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Trimetazidine Dihydrochloride: Brands, Price & Uses in Bangladesh
Trimetazidine Dihydrochloride is indicated as add-on (adjunct) therapy for the symptomatic treatment of adult patients with stable angina pectoris who are inadequately controlled by and more.
About Trimetazidine Dihydrochloride
Indications of Trimetazidine Dihydrochloride
Trimetazidine Dihydrochloride is indicated as add-on (adjunct) therapy for the symptomatic treatment of adult patients with stable angina pectoris who are inadequately controlled by, or are intolerant to, first-line antianginal therapies (such as beta-blockers or calcium channel blockers).
- Established/guideline-supported use: Symptomatic add-on treatment of chronic stable angina, used in combination with other antianginal agents.
- Not a monotherapy or rescue medication: Trimetazidine Dihydrochloride is not intended for the initial treatment of unstable angina or myocardial infarction, and it does not relieve an acute anginal attack.
- Other reported/investigational uses: Trimetazidine Dihydrochloride has been studied for adjunctive benefit in ischemic heart disease, heart failure symptoms, and Ménière's-type vertigo/tinnitus in some countries; these uses are not uniformly approved and should only be considered under a physician's guidance.
Full antianginal benefit is generally assessed after about three months of treatment; if no adequate response is seen, the physician may reconsider therapy.
Dosage & Administration of Trimetazidine Dihydrochloride
Adult Dose (Stable Angina, add-on therapy)
| Formulation | Dose |
|---|---|
| Modified-release (MR) tablet 35 mg | One tablet twice daily, with meals (morning and evening) |
| Immediate-release tablet 20 mg | One tablet three times daily, with meals |
Renal Impairment
| Creatinine Clearance | Recommended Dose |
|---|---|
| 30–60 mL/min (moderate impairment) | 35 mg once daily (morning) or 20 mg twice daily |
| Below 30 mL/min (severe impairment) | Contraindicated — see Contraindications |
Elderly Patients
Elderly patients, particularly those with reduced renal function, should be dosed cautiously; the renal-impairment dosing schedule above should be applied if creatinine clearance is reduced.
Hepatic Impairment
No well-established dose adjustment has been defined for hepatic impairment; use with caution and physician supervision.
Duration and Monitoring
Antianginal benefit with Trimetazidine Dihydrochloride should be reassessed after approximately three months of treatment; if no symptomatic improvement is observed, the physician should consider discontinuing therapy.
Side Effects of Trimetazidine Dihydrochloride
Adverse effects reported with Trimetazidine Dihydrochloride are usually mild and transient. Common effects include:
- Dizziness, headache
- Abdominal pain, nausea, vomiting, dyspepsia, diarrhea
- Rash, pruritus, urticaria
- Asthenia (generalized weakness)
Important (uncommon/rare) effects: Movement disorders — parkinsonian symptoms (tremor, rigidity, akinesia), gait instability, restless legs syndrome — have been reported, usually reversible after discontinuation (see Precautions and Warnings). Other rare effects include palpitations, extrasystoles, tachycardia, hypotension, and, very rarely, hepatic disorders and severe skin reactions (e.g., acute generalized exanthematous pustulosis).
Contraindications of Trimetazidine Dihydrochloride
Trimetazidine Dihydrochloride is contraindicated in patients with:
- Known hypersensitivity to Trimetazidine Dihydrochloride or to any excipient of the formulation.
- Parkinson's disease, parkinsonian symptoms, tremor, restless legs syndrome, and other related movement disorders (current or history of).
- Severe renal impairment (creatinine clearance below 30 mL/min).
Frequently Asked Questions about Trimetazidine Dihydrochloride
What is Trimetazidine Dihydrochloride used for?
Trimetazidine Dihydrochloride is used as an add-on (adjunct) treatment for chronic stable angina in adults who are not adequately controlled by, or cannot tolerate, first-line antianginal medicines such as beta-blockers or calcium channel blockers. It is not used alone to treat an acute angina attack.
Can Trimetazidine Dihydrochloride stop a sudden chest pain (angina) attack?
No. Trimetazidine Dihydrochloride is not a rescue medication and has no proven role in relieving an acute anginal attack or treating unstable angina or a heart attack. It works over time as background, add-on therapy alongside other antianginal medicines.
Who should not take Trimetazidine Dihydrochloride?
Trimetazidine Dihydrochloride should not be used by people who are hypersensitive to it or its ingredients, people with Parkinson's disease or other movement disorders (such as tremor or restless legs syndrome), or people with severe kidney impairment. Always inform your physician of your full medical history before starting Trimetazidine Dihydrochloride.
Does Trimetazidine Dihydrochloride cause any serious side effects?
Trimetazidine Dihydrochloride can, in some patients, cause or worsen movement disorders such as tremor, muscle stiffness, unsteady walking, or restless legs syndrome, resembling Parkinson's disease. These effects are usually reversible after stopping the medicine, but you should tell your doctor right away if they occur so that Trimetazidine Dihydrochloride can be discontinued and you can be evaluated.
Is Trimetazidine Dihydrochloride safe during pregnancy or breastfeeding?
Data on the use of Trimetazidine Dihydrochloride during pregnancy are limited, so it is generally avoided in pregnancy and should only be used if a physician determines the benefit clearly outweighs the potential risk. It is also not recommended during breastfeeding, as it is not known whether it passes into breast milk. Always consult your physician before use in these situations.
How should I take Trimetazidine Dihydrochloride, and what if I miss a dose or take too much?
Trimetazidine Dihydrochloride is typically taken with meals, either as a 35 mg modified-release tablet twice daily or a 20 mg tablet three times daily, exactly as prescribed by your physician. If you miss a dose, take it when you remember unless it is close to the next dose — do not double up. If an overdose is suspected, seek immediate medical attention or contact emergency/poison control services right away, as there is no specific antidote.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.