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Vastarel (TRIMETAZIDINE) is a drug used for the treatment of ischaemic heart disease (angina pectoris, sequelae of infarction). Trimetazidine is an anti-ischemic (anti-anginal) metabolic agent, that improves myocardial glucose utilization through inhibition of Fatty acid metabolism.

Common uses

By preserving the energy metabolism in cells exposed to hypoxia or ischemia, trimetazidine prevents a decrease in intracellular adenosine triphosphate levels, thereby ensuring the proper functioning of ionic pumps and transmembranous sodium-potassium flow whilst maintaining cellular homeostasis.
Controlled studies in angina patients have shown that trimetazidine increases coronary flow reserve, thereby delaying the onset of ischemia associated with exercise, limits rapid swings in blood pressure without any significant variations in heart rate, significantly decreases the frequency of angina attacks, and leads to a significant decrease in the use of nitrates.
It improves left ventricular function in diabetic patients with coronary artery disease. Recently, it has been shown to be effective in patients with heart failure of different etiologies.
It is described as the first cytoprotective anti-ischemic agent, acts by directly counteracting all the major metabolic disorders occurring within the ischemic cell. The actions of trimetazidine include limitation of intracellular acidosis, correction of disturbances of transmembrane ion exchanges, and prevention of excessive production of free radicals.
It is usually prescribed as a long-term treatment of angina pectoris, and in some countries (including France) for tinnitus and dizziness.

Dosage and administration

One tablet at mealtimes in the morning and evening.
Pharmacodynamic properties
By preserving the energy metabolism in cells exposed to hypoxia or ischemia, trimetazidine prevents a decrease in intracellular ATP levels, thereby ensuring the proper functioning of ionic pumps and transmembranous sodium-potassium flow whilst maintaining cellular homeostasis.

In man: controlled studies in angina patients have shown that trimetazidine increases coronary flow reserve, thereby delaying the onset of ischemia associated with exercise, limits rapid swings in blood pressure without any significant variations in heart rate, significantly decreases the frequency of angina attacks, and leads to a significant decrease in the use of nitrates.
Precautions
Pregnancy: Studies in animals have not demonstrated a teratogenic effect. However, in the absence of clinical data and for safety reasons, prescription should be avoided during pregnancy.

Breastfeeding: In the absence of data, breastfeeding is not recommended during treatment.

Possible side effects

As with all drugs, Vastarel is likely to have undesirable effects eg, rare cases of gastrointestinal disorders (nausea and vomiting).
If the patient observed any undesirable effects not mentioned previously, inform the doctor or