your doctor or pharmacist. This recommendation applies to any possible adverse reactions, including those not listed in the instructions. The following are undesirable reactions observed in previously conducted clinical studies (marked *), and undesirable reactions that were reported during the period after registration of the drug. Common (may occur in no more than 1 person in 10): • allergic reactions*; • headache*; • digestive disorders*. Rare (may affect up to 1 in 1000 people): • hypersensitivity, allergic dermatitis, urticaria, angioedema (difficulty breathing or swallowing, or swelling of the throat, face, arms and legs, lips and/or tongue), anaphylactic reaction (sudden general allergic reaction, the symptoms of which are itching, hives, swelling, difficulty breathing, shortness of breath, rapid heartbeat, rapid drop in blood pressure, dizziness, loss of consciousness, shock); • excitement, fear, obsessive thoughts, sleep disturbances; • feeling of “pins and needles”, trembling, decreased sensitivity, tinnitus, dizziness, gait disturbances, lightheadedness, loss of consciousness; • changes in heart rhythm, increased heart rate, atrial fibrillation, chest discomfort/chest pain; • increase/decrease in blood pressure, hypertensive crisis (rapid increase in blood pressure), increased blood flow to tissues (hyperemia), pallor; • sore throat, cough, difficulty breathing, short-term cessation of breathing; • disturbances in the sense of taste (metallic taste in the mouth), loss of appetite, retching, nausea, vomiting, gas accumulation, diarrhea, abdominal pain; • general/macular (limited, without elevation)/papular (small, dense with elevation) rashes, itching; • back pain, muscle weakness, muscle spasms; • frequent urination; • general weakness, chills, weakness, swelling, swelling of the face, swelling of the legs, feeling hot, feeling cold, cold sweat; • changes in the electrocardiogram (ECG), acceleration of heart function, eosinophilia (increase in the number of specific white blood cells)*. Upper abdominal pain and migraine have also been reported in connection with the use of Mildronate®. Reporting Adverse Reactions It is important to report suspected reactions after marketing authorization of a medicinal product to ensure continuous monitoring of the benefit-risk profile of the medicinal product. Healthcare professionals are encouraged to report any suspected adverse drug reactions through the national adverse reaction reporting systems of the member states of the Eurasian Economic Union. In the Republic of Belarus, it is recommended to report adverse reactions to the information database on adverse reactions (actions) to drugs, including reports of ineffectiveness of drugs (UE "Center for Expertise and Testing in Healthcare" of the Ministry of Health of the Republic of Belarus, website rceth.by).

Storage conditions

Store at a temperature not exceeding 25 °C. Store in original packaging to protect from moisture. Keep out of the reach of children. Do not use the drug after the expiration date indicated on the package after “Best before”. The expiration date is the last day of the month. Do not throw medications down the drain. Ask your pharmacist how to dispose of medications that you no longer need. These measures will protect the environment.

Buy Mildronate caps 250 mg in blister pack No. 10x4 in the pharmacy

Price for Mildronate caps 250 mg in blister pack No. 10x4

Instructions for use for Mildronate caps 250 mg in blister pack No. 10x4

Release form

The drug Mildronate is produced by the manufacturer in the form:

• clear colorless solution for injection;
• hard gelatin capsules No. 1 and No. 2, filled with hygroscopic white crystalline powder. The powder contained in the capsules has a weak characteristic odor and a sweetish taste (the capsule itself has a neutral taste);
• tablets Mildronate Gx 500 mg (tablet taste slightly sour).

The solution is sold in 5 ml ampoules (500 mg/5 ml). One cardboard package contains: 2 blister packs with 5 ampoules of Mildronate in each and instructions for use of the drug.

Capsules are packaged in blisters of 10 pieces each. One cardboard box contains 4 blisters and instructions for use of the drug.

pharmachologic effect

Meldonium is a synthetic drug that has a similar effect to γ-butyrobetaine (a substance that is a precursor to hydroxytrimethylaminobutyric acid, a natural vitamin-like substance related to B vitamins).

According to Wikipedia, meldonium is characterized by its ability to improve metabolism and energy supply to cells and is used as:

• cardioprotective;
• antihypoxic;
• angioprotective;
• antianginal agent.

The mechanism of action of meldonium determines a wide range of its pharmacotherapeutic properties. Taking this drug helps improve performance, reduces the severity of manifestations of mental, intellectual and physical stress, and activates tissue and humoral immunity.

In patients suffering from heart failure , it increases the strength of contractions of the heart muscle, reduces the frequency of heart attacks ( angina ), and also increases the body's tolerance to physical activity.

