Medicine Information

Cardimet-MR

Name: Cardimet-MR
Brand: Cardimet-MR
Rating: 4.5 (117 reviews)

Modified Release Tablet35 mgAntianginal; Myocardial metabolic agentATC: C01EB15

Generic Name

Trimetazidine Dihydrochloride Modified Release

Manufacturer

ACI Limited

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
cardimet mr 35 mg tablet	৳ 8.00	৳ 112.00

Description

Overview of the medicine

Cardimet-MR 35 mg Tablet is a medication containing Trimetazidine Dihydrochloride in a modified-release formulation. It is primarily used to prevent and treat angina pectoris (chest pain caused by reduced blood flow to the heart) and other ischemic conditions, by improving myocardial metabolic efficiency.

Uses & Indications

Prevention of angina pectoris (chest pain caused by reduced blood flow to the heart)

Adjuvant therapy for symptomatic treatment of stable angina pectoris

Treatment of symptoms of vertigo and tinnitus of vascular origin

Adjuvant therapy for visual field disturbances and decrease in visual acuity of vascular origin

Dosage

Adults

One tablet of 35 mg Trimetazidine modified release twice daily, orally, during meals.

Elderly

No dose adjustment is generally required in the elderly. However, caution should be exercised in patients with moderate renal impairment.

Renal_impairment

In patients with moderate renal impairment (creatinine clearance 30-60 ml/min), the recommended dose is one 35 mg modified release tablet once daily in the morning during breakfast.

How to Take

The tablet should be swallowed whole with a glass of water, during meals. Do not chew or crush the tablet.

Mechanism of Action

Trimetazidine protects cardiac cells from the effects of ischemia by preserving energy metabolism in cells exposed to hypoxia or ischemia. It inhibits β-oxidation of fatty acids by blocking long-chain 3-ketoacyl CoA thiolase (3-KAT), thereby enhancing glucose oxidation. In an ischemic cell, energy is generated during glucose oxidation with less oxygen consumption than during fatty acid β-oxidation. Trimetazidine shifts the heart's energy metabolism from fatty acid oxidation to glucose oxidation, which is more efficient under ischemic conditions, helping to maintain cellular ATP levels.

Pharmacokinetics

Onset

Not precisely defined for symptom relief, but metabolic effects start shortly after absorption.

Excretion

Mainly excreted in urine, largely as unchanged drug. Renal clearance accounts for 70% of total clearance.

Half life

Approximately 6 hours for immediate release, extended for modified release (around 7-12 hours in healthy volunteers).

Absorption

Rapidly absorbed after oral administration. Peak plasma concentration is reached approximately 2 hours after administration of the 20 mg immediate-release tablet and 5 hours for the 35 mg modified-release tablet. Steady-state is reached between 24 and 36 hours and remains constant throughout the dosing period. Bioavailability is approximately 90%.

Metabolism

Minimally metabolized; primarily excreted unchanged.

Side Effects

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Parkinson's disease, parkinsonian symptoms, tremors, restless leg syndrome and other related movement disorders
Severe renal impairment (creatinine clearance < 30 ml/min)

Drug Interactions

Levodopa

Trimetazidine can exacerbate parkinsonian symptoms when co-administered with levodopa.

Other cardiovascular drugs

Generally well-tolerated with other cardiovascular medications; however, monitor for any unusual effects.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Limited information available on overdose. General supportive measures should be implemented. Gastric lavage and activated charcoal may be considered if ingestion is recent. Monitor vital signs and provide symptomatic treatment.

Pregnancy & Lactation

Pregnancy: Limited data on use in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. As a precautionary measure, it is preferable to avoid the use of Trimetazidine during pregnancy. Lactation: It is unknown whether Trimetazidine is excreted in human milk. A risk to the newborns/infants cannot be excluded. Trimetazidine should not be used during breastfeeding.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

30 tablets (3x10's)

Shelf Life

Typically 24-36 months from manufacturing date.

Availability

Available in pharmacies nationwide

Approval Status

Approved in Bangladesh (DGDA)

Patent Status

Off-patent

Clinical Trials

Numerous clinical trials have demonstrated Trimetazidine's efficacy in reducing angina attacks and improving exercise tolerance in patients with stable angina. Studies have shown its cytoprotective effects on myocardial cells.

Lab Monitoring

No specific routine lab monitoring is required. Monitor renal function in elderly or renally impaired patients.

Doctor Notes

Advise patients about the potential for movement disorders, especially if they have a history of Parkinson's or restless legs syndrome.
Emphasize taking the MR formulation whole to ensure sustained release.
Trimetazidine is an add-on therapy and should not replace standard antianginal treatments like nitrates or beta-blockers without physician consultation.

Patient Guidelines

Take the tablet exactly as prescribed by your doctor.
Do not stop taking the medicine without consulting your doctor, even if you feel better.
Inform your doctor about all other medicines you are taking, including over-the-counter drugs and herbal supplements.
Report any new or worsening symptoms, especially movement disorders.

Missed Dose Advice

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Trimetazidine may cause dizziness and drowsiness, which could affect the ability to drive or operate machinery. Patients should be warned not to drive or operate machinery if these effects occur.