Intervein

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Intervein

Property Description
Active Ingredient Trimetazidine (as dihydrochloride salt)
Form Oral, Modified-Release Tablet
Pharmacological Class Metabolic Modulator (Anti-ischemic Agent)
Common Use Adjunct symptomatic treatment for stable angina pectoris
Origin Synthetic (Piperazine derivative)

Intervein is a prescription medication designed to help the heart muscle work more effectively, particularly during periods of low oxygen supply. Its primary function is to act as a Metabolic Modulator, a specialized type of drug that optimizes cellular energy use rather than altering circulation directly. The medication contains the active substance Trimetazidine, a synthetic piperazine derivative, which is clinically recognized for its cytoprotective properties in the myocardium.

What Type of Medicine is Intervein?

Intervein is classified as an Anti-ischemic Agent that belongs to the pharmacological group of Fatty Acid Oxidation Inhibitors. This class of medicine works by shifting the heart's energy source toward more oxygen-efficient glucose metabolism, thereby improving how heart cells utilize the oxygen they receive. It is a single-ingredient formulation, most commonly administered through the oral route as a Modified-Release Tablet. This solid pharmaceutical preparation is designed for sustained action, which allows the Trimetazidine dihydrochloride to be delivered consistently, allowing for prolonged therapeutic plasma concentrations.

Trimetazidine: The Non-Haemodynamic Approach

The general purpose of Intervein is the symptomatic treatment of heart conditions in adults, functioning as an adjunct therapy alongside standard treatments. This approach is distinct because Trimetazidine is a non-haemodynamic agent, meaning its anti-ischemic benefits are achieved directly through changes to cell function, without significantly lowering blood pressure or heart rate. When added to conventional therapy, Trimetazidine provides support to the heart. As a result, it is typically utilized as a second-line agent for patients whose stable condition remains inadequately controlled by or who are intolerant to their initial, first-line antianginal therapies.

What side effects are possible with Intervein?

Possible Side Effects and Safety Information

The official safety profile for Trimetazidine (Intervein) is based on adverse reactions classified by frequency and body system, as documented in regulatory sources.

Frequency-Classified Adverse Reactions

Adverse effects are categorized by frequency, typically according to the European Summary of Product Characteristics (SmPC) framework:

  • Common (may affect up to 1 in 10 people): Reactions mainly involve the Gastrointestinal System (e.g., nausea, vomiting, abdominal pain, diarrhea, dyspepsia) and the Nervous System (dizziness, headache). Other common effects include asthenia (weakness) and skin reactions such as rash, pruritus, and urticaria.
  • Uncommon (may affect up to 1 in 100 people): Less frequent reactions include palpitations, extra-systoles, tachycardia, and flushing.
  • Not known (frequency cannot be estimated from the available data): This category includes serious adverse reactions, notably symptoms associated with Parkinsonism (e.g., tremor, hypertonia, gait instability), as well as blood disorders like agranulocytosis and thrombocytopenia.

Serious Adverse Reactions and Safety Constraints

The most significant safety concerns documented in regulatory warnings involve motor function. Symptoms of Parkinsonism are listed as a serious adverse reaction. While generally reversible upon discontinuation, the regulatory profile notes that these symptoms may persist for more than four months in some cases. Orthostatic hypotension, which may carry a risk of falls, is also documented.

Safety is further defined by formal restrictions:

  • The medicine is contraindicated in individuals with pre-existing Parkinson's disease, Parkinsonian symptoms, tremor, restless legs syndrome, or other related movement disorders.
  • Use is not recommended in patients with severe renal impairment (creatinine clearance less than 30 mL/min), and older adults may be more susceptible to the motor side effects.

Overdose and Emergency Response

Overdose and when to seek help for Intervein

Officially documented information regarding acute overexposure to Intervein (Trimetazidine) focuses on specific clinical signs and the required emergency response. The regulatory prescribing information identifies a distinct presentation profile following overdose.

Manifestations & Outcomes Regulatory Actions
Documented Manifestations: Acute overexposure is officially reported to result in arterial hypotension (low blood pressure), dizziness, and generalized flushing. Mandatory Action: Patients must seek medical attention immediately upon suspected or confirmed overdose.
Outcomes & Management: The effects indicate a potential for cardiovascular instability. No specific antidote is known to exist. Supportive Treatment: Management is restricted to symptomatic and supportive treatment to stabilize vital functions.