In case of acute myocardial damage, the use of meldonium slows down the formation of necrotic zones, shortens the duration of the rehabilitation period, normalizes blood circulation in the area of ​​ischemic damage and redistributes blood in favor of the ischemic area.

Under conditions of increased stress, meldonium helps restore the balance between the transport of oxygen into cells and the cells' need for it, prevents the accumulation of cellular metabolic products and toxic substances in cells, protects cells and cellular structures from damage, ensures rapid compensation by the body of its energy reserves and maintains the highest speed metabolic processes.

By toning the central nervous system, meldonium effectively eliminates disturbances in the functional state of the somatic and autonomic (autonomic) parts of the nervous system, including disorders that accompany withdrawal syndrome in patients suffering from chronic alcoholism .

In addition, the substance has a beneficial effect on the condition of dystrophically altered retinal vessels, which makes it possible to use it for the treatment of vascular and dystrophic pathologies of the fundus.

Belarusian substitutes

Mildronate analogues produced in Belarus are produced in ampoules, tablets, and capsules. These drugs are distinguished by their simplicity of composition, but in terms of therapeutic effect they are not inferior to their more expensive analogues.

Mildrocard

The drug Mildrocard has angioprotective, antihypoxic, cytoprotective effects in various pathologies of the heart and blood vessels. The product enhances energy exchange, nourishes the affected tissues with oxygen and other vital elements.

The range of applications of Mildrocard is very wide. These include decreased performance, loss of strength after heavy physical exertion, including among athletes, disturbances in myocardial function, coronary artery disease, and heart failure. Besides. The drug is indicated for withdrawal symptoms in people with alcohol dependence, retinopathy, retinal hemorrhage and other conditions.

Tablets and injections are used according to a scheme selected by the doctor, individually for each patient. The standard regimen involves taking 1 tablet three times a day for 7–14 days or 5 ml of the drug intravenously 3 times a day for a week.

Mildrokat is a Belarusian-made product that contains meldonium.

Contraindications:

• allergy to the components of the product;
• serious diseases of the central nervous system;
• increased intracranial pressure;
• age up to 18 years.

Important! During pregnancy, Mildrocard may be taken as prescribed by a doctor in cases where the benefit outweighs the harm.

Riboxin

Riboxin has a positive effect on cellular energy metabolism, reduces ischemia and tissue hypoxia in diseases of the heart and blood vessels. The drug is intended to restore heart rhythm, coronary circulation, and stimulates increased energy exchange in myocardial tissues.

The medicine is used in complex therapy of coronary artery disease, diseases of the organs of vision, myocarditis, cardiomyopathy, arrhythmias, and during the recovery period after a heart attack.

The main contraindication of Riboxin is individual intolerance to the components of the drug. The product should not be used by patients suffering from gout and uric acid metabolism disorders. The drug is prescribed with great caution to patients undergoing chemotherapy treatment.

The most common complication when taking Riboxin is the development of a local allergic reaction. It manifests itself in the form of rashes and skin itching. Using the medication for too long can cause severe inflammation in the joints.

Pharmacodynamics and pharmacokinetics

The action of the active substance of the drug is aimed at inhibiting the enzymatic activity of γ-butyrobetaine hydroxylase, which is the last enzyme in the chain reaction of l-carnitine .

Meldonium helps reduce the concentration of free carnitine , prevents the transport of long-chain fatty acids across cell membranes, and prevents the accumulation in cells of activated forms of unoxidized fatty acids, which are derivatives of acylcarnitine and acyl coenzyme .

In ischemic tissues, it restores the balance between the transport of oxygen and its absorption by cells, prevents disruption of the transport of adenosine triphosphate, while simultaneously activating glycolysis, which occurs without additional oxygen consumption.

The result of a decrease in carnitine concentration is increased synthesis of the vasodilator γ-butyrobetaine.

After taking Mildronate tablets per os, the meldonium it contains is quickly absorbed in the digestive tract. The drug is characterized by a fairly high bioavailability index. The latter is approximately 78%.

The concentration of meldonium in the blood plasma reaches its maximum values ​​an hour or two after administration. In the body, meldonium is metabolized to non-toxic products - glucose, succinate, 3-hydroxypropionic acid.

Metabolites are excreted by the kidneys. The half-life (T½), depending on the characteristics of the particular organism and the dose taken, can range from three to six hours.

The drug in injection form is characterized by 100% bioavailability. The concentration of meldonium in the blood plasma reaches its maximum values ​​immediately after administration of the drug. The half-life (T½), depending on the characteristics of the particular organism and the dose taken, can range from three to six hours.

The result of the metabolization of meldonium is the formation of non-toxic metabolites (glucose, succinate, 3-hydroxypropionic acid), which are then excreted from the body by the kidneys.

