Metacard-MR
Generic Name
Trimetazidine Dihydrochloride (Modified Release)
Manufacturer
ACME Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metacard mr 35 mg tablet | ৳ 10.00 | ৳ 140.00 |
Description
Overview of the medicine
Metacard-MR 35 mg Tablet is a modified-release tablet containing Trimetazidine Dihydrochloride. It is primarily used to prevent angina attacks in patients with coronary artery disease and as an add-on therapy for symptomatic treatment of vertigo and tinnitus, and visual field disturbances of vascular origin.
Uses & Indications
Dosage
Adults
One tablet (35 mg) twice daily, morning and evening, during meals.
Elderly
No specific dose adjustment is required in elderly patients. However, caution is advised and dose should be individualized based on renal function.
Renal_impairment
In patients with moderate renal impairment (creatinine clearance 30-60 mL/min), the recommended dose is one 35 mg tablet once daily in the morning during breakfast. Trimetazidine is contraindicated in severe renal impairment (creatinine clearance <30 mL/min).
How to Take
Oral administration. Tablets should be taken whole with a glass of water during meals. Do not crush or chew.
Mechanism of Action
Trimetazidine works by protecting cardiac cells from the effects of ischemia (lack of oxygen) by optimizing energy metabolism. It inhibits beta-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 beta-oxidation. Thus, Trimetazidine shifts the myocardial energy metabolism from fatty acid oxidation to glucose oxidation, improving myocardial efficiency under ischemic conditions.
Pharmacokinetics
Onset
Within 15 days of treatment for significant clinical effect.
Excretion
Primarily excreted in the urine, mainly in unchanged form.
Half life
Approximately 7 hours (for Trimetazidine MR), extending to 12 hours in elderly subjects.
Absorption
Rapidly and almost completely absorbed after oral administration. Peak plasma concentration is reached approximately 5 hours after administration of the MR formulation. Food delays absorption.
Metabolism
Minimal hepatic metabolism.
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 may aggravate parkinsonian symptoms when co-administered with levodopa.
Other anti-anginal drugs
Generally safe to use with other anti-anginal drugs, but individual response should be monitored.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Limited data on Trimetazidine overdose. In case of overdose, symptomatic treatment and supportive measures should be implemented.
Pregnancy & Lactation
Pregnancy: Not recommended during pregnancy due to limited data. Consult a doctor. Lactation: Unknown if Trimetazidine is excreted in human milk. Breastfeeding should be discontinued if use is necessary.
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 may aggravate parkinsonian symptoms when co-administered with levodopa.
Other anti-anginal drugs
Generally safe to use with other anti-anginal drugs, but individual response should be monitored.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Limited data on Trimetazidine overdose. In case of overdose, symptomatic treatment and supportive measures should be implemented.
Pregnancy & Lactation
Pregnancy: Not recommended during pregnancy due to limited data. Consult a doctor. Lactation: Unknown if Trimetazidine is excreted in human milk. Breastfeeding should be discontinued if use is necessary.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved in many countries globally including Bangladesh (DGDA)
Patent Status
Generic available (original patent expired)
Clinical Trials
Numerous clinical trials have demonstrated Trimetazidine's efficacy in reducing angina symptoms, improving exercise tolerance, and improving myocardial function in patients with ischemic heart disease. The ATAMI study (Assessment of Trimetazidine in Angina and Myocardial Ischemia) and TRIMPOL trials are notable examples.
Lab Monitoring
- Regular monitoring of renal function is recommended, especially in elderly patients and those with known renal impairment.
Doctor Notes
- Ensure patients are aware of the risk of movement disorders and advise them to report any such symptoms.
- Regularly assess renal function, especially in elderly patients.
- Not for the treatment of an acute angina attack; rather it is a prophylaxis.
- Consider drug discontinuation if no benefit is observed after 3 months of treatment.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine suddenly without consulting your doctor, even if you feel better.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Report any unusual symptoms or side effects to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Trimetazidine may cause dizziness and visual disturbances. Patients should be cautious when driving or operating machinery, especially at the start of treatment.
Lifestyle Advice
- Maintain a healthy diet low in saturated fats and cholesterol.
- Engage in regular physical activity as advised by your doctor.
- Manage stress effectively.
- Avoid smoking and excessive alcohol consumption.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.