Idrinol^® (Capsules, Solution) Instructions for Use

ATC Code

C01EB (Other drugs for the treatment of heart diseases)

Active Substance

Meldonium (Rec.INN registered by WHO)

Clinical-Pharmacological Group

A drug that improves tissue metabolism and energy supply

Pharmacotherapeutic Group

Metabolic agent

Pharmacological Action

A metabolic-improving agent, an analog of gamma-butyrobetaine. It inhibits gamma-butyrobetaine hydroxylase, suppresses the synthesis of carnitine and the transport of long-chain fatty acids across cell membranes, and prevents the accumulation of activated forms of non-oxidized fatty acids – derivatives of acylcarnitine and acylcoenzyme A – in cells.

Under ischemic conditions, it restores the balance between oxygen delivery and its consumption in cells, prevents disruption of ATP transport; simultaneously, it activates glycolysis, which proceeds without additional oxygen consumption. As a result of the decreased carnitine concentration, gamma-butyrobetaine, which has vasodilating properties, is synthesized more intensively. The mechanism of action determines the diversity of its pharmacological effects: increased performance, reduction of symptoms of mental and physical overstrain, activation of tissue and humoral immunity, cardioprotective action.

In case of acute ischemic myocardial damage, it slows down the formation of the necrotic zone and shortens the rehabilitation period. In heart failure, it increases myocardial contractility, increases tolerance to physical exertion, and reduces the frequency of angina attacks. In acute and chronic ischemic cerebrovascular disorders, it improves blood circulation in the ischemic focus and promotes blood redistribution in favor of the ischemic area. It is effective in vascular and dystrophic pathologies of the ocular fundus. It has a tonic effect on the CNS and eliminates functional disorders of the nervous system in patients with chronic alcoholism during withdrawal syndrome.

Pharmacokinetics

After oral administration, it is rapidly absorbed from the gastrointestinal tract. The bioavailability is about 78%. C_max in plasma is reached 1-2 hours after administration. It is biotransformed in the body with the formation of two main metabolites, which are excreted by the kidneys. T_1/2 is 3-6 hours and depends on the dose.

Indications

For oral or intravenous administration: as part of complex therapy for coronary artery disease (angina pectoris, myocardial infarction), chronic heart failure, dishormonal cardiomyopathy; as part of complex therapy for acute and chronic cerebrovascular disorders (strokes and cerebrovascular insufficiency); reduced performance, physical overexertion (including in athletes), postoperative period to accelerate rehabilitation; withdrawal syndrome in chronic alcoholism (in combination with specific therapy for alcoholism).

For parabulbar administration: acute circulatory disorders in the retina, hemophthalmos and retinal hemorrhages of various etiologies, thrombosis of the central retinal vein and its branches, retinopathies of various etiologies (including diabetic and hypertensive) – only for parabulbar administration.

ICD codes

Dosage Regimen

Capsules

The drug is administered orally. Due to the possible stimulating effect, the drug is recommended to be used in the first half of the day.

The daily dose for adults is 500 mg (2 caps.). The entire dose is taken in the morning as a single dose or divided into 2 doses.

The course of treatment is 10-14 days. If necessary, treatment is repeated after 2-3 weeks.

The drug should be used only according to those indications, method of administration, and in those doses that are indicated in the instructions for use.

If after treatment there is no improvement, or the symptoms worsen, or new symptoms appear, the patient should consult a doctor.

Solution

Due to the possibility of developing a stimulating effect, it is recommended to use it in the first half of the day. The dose is set individually depending on the indications and route of administration.

When taken orally, a single dose is 0.25-1 g, the frequency of administration and duration of treatment depend on the indications.

For intravenous administration, the dose is 0.5-1 g once/day, the duration of treatment depends on the indications.

For parabulbar administration, 0.5 ml of the injection solution with a concentration of 500 mg/5 ml is administered for 10 days.

Adverse Reactions

From the cardiovascular system rarely – tachycardia, changes in blood pressure.

From the central nervous system rarely – psychomotor agitation.

From the digestive system rarely – dyspeptic symptoms.

Allergic reactions rarely – skin itching, redness, rash, edema.

Contraindications

Increased intracranial pressure (including in cases of impaired venous outflow, intracranial tumors), pregnancy, lactation period (breastfeeding), children and adolescents under 18 years of age, hypersensitivity to meldonium.

Use in Pregnancy and Lactation

The use of the drug during pregnancy and lactation (breastfeeding) is contraindicated.

Use in Hepatic Impairment

Use with caution in liver diseases, especially for a long time.

Use in Renal Impairment

Use with caution in kidney diseases, especially for a long time.

Pediatric Use

In children and adolescents under 18 years of age, the efficacy and safety of meldonium have not been established.

Meldonium in capsule form is contraindicated for use in children and adolescents under 18 years of age; in syrup form – in children under 12 years of age.

Special Precautions

Use with caution in liver and/or kidney diseases, especially for a long time.

Long-term experience in treating acute myocardial infarction and unstable angina in cardiology departments shows that Meldonium is not a first-line agent for acute coronary syndrome.

Drug Interactions

When used concomitantly, Meldonium enhances the effect of antianginal agents, some hypotensive drugs, and cardiac glycosides.

With simultaneous use of meldonium with nitroglycerin, nifedipine, alpha-blockers, antihypertensive agents and peripheral vasodilators, the development of moderate tachycardia and arterial hypotension is possible (caution is required with these combinations).

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Rx Only

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.