Mildronate or Cardionate – which is better?

Manufacturer: Nizhpharm, Russia
Release form: capsules, ampoules

Active ingredient: meldonium dihydrate

Synonyms: Mildronate, Idrinol, Meldonium

Cardionate is a domestic analogue and substitute for Mildronate. Capsules are available in a dose of 250 mg of the medicinal substance. The analogue has medicinal properties similar to Mildronate: normalizes blood circulation in the brain, cardioprotective, antianginal, reduces tissue hypoxia, adaptogenic.

Used to treat the following diseases:

• in a complex setting for ischemic heart disease, angina pectoris, heart attack, heart failure, stroke, cerebral circulatory disorders;
• physical and mental fatigue;
• to relieve withdrawal symptoms during long-term alcoholism;
• circulatory disorders and bleeding into the retina.

The dose and method of administration of the analogue are selected by the doctor depending on the stage and nature of the disease.

Which medication is better depends on the individual, since they have the same active ingredient. Mildronate's analogue is cheaper and differs in that it does not have a dosage of 500 mg.

Indications for use of Mildronate

What are Mildronate tablets for and what is the medicine for in the form of injections?

All dosage forms of the drug are intended for the treatment of adult patients.

Indications for use of Mildronate (for all dosage forms of the drug):

• IHD (in combination with other drugs and treatment methods);
• peripheral artery disease;
• reduced performance;
• encephalopathy;
• physical overload (including in sports);
• postoperative period (to speed up the recovery of the body);
• chronic heart failure
• cardialgia (pain in the left side of the chest) caused by dyshormonal myocardiopathy ;
• bronchial asthma;
• COPD;
• alcohol withdrawal (as an addition to specific therapy);
• stroke.

Additional indications for the use of drug injections:

• hemorrhage into the vitreous cavity of the eye ( hemophthalmos );
• hemorrhage in the retina of the eye;
• thrombosis and occlusion of the central retinal vein or its branches;
• retinopathy of various origins (for example, hemorrhagic or diabetic ).

Use of Mildronate in sports

Mildronate is a drug that is characterized by the ability to expand the range of tolerance to physical (both dynamic and static) stress and intellectual function not only in ischemic injuries, but also in healthy people.

The drug is very useful for athletes due to its properties to improve the nutrition of the heart muscle and other muscles of the body and reduce fatigue, while simultaneously increasing the effectiveness of sports training.

Contrary to popular belief, Mildronate is not used as a means to increase muscle mass. Its task in sports and in bodybuilding in particular is somewhat different: Mildronate for athletes is indicated as a prophylactic agent that prevents fatigue (including the heart muscle) and overtraining.

In addition, by promoting faster removal of breakdown products from cells and accelerating the restoration of cellular energy resources, Mildronate improves metabolism at the cellular level and accelerates muscle recovery in athletes after physical activity. Moreover, the latter applies to both strength loads and physical loads on the speed and/or endurance of the body.

There is an opinion that the use of Mildronate in sports can provoke fatty liver hepatosis . However, it is unfounded.

Mildronate prevents fatty acids from penetrating into the cells and thus prevents the accumulation of fats in the liver. In addition, by burning predominantly sugar, the body spends a larger amount of raw materials, which are fats, for each molecule of adenosine triphosphate produced ( that is, for energy production).

Meldonium was not classified as a doping drug until January 1, 2021, which made it possible to use it absolutely legally in all sports.

However, after the introduction of a ban on the use of the drug by the World Anti-Doping Agency (WADA) at the beginning of 2021, a number of athletes, mainly from Russia and the former CIS countries, were caught using this drug. Mildronate also became the subject of a huge scandal when Maria Sharapova admitted using this doping on March 7, 2021.

Mildronate or Mexidol

Manufacturer: ZiO-Zdorovye, Russia
Release form: tablets, ampoules

Active ingredient: ethylmethylhydroxypyridine succinate

Synonyms: Mexifin, Mexiprim, Neurox, Mexicor

Mildronate substitute in Mexidol tablets has the following properties:

• antioxidant;
• antihypoxic;
• nootropic;
• anxiolytic (reduces feelings of fear);
• membrane-protective;
• anticonvulsant;
• improves metabolic processes and blood circulation in the brain;
• increases the body's resistance to stress and oxygen-dependent factors (ischemia, hypoxia).

