“Cardionate” or “Mildronat” - which is better? Indications for use, reviews

Updated: 04/23/2021 15:13:42

Expert: Abramova Tsilya

Cardionate and Mildronate are analogues, but have some distinctive properties. We analyzed the similarities and differences between the drugs to determine which is better and in which situations.

Medicine for life?

One of the medicinal substances actively used to maintain health is meldonium. It is part of a group of metabolic elements that actively work in energy metabolism processes at the cellular level. The pharmaceutical industry of different countries has developed and produced a huge number of drugs using this substance as the main active component. Frequently asked questions about two of them: Cardionate or Mildronate - which is better? Feedback from doctors and patients, as well as a comparative analysis, will allow you to answer it as accurately as possible.

History of discovery

The substance meldonium has a very interesting path into the pharmaceutical industry and is in demand on the drug market. It was originally obtained synthetically as a result of searching for the problem of rocket fuel disposal. This happened in the 1970s in the Latvian SSR at the Institute of Organic Synthesis at the Academy of Sciences. First, meldonium began to be used in plant growing to stimulate growth, then its ability to act as a cardioprotector in animals was discovered. It was then that the decision was made to conduct the necessary research and testing so that meldonium would be among the medicinal substances. Today it is widely used both in clinical medicine and in sports. Meldonium is included in the List of vital and essential drugs, which is approved by the Russian Government. This substance is included in many medications, for example, Mildronate and Cardionate. Comparing these drugs will ensure that they are similar.

In what form are medications containing meldonium available?

For many patients who are prescribed a drug with meldonium, the question arises: “Mildronat”, “Cardionate” - is there a difference between them? Let's consider these drugs from the point of view of release form. The drug "Mildronat" has three dosage forms:

• gelatin capsules containing 250 or 500 mg of meldonium;
• tablets 500 mg of active substance;
• injection solution, 1 ml of which contains 100 mg of the active ingredient.

Two forms of release are registered for the drug "Cardionat":

• gelatin capsules containing either 250 mg or 500 mg of meldonium;
• solution for injection in 5 ml ampoules containing 500 mg of active substance.

Answer the question by considering the release forms of the drugs: “Cardionat” or “Mildronat” - which is better? - it’s impossible, since they are produced in the same form with the same amount of active ingredient.

Description of Cardionate

Cardionat is available in the form of tablets and solution. The active component is meldonium. One capsule contains 250 mg, 1 ml of solution – 100 mg.

The medicine has antihypoxic, metabolic and antioxidant effects. It helps in eliminating the symptoms of psycho-emotional and physical stress. The drug activates immunity at the tissue level, shortening rehabilitation time.

The product is used to improve performance. It helps in combination therapy of nervous system disorders during withdrawal syndrome due to alcoholism.

What effect does meldonium have on the body:

1. improves blood circulation;
2. helps prevent coronary heart disease;
3. protects cells from oxygen deficiency;
4. increases the body's resistance;
5. increases resistance to mental and physical stress;
6. protects the heart during high-intensity exercise;
7. increases endurance;
8. shortens the rehabilitation period after physical overexertion.

Sold in 2, 4 and 10 cells of 10 capsules. Russia.

Research and effectiveness

A study was published in Consilium medicum in 2010, the purpose of which was to study the effect of Cardionate on the quality of life of patients with AMI after a heart attack.

It was found that the drug is capable of correcting metabolic disorders in the affected area of ​​the myocardium. Cardionate can prevent the progression of heart failure, as well as its development in the presence of risk factors.

Another study, which is described in the Russian Journal of Cardiology 2010: 35-36, concluded that the drug has a positive effect on carbohydrate and lipid metabolism. It improves exercise tolerance and has a beneficial effect on kidney function.

Contraindications

Cardionate has few restrictions on its use. These are intolerance to the active ingredient, childhood and severe pathologies of the circulatory system.

The product is not used during pregnancy. During lactation, when there is a need for treatment, breastfeeding should be stopped for a while until the substance leaves the body.

Side effects

Taking the drug can provoke undesirable symptoms such as allergies, decreased blood pressure, sleep disturbances, gastrointestinal disorders, and changes in heart rhythm. In case of overdose, an increase in adverse reactions is observed.

Dosage

The solution can be used in different ways - intravenous, intramuscular, parabulbar, retrobulbar. The injection is given in the first half of the day.

For the treatment of cardiovascular diseases, the standard dosage is 500-1000 mg per day. Duration of therapy is 1-1.5 months. In case of cerebrovascular accident, 500 mg is prescribed for 10 days. Duration – 3 weeks.