Due to the potential for symptomatic instability, the official regulatory profile confirms that hospital monitoring may be required until the patient's clinical status is stable. This required course of action, which involves managing symptoms and maintaining stable vital signs, constitutes the entirety of the official regulatory guidance for Trimetazidine overdose, as no specific antidote is available according to official labeling. This immediate response is critical when severe hypotension is suspected.

Therapeutic Uses of Intervein

What Intervein Treats: Main Uses and Benefits

Intervein is a prescription medication generally used in adults for the symptomatic management of stable angina pectoris, a chronic condition characterized by recurrent chest discomfort or pressure. It is commonly used as an additional medication (adjunct therapy). This approach is relevant for easing symptoms related to physical discomfort that interfere with daily functioning, and it may assist with maintaining functional stability when symptoms persist. The medication is applied across therapeutic domains involving distressing symptoms of myocardial ischemia—the inadequate oxygen supply to the heart muscle.

The medication generally plays a role in managing symptoms that persist or become more noticeable when a patient's condition is inadequately controlled by, or when the patient is intolerant to, standard first-line antianginal agents.

“This supportive use helps address symptom clusters that may become intense or disruptive during daily activities.”

A key patient-oriented benefit is the support it provides that may assist with physical activity tolerance. By managing the symptoms of effort-induced ischemia, the medication may help patients cope more steadily with symptom fluctuations, providing supportive relief when symptoms interfere with routine activities.

Quick Fact: Context for Symptom Management
Symptom Type: Recurrent Chest Discomfort
Clinical Role: Adjunct symptomatic therapy
Supports: Maintaining functional stability

Regulatory References

  1. European Medicines Agency (EMA) Therapeutic Overview

Eligibility and Restrictions for Use

Eligibility and Contraindications

Official regulatory documentation confirms Intervein (Trimetazidine) is indicated only for use in adults. Its use is governed by explicit non-eligibility rules related to neurological status, renal function, and age.

Absolute Contraindications: Use is strictly contraindicated in patients with certain pre-existing neurological conditions, specifically Parkinson disease, parkinsonian symptoms, tremors, restless leg syndrome, and other related movement disorders. Use is also prohibited for patients with severe renal impairment, defined as a creatinine clearance below 30 mL/min, or known hypersensitivity to the active substance.

Restricted and Excluded Populations:

  • Pediatric Use: The safety and efficacy of the medicine have not been established in children and adolescents, and it must not be administered to individuals under 18 years of age.
  • Pregnancy and Lactation: Use is preferable to avoid during pregnancy. It should not be used by women who are breastfeeding.
  • Conditional Use: Caution is required in elderly patients (especially those over 75 years old) and patients with moderate renal impairment (creatinine clearance 30 –60 mL/min), as labeling specifies the need for special consideration in these groups.

What should I know about interactions with other medicines?

The official regulatory profile for Intervein (Trimetazidine) indicates that no formal drug-drug interactions have been identified or reported [1.3, 2.3, 3.4]. This conclusion is supported by the drug's primary elimination pathway being renal, which suggests a low potential for involvement in metabolic interactions typically seen with hepatic enzymes or drug transporters. Consequently, regulatory documents do not list any specific medicinal products that are contraindicated due to a pharmacokinetic interaction risk, nor are there mandatory timing separation rules for co-administered drugs.

Documented Interaction Cautions

Interaction Type Official Regulatory Statement
Pharmacodynamic Reinforcement A caution exists regarding the co-administration of antihypertensive treatments. The official label notes a potential for orthostatic hypotension (fall in blood pressure upon standing) and related falls in patients taking these agents [1.2, 2.3].
Pharmacokinetic / Metabolic No drug interactions have been identified; no substances are officially listed as altering the exposure (AUC/Cmax) of Trimetazidine [1.3, 2.3].
Food and Substances No interactions with foodstuffs have been found, according to explicit statements in regulatory prescribing information [2.1]. No specific interactions with alcohol or herbal products are documented in regulatory sources.

Population-Specific Clearance Notes

The label notes that increased Trimetazidine exposure is expected in both elderly patients and individuals with moderate renal impairment (creatinine clearance 30-60, mL/ min) [1.1, 3.4]. This observation is due to the age- or impairment-related decrease in renal clearance, which is a factor of the drug's elimination, not an interaction with another substance.