Mexidol is used to treat:

• vegetative-vascular dystonia (VSD);
• brain pathologies associated with atherosclerotic changes in blood vessels;
• encephalopathy of various origins;
• neuroses, neurasthenia with anxiety;
• to stop withdrawal symptoms in case of poisoning with antipsychotics;
• acute stage of peritonitis, pancreatitis (not antibiotic) - in a complex treatment regimen;
• uncomplicated traumatic brain injuries and consequences;
• IHD in joint treatment regimens;
• mild cognitive impairment;
• asthenia.

The duration of treatment, depending on the disease, ranges from 1 week to 2 months. Tablets are taken 1-2 pieces 3 times a day.

Compared to Mildronate, the Mexidol analogue still has anti-anxiety properties. Reviews from patients indicate that the drug effectively copes with neurosis-like conditions.

Side effects

Side effects caused by taking Mildronate occur quite often. Typically they are expressed as:

• allergic reactions (redness, skin rashes, itching and swelling);
• dyspeptic symptoms, manifested by belching, attacks of nausea, vomiting, heartburn, a feeling of fullness in the stomach even after a small portion of food;
• tachycardia;
• increased arousal;
• decrease in blood pressure.

Instructions for use of Mildronate

You can often come across questions “.. can Mildronate be administered intramuscularly?” or “.. is it possible to inject the drug intramuscularly?”

The instructions for medical use indicate that the drug in injection form is intended for intravenous administration, and capsules and tablets are intended for oral administration (per os).

Dosage forms for oral administration should be taken whole, without chewing, crushing or pouring out the contents of the capsules.

Mildronate for intravenous administration is produced in finished form. Mildronate should be administered intravenously separately from other drugs; dilution with an aqueous solution of sodium chloride is not required (however, in some cases it is allowed).

When injected into a muscle, the injection solution has an irritating effect and can provoke local pain and local allergic reactions. For this reason, the drug Mildronate is usually injected into a vein.

Mildronate injections: instructions for use, why they are prescribed and how to dose the injection solution

Indications for the use of Mildronate injections: unstable (progressive) angina pectoris , myocardial infarction , vascular pathologies of the fundus and cerebral circulatory disorders.

For patients with coronary syndrome, the drug is administered into a vein as a bolus at a dose of 500-1000 mg once a day. After this, therapy is continued by taking tablets or capsules.

For patients with vascular pathologies of the fundus of the eye, the medicine is administered retrobulbarly (behind the eyeball) or subconjunctivally (under the outer shell of the eyeball) 0.5 ml for 10 days.

For patients with cerebral circulatory disorders in the acute stage, the solution is administered into a vein once a day at a dose of 500 mg. The duration of the therapeutic course is 10 days. Further treatment is carried out using oral dosage forms.

Patients with chronic cerebral circulatory disorders are advised to administer Mildronate intramuscularly one to three times a day at a dose of 500 mg (optimally before lunch). The duration of the therapeutic course is from 2 to 3 weeks.

Mildronate tablets: instructions for use

For patients with diseases of the cardiovascular system, Mildronate tablets and capsules are indicated in combination with specific therapy. The drug is taken at 500-1000 mg per day. The entire dose can be taken either at once or divided into two doses.

As a rule, the course of treatment lasts from 4 to 6 weeks.

For cardialgia caused by dishormonal myocardiopathy , Mildronate is taken once a day, one 500 mg tablet or 2 250 mg tablets.

For patients with cerebral circulatory disorders, after eliminating acute disorders, the drug is recommended to be used at a dose of 500-1000 mg per day. Take it in one dose or divided into two doses.

Patients with chronic cerebral circulatory disorders are recommended to take 500 mg of Mildronate per day.

The duration of treatment varies from 4 to 6 weeks. At the discretion of the attending physician, the patient may be prescribed repeated courses of treatment (usually two or three times a year).

Patients with pathologies of peripheral arteries are prescribed to take the drug twice a day, 500 mg. The recommended dose for increased intellectual and physical stress on the body (including athletes) is 1000 mg, which should be divided into two doses.

The duration of treatment is from 10 to 14 days. If necessary, the course is repeated after a two- or three-week interval.

In the period before training, athletes are recommended to take Mildronate twice a day at a dose of 500-1000 mg. The duration of treatment in the preparatory period is usually from two to three weeks; during the competition period its duration varies from 10 to 14 days.

For alcohol withdrawal , patients suffering from chronic alcoholism should take Mildronate 500 mg four times a day. The duration of the course is from 7 to 10 days.

The maximum permissible daily dose is considered to be 2000 mg.

Ukrainian analogues

Analogues of Mildronate, produced in Ukraine, are good substitutes for the drug, include meldonium in their composition, and are produced in various dosage forms. Let's look at some of them.