The medicine in the form of capsules for abnormalities of cerebral circulation is used at a dose of 500 mg for 4-6 weeks. In cardiology, 500-1000 mg is prescribed for a course of 6 weeks.

For increased loads, 2 capsules 4 times for 10 days are recommended.

Who is it suitable for?

The medicine in the form of a solution is used in the treatment of heart failure, ischemia and cerebrovascular accidents. It is also included in complex therapy for withdrawal symptoms and for rehabilitation after physical activity.

Capsules have the following indications for use:

1. hemorrhagic stroke;
2. cerebrovascular insufficiency;
3. decreased performance;
4. withdrawal syndrome.

The product in capsule form is often prescribed to athletes after heavy physical exertion for a speedy recovery.

About Cardionate

The drug "Cardionat" is produced in Russia, located in Moscow. The company is engaged in the development and production of finished dosage forms. The product line includes 43 items, including the drug with meldonium “Cardionat”. It is available in two medicinal forms - in capsules and as an injection solution, and in both forms it is the only active component. The remaining substances present in drugs play a formative role. For capsules it is:

• colloidal silicon dioxide;
• calcium stearate;
• potato starch.

In addition to meldonium, the ampoules contain water for injection in the amount necessary to concentrate the solution.

Release form. Compound. Manufacturer

Both drugs are produced on the basis of one active ingredient - meldonium and are almost identical. However, medicines differ in their manufacturer and release form.

Mildronate is produced by Latvian in the form of capsules and syrup intended for oral administration. It is also produced as a solution for administering the drug intramuscularly, intravenously and parabulbarly.

Cardionate is a Russian analogue of Mildronate, produced by pharmaceutical companies and MAKIZ-PHARMA in the form of capsules and as an injection solution.

A small difference in the amount of additional components has virtually no effect on the effects of the drugs.

About "Mildronat"

The medicinal substance with meldonium under the brand name “Mildronat” is produced by the pharmaceutical company (AS Grindeks), which unites five enterprises from Latvia, Slovakia, Russia, and Estonia. It was in Latvia that the substance meldonium was patented in 1992. The Grindeks association is engaged in the development, production and sale of both dosage forms and individual substances used in pharmaceuticals, in the production of cosmetics, and sports nutrition. One of these substances is meldonium. The drug "Mildronat", which is produced in three dosage forms, contains the only working substance - meldonium. All other components included in the structure of drugs are formative substances:

• the capsule shell consists of titanium dioxide (white coloring matter), gelatin, calcium stearate, potato starch, colloidal silicon dioxide;
• tablet form consists of silicon dioxide, potato starch, mannitol, povidone, magnesium stearate, microcrystalline cellulose;
• the injection solution is based on special water, taken in the amount necessary to obtain the percentage of the medicinal substance in 1 ml of solution.

Considering the dosage forms and composition of the active component and excipients, we can conclude that Cardionat and Mildronate are the same medicine from different manufacturers.

Cost and analogues

How does the active substance work?

Meldonium is a metabolic substance that responds and actively participates in energy metabolic processes occurring in the cells of living organisms. Balance is the basis of life, and balance at the cellular level is the basis of health. In some conditions, the active work of carnitine, which serves as a conductor of long-chain fats into the mitochondria of cells for their breakdown and energy production, should be reduced, since the fats do not have time to be broken down and accumulate in the form of unoxidized fatty acids of active forms.

The process of proper healthy oxidation takes place with the participation of oxygen, but during certain diseases and pathological conditions there is a lack of oxygen and a slowdown in the oxidation of fats to biologically digestible structures. Meldonium blocks carnitine, preventing fats from entering the mitochondria without sufficient oxygen.

This substance has the following functional abilities based on improving metabolic processes by activating the supply of oxygen to cells:

• antianginal;
• antihypoxic;
• angioprotective;
• cardioprotective.

The bioavailability of meldonium in various pharmaceutical forms is about 80%. It is quickly absorbed from the gastrointestinal tract, and reaches peak concentration in the patient’s blood within 1.5-2 hours. This substance is then metabolized in the liver to non-toxic components, which are excreted in the urine.

In what cases is the use of drugs with meldonium indicated?

