Pidomod

Indications

Trimetazidine is used in adults as an add-on treatment for stable angina pectoris (chest pain on effort caused by narrowed heart arteries) when other angina medicines do not control symptoms well enough or are not tolerated. It does not relieve an angina attack that has already started.

How It Works

It helps heart muscle cells use oxygen more efficiently by shifting their energy source from fat towards glucose. This protects the heart muscle when its blood supply is reduced, without changing heart rate or blood pressure.

Dosage and Administration

Adults: 35 mg modified-release tablet twice a day, morning and evening, with meals; or 20 mg immediate-release tablet three times a day with meals, as prescribed. Swallow modified-release tablets whole with water; do not crush or chew them. People with moderate kidney impairment and many people over 75 years: the doctor usually lowers the dose (for example, 35 mg once a day). The doctor will review whether the medicine is still helping after about 3 months.

Interactions

No important interactions are known. Tell your doctor about all other medicines you take, especially medicines for Parkinson's disease or other medicines that can cause tremor or stiffness.

Contraindications

• Allergy to trimetazidine.
• Parkinson's disease, parkinsonian symptoms, tremor, restless legs syndrome or other related movement disorders.
• Severe kidney impairment (creatinine clearance below 30 ml per minute).

Side Effects

Common: dizziness, headache, stomach pain, diarrhoea, indigestion, nausea, vomiting, rash, itching and weakness. Less common: palpitations, low blood pressure on standing, flushing and sleep problems. It can cause or worsen movement problems such as tremor, stiffness, slow movements and an unsteady walk, which usually go away after stopping. Get urgent medical help if you have a severe allergic reaction or severe skin rash, chest pain that is worse or more frequent than usual, fainting, or a fall caused by unsteadiness. Report any new shaking, stiffness or difficulty walking to your doctor promptly.

Pregnancy and Lactation

It is best avoided during pregnancy because safety information is limited. It is not recommended during breastfeeding.

Precautions and Warnings

It is not a treatment for an angina attack, unstable angina or heart attack; seek emergency care for chest pain that lasts or is severe. Tell your doctor if you have kidney problems or are over 75 years. Take care when standing up, as dizziness and falls can occur, especially in older people. Do not drive or use machines if you feel dizzy or drowsy. Stop taking it and see your doctor if movement problems appear.

Overdose

Limited information is available. Seek medical help; treatment is supportive and based on symptoms.

Therapeutic Class

Antianginal medicine (metabolic agent).

Storage

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