Energoton

The product is widely used in otorhinolaryngology, cardiology, and ophthalmology. Energoton is produced in tablets of 30 and 60 pieces in cardboard packaging. The purpose of the medicine is complex therapy of coronary heart disease, prevention of angina attacks and other disorders of myocardial functioning. In otorhinolaryngology, the drug is used to eliminate symptoms such as dizziness, headaches, tinnitus, and decreased hearing acuity.

The dosage is usually 1 tablet with meals three times a day for 7 to 14 days. The duration of the course can be adjusted by the attending physician, taking into account the individual characteristics of the patient.

Energoton is produced by a Ukrainian company, contains meldonium and various excipients

Side effects include:

• allergic manifestations;
• Quincke's edema;
• decreased blood pressure;
• bradycardia;
• redness of the facial skin;
• muscle tremors;
• pain in the abdomen.

Contraindications include severe renal failure and liver pathologies, personal intolerance to the constituent components of the drug, and age under 12 years.

Important! No studies have been conducted on the effect of the drug on the intrauterine development of the fetus, so it is not recommended to use the medicine during this period.

Triductane

The main active ingredient of the drug is trimetazidine dihydrochloride. The drug costs less than Mildronate, but its effect is not inferior to more expensive drugs. The main indications for use are the following conditions:

• coronary heart disease and its manifestations;
• disturbances in the functioning of the vestibular apparatus;
• disorders associated with the functioning of blood vessels.

Triductan is used both in complex and independent therapy. The dose is usually 2 tablets throughout the day, the duration of therapy is selected individually based on the diagnosis.

Patients with individual intolerance to the components of the drug may experience side effects such as dizziness, headache, irritability, and very rarely, fainting and tremors. From the digestive side, nausea, vomiting, and epigastric pain develop. There are known cases of allergies on the body in the form of hives and itching.

Cardazin

Ukrainian Mildronate substitutes include Cardazin in their list. This product is in the form of tablets coated with a pink-red coating.

Indications for use:

• IHD and its manifestations;
• ischemic disorders in the form of dizziness, tinnitus;
• hearing loss;
• cardiovascular failure.

Take Cardazin 1 - 2 tablets 3 times a day, washing down the drug with water. It is recommended to take the tablet with food. The duration of therapy is selected by the doctor. For severe disorders of the functioning of the heart and blood vessels, therapy can last 4–6 weeks.

Cardazin is used for various conditions caused by diseases of the heart and blood vessels

In case of an overdose, phenomena such as nausea, vomiting, and pain in the abdominal area occur. In addition, dizziness, allergic rashes on the body, and hyperthermia develop.

Carduktal

A cardiological drug in the form of tablets, widely used for the treatment of pathologies of the heart and blood vessels. The main active ingredient is trimetazidine dihydrochloride. The medicine helps to establish cellular homeostasis, maintain the normal functioning of membrane ion channels, and transfer necessary substances to the body’s tissues. Carduktal is indicated for patients with coronary heart disease to prevent attacks of angina and other manifestations of pathology.

The standard dosage regimen is 1 tablet 3 times a day. The course of therapy depends on the severity of the disease, sometimes lasting 3 weeks. After completion of treatment, the achieved therapeutic effect is assessed. If necessary, the course is repeated after a few months.

Information about overdose is limited. Side effects include neuralgic disorders, tremors in the limbs, unsteady gait, and increased muscle tone. From the cardiovascular system, there is an increase in pressure, tachycardia, facial flushing, and fainting.

Interaction

Combination of Mildronate with antianginal, antiarrhythmic, anticoagulant, antiplatelet and diuretic drugs, cardiac glycosides, bronchodilators and other drugs is allowed.

Mildronate has the ability to potentiate the effect of Nitroglycerin and β-adrenergic blockers, Nifedipine and other drugs with coronary action, antihypertensive drugs, as well as drugs whose action is aimed at dilating peripheral blood vessels.

Due to the possible development of moderate tachycardia and a decrease in blood pressure, the above drugs should be used in combination with Mildronate with caution.

Contraindications

Children under 18 years of age are contraindicated to take Mildronate.

Contraindications to the use of the drug Mildronate (for all forms of release of the drug) are:

• increased individual sensitivity to the active substance of the drug - meldonium - or any of the auxiliary components of the drug;
• intracranial hypertension, including those caused by intracranial tumors and disorders of venous outflow;
• children under 18 years of age;

• pregnancy and breastfeeding period.

special instructions

Due to the fact that the drug can provoke a stimulating effect, it is recommended to use it in the first half of the day.

There are no data regarding the ability of Mildronate to change the reaction rate and influence transport control.

The drug is prescribed with caution to people with liver and/or kidney pathologies.

