Preductal and Mildronate, drug choice

It is impossible to unequivocally answer which drug is better. Despite the different mechanism of action, both drugs have a positive effect on the myocardium. Their effectiveness is compared in many clinical studies. There is no clinically proven preference for one drug over another.

Of course, price is an important criterion. Most cardiac patients are in advanced age. Often this means limited financial resources, and the purchase of an additional metabolic drug rises ribbed. In this case, the acquisition of mildronate will be more beneficial.

Another advantage of mildronate is its injectable form. Like most drugs, the effectiveness of mildronate increases with its intravenous administration. Sometimes a course of droppers with mildronate is more effective than prolonged use of tablet preparations.

The most common cause of coronary heart disease is arterial hypertension, which has been existing for a long time. Mildronate has a mild antihypertensive effect.

Arterial hypertension and coronary artery disease itself negatively affect kidney function. This is manifested in the fact that most patients with cardiac disease also have kidney problems. Since the preduct is excreted by the kidneys, it becomes contraindicated in chronic renal failure – a condition where normal excretory function of the kidneys is impaired.

Mildronate in the body breaks down into two forms, which have less toxic effect on the kidneys. Therefore, the drug can be used for impaired renal function, but with caution.

Unfortunately, mildronate can aggravate cerebral blood flow with increased intracranial pressure. Therefore, before starting its use, you must make sure that there are no contraindications.

If the choice between the two drugs is difficult and there is enough money, you can use them simultaneously. There are no official contraindications to such a combination, but it should be understood that there will also be no double effect.

In general, any drug should be prescribed only by your doctor. Self-medication, especially if there is a coronary heart disease, is clearly not worth it.

Cardiological patients occupy a special group of patients, the treatment of which should be carried out taking into account all the attendant complications. Since kidney function is often impaired, preparations with a renal type of excretion should be prescribed with extreme caution.

Therefore, before buying a product or Mildronate, it is better to consult with your doctor.

Metabolic therapy is a new trend in cardiology. These drugs improve metabolic processes in the myocardium, which affects the efficiency of the heart. Among the popular remedies, a drug such as a preduct appears. An analysis of medical prescriptions shows that it is recommended for most patients.

A similar effect has another representative of the metabolic group – Mildronate, which has gained great popularity as a dope called meldonium.

So which drug is better? Most often prescribed by doctors or the one used by athletes to improve outcome indicators?


The drug is based on the active substance trimetazidine. A positive effect arises by increasing the energy potential. It also streamlines oxygen consumption. One of the obvious reasons for the progression of cardiac problems is a violation of ion exchange in the myocardium. Preductal normalizes the operation of ion channels. It has an antioxidant effect, preventing the damaging effects of free radicals.


Clinically, this is manifested by an increase in exercise tolerance, the severity of cerebrovascular accidents decreases, and vision improves.

The attitude of world experts towards the preductal is ambiguous. In 2007, it was recognized as a drug with unproven efficacy, and after 6 years it was recommended by the European Cardiology Society for inclusion in the treatment of coronary heart disease. Probably, this led to its widespread use in cardiac patients.

It is excreted by the kidneys. Among the contraindications, hypersensitivity to the drug, childhood, severe renal failure are indicated.

Available in capsule form of 20 mg. It is used during meals 3 times a day.

There is also a retard form, which has a longer action – Preductal MB.

Preducted MB

The average price of the product was from 700 to 1,500 rubles per pack.


The mechanism of action of meldonium is based on improving the function of the heart by reducing the content of carnitine. This substance promotes the transition of fatty acids into the cell. Fatty acids are important for the functioning of the body, but during the period of oxygen deficiency (which occurs at the peak of physical activity), their oxidation is disrupted. Intermediate products that have a negative effect on heart tissue accumulate.


The history of this substance is extremely interesting. It was originally used in the household industry to stimulate the growth of domestic animals. It is excreted by the kidneys.

It can not be used during pregnancy, breastfeeding, increased intracranial pressure. There are injectable and tablet forms.

The average price of a tablet form is from 500 to 700 rubles per pack.

Comparison and features

Both drugs are metabolic agents and are indicated for the treatment of coronary heart disease. The similarities end there.

Comparing these two drugs is extremely difficult. The first difference is the mechanism of action. Preductal increases the synthesis of necessary energy molecules, and Mildronate inhibits the formation of carnitine.

The second distinguishing feature is the form of release. Mildronate is also available in injectable form.

Another difference is that the preduct is contraindicated in patients with end-stage renal failure.

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