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Trimetazidine prevents stable angina attacks in people whose symptoms are not controlled by other anti-anginals; two 20mg tablet listings are offered here, Trimetazidine and Vastarel.
Trimetazidine
20mg
Trimetazidine 20mg tablets are taken every day to make angina attacks less frequent, and come in pack sizes from 30 to 180 tablets.
Stable angina shows up as tightness, pressure or a heavy feeling in the chest, most often during effort, when narrowed coronary arteries cannot deliver as much oxygen as the heart muscle needs. Trimetazidine is an anti-anginal used for long-term prevention in people whose symptoms are not well controlled by a beta-blocker, a calcium channel blocker or a nitrate. It has no part in stopping an attack that is already happening. The only use it keeps today is stable angina; dizziness, tinnitus (ringing in the ears) and eyesight problems were once treated with it and are no longer.
Other angina drugs act on the vessels or on how fast the heart beats. This one acts on fuel. Heart muscle burns fatty acids by preference, an inefficient route when oxygen is scarce; trimetazidine blocks the first step of that process, so the cells turn to glucose, which releases more energy for each unit of oxygen used. Pulse and blood pressure are not affected, which is why it can sit alongside medicines that do lower them. Improvement builds up over weeks of steady dosing rather than after one tablet.
One 20mg tablet is taken with food three times over the day — at breakfast, at lunch and at the evening meal. Taking the tablet at mealtimes also makes stomach upset less likely. Keep the tablets in their original packaging until you need them.
Headache, dizziness, stomach pain, indigestion, diarrhoea, nausea, vomiting and tiredness are the complaints reported most often, and they are usually mild. The effects that need watching are the movement ones: shaking, muscle stiffness, a walk that becomes slow or shuffling, restless legs and a feeling of unsteadiness. They can appear after weeks or months of use, are seen more often in older people, and usually go once the tablets are stopped. Rarely, the blood count falls — platelets and white cells can drop. Trimetazidine is not suitable for anyone with Parkinson's disease or parkinsonian symptoms, tremor or restless legs syndrome, or for anyone with severe kidney impairment, where it clears from the body too slowly.
Both listings hold trimetazidine 20mg in standard tablets — Trimetazidine, named after the ingredient, and generic Vastarel, the brand name it is best known by. Strength and form are the same; only the pack and the name differ. Both sit in Heart and Blood Pressure with the other angina and blood-pressure medicines.
Trimetazidine can be ordered online with delivery to Hong Kong. It is listed as Trimetazidine tablets and generic Vastarel, both as 20mg tablets. Every order ships in plain, unbranded packaging with nothing on the outside about the contents.
It depends on the product, strength and pack size. Each of the two trimetazidine products listed here shows its current prices in HKD or the currency you select.
PockDose does not ask you to upload a prescription when you order trimetazidine. See the ordering FAQ for details.
Preductal and Vastarel are brand names of trimetazidine. Here, trimetazidine can be bought online as generic Vastarel and trimetazidine tablets. These are generics, not the original brand.
Several weeks of daily tablets. A single tablet does not reduce angina attacks, because the effect depends on steady dosing. It also cannot end an attack in progress, which is the job of a fast-acting nitrate.
Yes — it is meant to be used alongside them. It is added when a beta-blocker, calcium channel blocker or nitrate is not keeping symptoms under control, or when one of those cannot be taken. Because it leaves blood pressure and pulse untouched, it does not deepen their effects.
Anyone with Parkinson's disease or parkinsonian symptoms, tremor or restless legs syndrome should avoid it, since it can make those movement problems worse. Severe kidney impairment is another reason to leave it alone: the body clears the medicine too slowly, so it builds up.
No. Nitrates widen the blood vessels and work within minutes, which is why they stop an attack as it happens. Trimetazidine has no effect on vessel width or heart rate; it changes which fuel the heart muscle burns so less oxygen is needed, and it is taken on a fixed daily schedule.
Angina usually goes back to its earlier pattern, because the tablets relieve symptoms rather than correcting the narrowed arteries underneath. No withdrawal reaction is known, but the protection against attacks stops with the last tablet.