Experience in treating patients with myocardial infarction and unstable angina shows that the active substance Mildronate is not a first-line drug for ACS.

Mildronate or Riboxin - which is better for the heart

Manufacturer: Biosintez, Russia
Release form: tablets, ampoules

Active ingredient: inosine

Riboxin is a cheap analogue of Mildronate in tablets, produced in Russia. The composition is different, but the pharmacological effect is similar: it normalizes the processes of oxygen and glucose metabolism in body tissues, reduces hypoxia, reduces cardiac arrhythmia, normalizes coronary circulation, and stimulates the regeneration of myocardial tissue.

The Riboxin analogue is used to treat:

1. IHD, heart defects, dystrophic changes in the myocardium, after a heart attack - in complex therapy;
2. liver diseases: cirrhosis, hepatitis, fatty degeneration;
3. prevention of leukopenia after radiation exposure;
4. during surgery on an isolated kidney as pharmaceutical protection.

The drug is not used in acute cases of cardiac muscle dysfunction. The analogue is used to maintain the myocardium and prevent the development of emergency pathological conditions. In sports, Riboxin is also used to improve metabolic processes and endurance of the body.

Tablets are taken before meals for 1–3 months.

Both drugs are used for diseases of the cardiovascular system; which drug is better in each case, you should consult a doctor, as they have contraindications.

Analogues of Mildronate

Level 4 ATX code matches:
Vazonat

Phosphaden

Hawthorn fruit

Preductal

Meldonium

Angiosil Retard

Ranexa

Lily of the valley tincture

Neocardil

Rimecore

Triductane

ATF-Long

Hawthorn tincture

Triductan MV

Trimectal MV

Trimectal

Neoton

Predisin

Trimetazidine

Tivortin Aspartate

Analogues of Mildronate:

• Vasopro
• Vazonat
• Metamax
• Methonate
• Trizipin
• Mildracore
• Mildrocard
• Cardionate
• Melfort
• Idrinol
• Riboxil
• Meldonium

The price of drug analogues starts from 170 rubles.

Riboxin or Mildronate - which is better?

Riboxin is a natural compound found also in the human body.

Being a precursor of adenosine triphosphate , it helps to increase the energy balance of the heart muscle, improve coronary circulation, reduce the severity of the consequences of intraoperative ischemic kidney damage, stimulate the production of nucleotides and the activity of individual enzymes of the citrate cycle.

The drug has a positive effect on metabolic processes in the heart muscle, increases the force of its contractions and stimulates its more complete relaxation in diastole, which in turn leads to an increase in stroke volume (stroke volume of blood).

Mildronate has a similar effect, but is not itself involved in the synthesis of other substances. At the same time, the drug regulates the activity and biosynthesis of enzymes involved in energy production, and thus normalizes metabolism.

The conclusion is this: Mildronate is a drug whose action is aimed at correcting metabolic processes, while Riboxin takes part in biochemical reactions and is a means of metabolic action.

To obtain the expected effect from the use of Riboxin, it should be administered in quantities that are comparable to its consumption in the body. And since Riboxin is used by the body in various reactions, it is required in very large quantities.

Mildronate, on the contrary, is not consumed in metabolic reactions, its effect lasts for a longer period of time, and its body requires much less than Riboxin.

Therefore, the use of Mildronate also improves the body’s use of Riboxin. Thus, the combined use of these drugs will potentiate each other's effects.

Cardionate or Mildronate - which is better?

Cardionate and Mildronate are synonymous drugs. They are based on the same active ingredient, so both products have a similar mechanism of action.

The only difference is that, unlike Mildronate, Cardionate is available only in the form of 250 mg capsules and 500 mg/5 ml injection solution.

Analogs from other manufacturers

Among foreign manufacturers, you can choose Mildronate substitutes that have a similar effect and composition.

Vazonat

The medicine from the Latvian company Vazonat contains meldonium dihydrate and is available in the form of capsules for oral administration and ampoules for injections.

The product has the following therapeutic effects:

• improves blood circulation in areas affected by ischemia and hypoxia;
• stimulates and protects blood vessels;
• improves the supply of oxygen to body tissues;
• prevents the formation of blood clots.

Prescribed for any pathologies accompanied by circulatory disorders. These diseases include encephalopathy, atherosclerosis, coronary heart disease, retinopathy, hearing and vision impairment.

The medicine is strictly prohibited during the acute period of myocardial infarction, during hemorrhagic stroke, during pregnancy, for children under 18 years of age, and with individual intolerance to the components of the drug.

Vasonate is widely used for ischemia and hypoxia

Side effects include local allergic manifestations and disorders of the central nervous system - dizziness, headaches, irritability, insomnia.

