What is Trimetazidine used for?
Trimetazidine may be classified as a coronary vasodilator. Vasodilators open blood vessels.
Trimetazidine is used to treat:
- Angina: chest pain that occurs when the heart doesn’t get enough oxygenated blood
- Heart failure: when the heart doesn’t pump as well as it should
- Peripheral artery disease (PAD): when there’s a narrowing of the blood vessels that take blood from the heart to the rest of the body
Trimetazidine is widely available under various names in many countries, but it is not approved for use in the United States. In Europe, trimetazidine is also marketed under the name Vastarel.
It’s available in:
- Bulgaria
- Cyprus
- Czech Republic
- Denmark
- Estonia
- France
- Germany
- Greece
- Hungary
- Ireland
- Italy
- Latvia
- Lithuania
- Luxembourg
- Malta
- Poland
- Portugal
- Romania
- Slovakia
- Slovenia
- Spain
Vasodilators work by relaxing the smooth muscle of arteries and veins, which lets blood flow more freely. Trimetazidine inhibits fatty acid metabolism and stimulates the metabolism of glucose. It helps the body use oxygen, which relieves chest pain caused by blocked blood vessels.
Trimetazidine comes in two strengths:
- A 35 mg modified-release tablet that’s taken by mouth twice daily
- A 20 mg immediate-release tablet that’s taken by mouth three times daily
Side effects include:
- Burning of the stomach or throat
- Muscle cramps
- Dizziness
- Discomfort on exertion
- Depression
- Drowsiness
- Heart palpitations
- Changes in vision
- Changes in appetite
Trimetazidine was in the news in early 2022 because the Russian figure skater Kamila Valieva tested positive for it during the Winter Olympics. Trimetazidine is on the World Anti-Doping Agency’s prohibited list of substances. It’s listed under “Metabolic Modulators.”
In the United States, the most commonly prescribed classes of drugs for angina are:
- Beta blockers like atenolol and metoprolol
- Calcium channel blockers like nifedipine or amlodipine
- Sublingual nitroglycerin
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References
- Drugs.com. Trimetazidine. 2022. Available at: https://www.drugs.com/international/trimetazidine.html. [Accessed March 14, 2022].
- Ciapponi A, Pizarro R, Harrison J. Withdrawn: Trimetazidine for stable angina. Cochrane Database Syst Rev. 2017;3(3):CD003614. https://doi.org/10.1002/14651858.cd003614.pub3.
- Npr.org. What is trimetazidine, the drug found in Russian skater Kamila Valieva's system? February 15, 2022. Available at: https://www.npr.org/2022/02/15/1081008770/what-is-trimetazidine-the-drug-found-in-russian-skater-kamila-valievas-system. [Accessed March 14, 2022].
- American Heart Association (AHA). Angina (chest pain). 2022. Available at: https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain. [Accessed March 14, 2022].
- American Heart Association (AHA). Heart failure. 2022. Available at: https://www.heart.org/en/health-topics/heart-failure. [Accessed March 14, 2022].
- American Heart Association (AHA). Peripheral artery disease. 2022. Available at: https://www.heart.org/en/health-topics/peripheral-artery-disease/about-peripheral-artery-disease-pad. [Accessed March 14, 2022].
- European Medicines Agency (EMA). Trimetazidine. October 17, 2012. Available at: https://www.ema.europa.eu/en/medicines/human/referrals/trimetazidine. [Accessed March 19, 2022].
- Dézsi CA. Trimetazidine in Practice: Review of the Clinical and Experimental Evidence. Am J Ther. 2016;23(3):e871-e879. https://doi.org/10.1097/mjt.0000000000000180.
- World Anti-Doping Agency (WADA). World Anti-Doping Code International Standard Prohibited List 2022. 2022. Available at: https://www.wada-ama.org/sites/default/files/resources/files/2022list_final_en.pdf. [Accessed March 14, 2022].
- Ben-Dor I, Battler A. Treatment of stable angina. Heart. 2007;93(7):868-874. https://doi.org/10.1136/hrt.2005.083659.
- Jiang J, Cong H, Zhang Y, et al. Effect of Metoprolol Succinate in Patients with Stable Angina and Elevated Heart Rate Receiving Low-Dose β-Blocker Therapy. Int J Med Sci. 2017;14(5):477-483. https://doi.org/10.7150/ijms.18054.
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