Since the active substance meldonium is included in the preparations Cardionat or Mildronate, their indications for use will be the same. They are used in the treatment of such diseases and conditions:

• alcohol withdrawal;
• peripheral arterial disease;
• bronchial asthma;
• encephalopathy;
• stroke;
• cardiac ischemia;
• cardialgia with myocardiopathy;
• retinal hemorrhages;
• occlusion of the central retinal vein or its branches;
• acute disturbance of the blood supply to the retina;
• postoperative period;
• retinopathy of various etiologies;
• chronic heart failure;
• reduced performance;
• thrombosis of the central and peripheral retinal veins;
• physical overload (including sports);
• chronic obstructive pulmonary disease;
• cerebrovascular insufficiency.

When prescribing this drug, all basic methods of treating diseases are preserved. The drug can be used both as the main and as an auxiliary component.

Comparison of addiction between Cardionate and Mildronate

Like safety, addiction also involves many factors that must be considered when evaluating a drug.

So, the totality of the values ​​of such parameters as “o syndrome” in Cardionat is quite similar to the similar values ​​in Mildronate. Withdrawal syndrome is a pathological condition that occurs after the cessation of intake of addictive or dependent substances into the body. And resistance is understood as initial immunity to a drug; in this it differs from addiction, when immunity to a drug develops over a certain period of time. The presence of resistance can only be stated if an attempt has been made to increase the dose of the drug to the maximum possible. At the same time, Cardionat has quite a small amount of “syndrome”, however, the same as Mildronate.

Are there any contraindications?

If necessary, the doctor prescribes the drugs Cardionat or Mildronate. They contain the same active substance - meldonium. Contraindications to the use of these drugs will be the same:

• individual high sensitivity to meldonium or to the auxiliary components of the drug;
• intracranial hypertension resulting from intracranial tumors or impaired venous outflow.

The use of drugs with meldonium is not recommended for children under 18 years of age, as well as for pregnant and breastfeeding women. This ban is due to the lack of knowledge of the effect of the active substance on the body of a child or fetus. Extreme caution and constant monitoring of health requires taking meldonium preparations for pathologies of the liver and/or kidneys.

What about the side effects?

When deciding whether Cardionate or Mildronate is better, for many patients one of the factors is the potential for side effects. But since both drugs are drugs with meldonium and do not contain other active components, their manifestation will be the same. Side effects when using these medications may include:

• rashes on the skin;
• hyperemia;
• hypotension;
• itching;
• heartburn;
• edema;
• belching;
• increased arousal;
• tachycardia;
• nausea.

Side effects of drugs containing meldonium are extremely rare.

Meldonium and sporting achievements

Until recently, one could hear a debate about “Cardionate” or “Mildronate” - which is better for sports? Meldonium increases the endurance of athletes, allowing them to recover faster after active training and performances in competitions. The World Anti-Doping Agency (WADA) has included this substance in the list of prohibited substances for use by athletes. The Meldonium scandal with Russian athletes has caused significant harm to the prestige of our sport. Today, the question of whether Cardionate or Mildronate is better is debated only in clinical medicine and behind the scenes of sports.

Features of the use of drugs with meldonium

Only a doctor can prescribe the use of drugs with meldonium according to the available indications. He will choose the form of the medicine and the mode of application. Patients should take into account some features of the use of both Cardionate and Mildronate:

• It is best to take the medicine in the first half of the day, so that as a result of the development of increased arousal, as a side effect, it does not spoil the night’s sleep;
• when administering the drug intramuscularly, quite severe pain may be felt at the injection site, so administering the drug intravenously is preferable;
• in the treatment of retinopathy, drugs with meldonium are administered only parabulbarly (in the area of ​​the lower eyelid under the skin or to a depth of 1 centimeter), this is a very painful injection;
• It is not recommended to take alcohol during treatment with drugs containing meldonium due to a possible decrease in the quality of treatment and the development of adverse reactions in the body.

The doctor must take into account the interaction of drugs, as well as the patient’s condition and the course of the disease. Meldonium potentiates the activity of drugs with coronary action, antihypertensive drugs, as well as drugs that promote dilation of peripheral blood vessels. The combined use of such drugs may cause tachycardia and low blood pressure.

Description of the drug Mildronate

The drug Mildronate also contains meldonium and is available in the form of 500 mg capsules, 500 mg/5 ml solution and 100 and 250 ml syrup. It is a metabolic drug.

With increased physical activity, this remedy ensures normal delivery of oxygen to cells, while eliminating toxic metabolic products. The product has a tonic effect, which is why it is popular among athletes.

The use of Mildronate helps the body quickly restore energy, while withstanding greater mental and physical stress.

The medicine is produced in Latvia by the company Grindeks.