Metazidine

Metazidine is a German drug that is produced in tablet form. The drug has a cardioprotective and antiangial effect, stabilizes the body's metabolic processes, thereby improving the supply of oxygen and nutrients to all organs and tissues.

Metazidine is used when symptoms such as tinnitus, dizziness, and rapid heartbeat appear. The drug is widely used as a complex therapy for coronary heart disease and heart failure.

Metazidine is well tolerated by patients. The standard dosage regimen is 1-2 tablets three times a day for 7-10 days. The medicine causes side effects extremely rarely. Among them are skin rashes, itching, urticaria, and, less commonly, nausea and abdominal pain.

Contraindications include pregnancy, breastfeeding, and intolerance to the components of the product.

Selecting analogs of Mildronate is not difficult, because many countries produce medicines containing meldonium that have a similar therapeutic effect. All of them have predominantly positive reviews from patients. Despite the detailed instructions for the drugs and their availability, before taking each drug it is recommended to undergo a full examination and consult a doctor.

Alcohol compatibility

The active substance of Mildronate is excreted from the body within 12 hours, therefore, after this time, the risk of interaction of the drug with another active substance is extremely low or completely absent.

In general, drinking alcohol during treatment with Mildronate is not prohibited; however, if this drug is used to treat a cardiovascular disease or a cerebral circulatory disorder, the patient is still advised to stop drinking alcohol.

This is due to the fact that taking the drug in combination with alcohol can negate all the positive results that have been achieved in treating the disease.

Taking Mildronate with alcohol can provoke:

• tachycardia;
• pronounced allergic reactions ;
• sharp fluctuations in blood pressure;
• dyspeptic symptoms.

The poor compatibility of Mildronate with alcohol is due to an increased risk of various types of complications and the likelihood of a relapse of the disease. For this reason, alcohol should be excluded for the entire period of treatment with the drug.

Mildronate or Enerion - which is better?

Manufacturer: Servier, France
Release form: tablets

Active ingredient: sulbutiamine

Enerion is an imported analogue of Mildronate in tablets. It is produced in one therapeutic dosage, the price depends on the amount of medication in the package - 20 or 60 tablets.

The active substance of the analogue is synthetic, similar in structure to vitamin B1. Thanks to the modified formula, it is well absorbed by the body.

While taking the analogue, coordination of movements is normalized, endurance of physical activity increases, and the resistance of the cerebral cortex to hypoxia increases. The Mildronate analogue has proven itself effectively in the symptomatic treatment of functional asthenia.

Enerion is approved for use only by adults. The dose is taken 2 times per day in the morning and lunchtime. The duration of therapy with the analogue should not exceed a month.

It is difficult to select the best drug, since they differ in composition, and the analogue is used to treat one disorder. You should rely on the symptoms of the disease and select the appropriate medication.

Use of Mildronate during pregnancy and lactation

The safety of Mildronate for the treatment of pregnant women has not been proven. To exclude the possibility of its adverse effects on fetal development, the drug is not prescribed during pregnancy .

It has not been established whether meldonium can be excreted in the milk of a nursing woman. Therefore, if treatment with Mildronate is indicated for the mother, she must stop breastfeeding .

Prices for the drug and its main analogues, average in Russia

In a situation where Mildronate is not suitable, available analogues of the drug (generics or substitutes) are selected. The most popular and cheapest of them are presented in the table. They can be used when the main drug is unaffordable or has other restrictions. The selection of a specific medicine is carried out by the doctor, taking into account the diagnosis, concomitant diseases, and possible contraindications.

Reviews of Mildronate

Reviews about Mildronate on forums are mostly positive . The unique mechanism of action of this drug allows it to be widely used to eliminate problems with the cardiovascular system, as well as as a means of increasing performance in healthy people who are subject to frequent physical and intellectual overload.

Both patients in cardiology departments, doctors, and athletes note the fact that Mildronate provokes a tonic effect. Its use significantly improves memory function, accelerates thought processes, increases dexterity, endurance and the degree of body resistance to adverse factors.

Reviews from cardiologists confirm the data of numerous studies that have shown that the use of Mildronate in capsules and in the form of a solution for injections can reduce the incidence of repeated myocardial infarction .

Reviews from patients about Mildronate allow us to conclude that the drug is simply necessary for people whose activities are associated with increased stress on the body, as well as during the recovery period after prolonged alcohol abuse, with pain and burning in the heart, VSD and other pathologies of the cardiovascular system .

The average rating for this product is quite high. However, sometimes you come across negative reviews about Mildronate. It is important to remember that, like any other drug, Mildronate gives a good result only if its dose and concomitant treatment (if necessary) are selected correctly.