Research and effectiveness

In the publication International Journal of Applied and Fundamental Research. – 2021. – No. 11 (part 4) – pp. 763-765 describes the study “The influence of Mildronate on the recovery process after physical activity.” Author Romanenko A.A. expressed the opinion that this remedy is unique in its mechanism of action and has a positive effect on many body processes, including regenerative ones. It can be used for athletes during the period of adaptation and rehabilitation.

WADA added meldonium to the list of prohibited substances from January 1, 2021, which is associated with the active use of the substance by athletes to improve physical fitness.

Contraindications

Mildronate is not used for allergies to meldonium, with increased intracranial pressure and in pediatrics. The safety of its use during pregnancy has not been proven.

Side effects

When treated with Mildronate, undesirable symptoms such as agitation, dyspepsia, tachycardia, and allergic manifestations may be observed. Severe allergy symptoms such as anaphylactic shock and angioedema may occur.

There is a possibility of a sharp decrease in blood pressure. Less common symptoms include difficulty breathing, pale skin, narrowing of the bronchi and loss of consciousness.

Dosage

Mildronate is recommended to be taken in the first half of the day. For diseases of the cardiovascular system, 500-1000 mg per day is indicated for 4-6 weeks. For heart pain, 500 mg is prescribed for 12 days. In case of cerebrovascular accident, 500 mg is used intravenously with a gradual increase in dosage to 1000 mg. The course of therapy is at least 4 weeks.

Who is it suitable for?

Mildronate is widely used to treat decreased mental and physical activity.

Other indications for use are:

1. pathologies from the cardiovascular system;
2. alcohol withdrawal;
3. bronchial asthma;
4. thrombosis;
5. circulatory disorders in the brain;
6. postoperative period.

The drug can be used in the complex treatment of angina, heart attack, coronary artery disease and heart failure.

Reviews from doctors and patients about the drugs

Preparations containing meldonium, produced in the same dosage forms, cannot differ significantly from one another. The doctor decides which remedy to choose for use. The only difference between these two medicines is the price - Russian meldonium is much cheaper than its Latvian analogue. For a package of Cardionat capsules you should pay about 220-270 rubles, while a similar package of Mildronate will cost the buyer almost 3.5 times more - about 800 rubles.

Which method is preferred is determined by the patient’s financial capabilities. It is difficult to choose which of the remedies is more effective - Cardionat or Mildronate. Reviews left by both doctors and patients are mostly advisory in nature. The product helps to cope well with many health problems if taken as prescribed by a doctor and in compliance with the dosage regimen.

To answer the question often asked to pharmacists in pharmacies: “Cardionat” or “Mildronat”, which is better?” - almost impossible. These are absolutely similar drugs that have the same composition, which means that the indications and contraindications for use, and potential side effects will also be the same. Only the price of the drugs will help you decide which product to purchase.

Reviews

Evgeniy, 24 years old, Kursk, student I can’t be called a professional athlete, but morning jogging and going to the gym 3 times a week help me maintain good physical shape. I took Mildronate constantly, and in different forms: I drank capsules and took injections. A good remedy. Allows you not to feel tired after quite serious loads and study normally at the university. I have little faith in the doping properties of Mildronate and scandals in the “world of sports” could not change my opinion about the drug.

Svetlana Igorevna, 42 years old, Belgorod, doctor I like meldonium-based drugs. With a minimum of side effects, maximum results are achieved. The drugs have proven themselves well in the treatment of cardiovascular diseases, chronic alcoholism, for increasing physical activity, and reducing the rehabilitation period after illness. I especially recommend it to elderly patients who literally “come to life” after a course of treatment. Cardionate or Mildronate – I always leave the choice to the patients, because their effects are identical. Judging by their price, it is quite high, but Cardionat is still a little cheaper.

Svetlana, 16 years old, school graduate, Pskov The last years of school were difficult for me. A large number of lessons, homework, difficult-to-learn material. In general, the loads are solid. I just lost my strength: I can’t wake up in the morning, I’m sleepy all day, I don’t perceive information. The therapist prescribed Mildronate injections. One injection a day in a reduced dosage for two weeks gave me strength for further training. Now I’m preparing to enter college, full of strength and energy.

Svetlana Ivanovna, 58 years old, pensioner, Tver I don’t wish anyone to know what angina is. Systematic pressing pain in the chest sometimes causes incredible agony. The cardiologist prescribed Cardionat. Twice a day, 250 mg for the first 4 days of treatment, followed by a transition to twice a week for a month, allowed me to significantly reduce the number and intensity of attacks. Thanks to the doctor and Cardionat.