Patient reviews

Anna, Kharkov “I have been using Mildronate for several years in a row, but now it is quite difficult to find it on the shelves of pharmacies, so I had to switch to a similar product. The doctor advised me an inexpensive but effective remedy, Meldonium. The composition of these medications is the same, so I purchased the drug without any doubt. I have only positive impressions of its action; I completed a course of treatment and was satisfied with the effect. I want to say that this product is no worse than the original.”

Alena, Khabarovsk “I was diagnosed with vegetative-vascular dystonia back in my student years. Since then I have suffered from weakness, headaches, and poor sleep. After another visit to the doctor, I was prescribed Metazidine. The doctor said that this remedy increases metabolic processes, increases vascular tone, and increases blood circulation. After finishing the course, I really felt an improvement, the headaches and weakness went away. Even homework is much easier to do.”

Anton, Yaroslavl “After going to the hospital about nagging pain in the heart area, it turned out that I had functional heart failure. In addition to chest discomfort, I suffer from low blood pressure and frequent dizziness. The doctor prescribed complex treatment using cardiac medications. One of them was Riboxin. After completing the course, my health improved, my blood pressure normalized, and my headaches went away. The doctor said that the treatment would have to be repeated annually.”

Mildronate price

Price of the drug in Russia

You can buy 250 mg capsules in Russian pharmacies for an average of 300 rubles, 500 mg capsules for 650 rubles. The price of Mildronate for intravenous administration is 350 rubles. Price Mildronate Gx 500 mg - about 800 rubles.

Price of the drug on the Ukrainian market

The average price of Mildronate 250 mg tablets is 250 UAH. The price of Mildronate ampoules of 5 ml is 450 UAH. 500 mg capsules cost about 400 UAH per package. Mildronate GX is sold for an average of 450 UAH.

Moreover, Mildronate injections, tablets and capsules in pharmacies in Kharkov or Odessa are somewhat cheaper than in most pharmacies in the capital.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Mildronate caps.
  500 mg 60 pcs. JSC Grindeks 586 rub. order
• Mildronate solution IV, IM and parabulb. input 100 mg/ml amp. 5ml No. 10HB Pharma s.r.o.

  RUB 355 order

• Mildronate caps. 250 mg 40 pcs. JSC Grindeks

  RUB 264 order

• Mildronate solution for IM, IV and parabulb. input 0.1g/ml 5ml 20pcsHB Em Pharma s.r.o.

  675 rub. order

Pharmacy Dialogue

• Mildronate 10% ampoules 5ml No. 10Grindex/HM Pharma

  RUB 294 order

• Mildronate capsules 500 mg No. 60Grindex

  RUR 539 order

• Mildronate (amp. 10% 5ml No. 10) Sotex

  RUB 333 order

• Mildronate capsules 250 mg No. 40Grindex

  RUB 246 order

• Mildronate (amp. 10% 5ml No. 10) Sanitas

  RUB 334 order

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Pharmacy24

• Mildronate 0.5 g/5 ml 5 ml No. 10 solution AT "Grindeks", Latvia
  830 UAH. order
• Mildronate 500 mg N60 capsules AT "Grindeks", Latvia

  409 UAH order

• Mildronate GX 500 mg N60 tablets AT Grindeks, Latvia

  442 UAH order

• Mildronate 5 ml N10 solution AT "Grindeks", Latvia/HBM Pharma s.r.o., Slovakina

  461 UAH order

PaniPharmacy

• Mildronate capsule Mildronate caps. 0.25g No. 40 Latvia, Grindeks

  251 UAH order

• Mildronate GX tablets Mildronate GX tablets 0.5g No. 60 Latvia, Grindeks

  487 UAH. order

• Mildronate ampoule Mildronate solution d/in. 10% amp. 5ml No. 10 Lithuania, Sanitas

  450 UAH. order

• Mildronate solution d/in.amp.0.5g/5ml 5ml N20

  901 UAH. order

• Mildronate capsule Mildronate caps. 0.5g No. 60 Latvia, Grindeks

  412 UAH. order

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Mildronate or Idrinol

Manufacturer: Sotex, Russia
Release form: capsules, ampoules

Active ingredient: meldonium dihydrate

Synonyms: Mildronate, Cardionate, Meldonium

The Russian analogue Idrinol consists of the same active ingredient as Mildronate - meldonium. It has identical pharmacological actions and indications for use. An analogue of Mildronate is produced in ampoules and capsules in a dosage of 250 mg.

According to reviews from doctors and patients who took the analogue, it is not inferior in effectiveness to the therapy of the original medication. It has a more affordable price, which allows it to be used by different segments of the population.