Mechanism of Action

Intervein (Trimetazidine) functions as a metabolic modulator, altering the heart's cellular energy utilization pathway without modifying heart rate or blood pressure. The primary action is the selective and partial inhibition of the mitochondrial enzyme long-chain 3-ketoacyl coenzyme A thiolase (LC-3-KAT). By limiting LC-3-KAT activity, Trimetazidine reduces the rate of fatty acid oxidation (FAO) and shifts the myocyte's energy production toward the more oxygen-efficient glucose oxidation pathway. This metabolic shift increases the ratio of Adenosine Triphosphate (ATP) generated per unit of oxygen consumed. The resulting change establishes a mechanism for cytoprotection against injury induced by oxygen deprivation. By increasing glucose utilization, the mechanism limits the buildup of harmful metabolic by-products, preventing excessive intracellular acidosis and stabilizing the activity of essential ion pumps. This action prevents destructive calcium ion ( Ca^2+) overload and contributes to the maintenance of contractile function and cellular structure during oxygen-deficient conditions. The effect is entirely non-haemodynamic, achieved solely through direct changes to the cell's energy processing.

Dosage and Administration Information

How Intervein is Used

Intervein, which contains the active substance Trimetazidine, is administered via the oral route as a Modified-Release (MR) Tablet. The standard administration pattern for adults is to take one 35 mg tablet twice daily, resulting in a 70 mg total daily dose. This dosing schedule is intended to maintain consistent levels of the active substance over time.

Tablets must be taken during meals and require specific handling during intake: they must be swallowed whole and must not be chewed, crushed, or split, as this would compromise the modified-release design of the medication. If a dose is missed, treatment should be resumed with the next scheduled dose; patients are instructed not to double the dose to compensate.

Dose adjustments are specified for certain populations. For patients with moderate renal impairment (creatinine clearance between 30 and 60 mL/min), the total daily dose is reduced to 35 mg, taken once daily. Usage in pediatric patients is not established and is generally not recommended. Furthermore, the benefit of the treatment is typically assessed after three months of use, and the medication should be discontinued if the patient does not show an adequate response to the therapy.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Intervein (Trimetazidine)

Overview of Studies for Stable Angina Pectoris

The research exploring Intervein as an adjunct therapy for stable angina pectoris primarily involves Systematic Reviews and Meta-analyses compiling data from multiple Randomized Controlled Trials (RCTs). These study designs were used in research exploring how symptoms change over time when the drug is added to a patient’s existing treatment. The data is further supported by prospective, multicenter observational studies which explore the use of the drug in real-world clinical settings over several months. This body of research contributes to the understanding of study patterns in conditions where symptoms may vary in intensity.

Focus of Clinical Trials: Symptoms and Functional Capacity

Research examined outcomes related to physical discomfort and outcomes reflecting daily functioning or activity level. Studies specifically measured the frequency of weekly angina attacks and any changes in the patient's need for short-acting nitrates (like nitroglycerin). Additionally, research explored functional measurements. Findings describe patterns observed in outcomes reflecting daily functioning or activity level, such as exercise tolerance and the time required to reach the ischemic threshold during controlled exercise testing. This research contributes to understanding short-term changes in the context of effort-induced symptoms.

Research in Specific Patient Groups

Intervein was studied for its use in various patient groups beyond the general population with stable angina. Research specifically focused on adults with the condition who also have coexisting health issues, such as Type 2 Diabetes Mellitus, where research describes patterns related to both angina symptoms and specific metabolic markers. Other studies was studied for its use in populations with a prior history of myocardial infarction (heart attack). Research provides context but not individual predictions for specific populations where symptoms may vary. Data for certain groups, such as pediatric populations, remain insufficient.

Duration of Study and Long-Term Data

The clinical research for Intervein consists primarily of controlled trials and observational studies conducted over relatively short- and intermediate-term follow-up periods. Regarding maintenance of measured outcomes, studies report how outcomes evolved in the observed populations within these defined time intervals. However, long-term effects are not fully established. Evidence is limited regarding the relationship of Intervein with long-term major cardiovascular outcomes (such as mortality or hospitalization).

Evidence Gaps and Research Limitations

Scientific reviews research describes certain limitations in the overall evidence landscape. Evidence quality varies across studies, particularly among some of the older trials. For instance, comparative evidence is lacking for the medicine's use as a monotherapy (used alone) versus its use in combination. Additionally, there is limited information for long-term outcomes related to cardiovascular events. Research provides context but not individual predictions.

Key Studies & References

  1. Efficacy and Safety of Trimetazidine in Patients With Stable Angina Pectoris and Type 2 Diabetes Mellitus

Frequently Asked Questions (FAQ)

Common questions about Intervein (FAQ)

Q: Does Intervein permanently cure the condition, or is it a long-term management drug?

According to official regulatory documents, Intervein is indicated as an add-on therapy for the symptomatic treatment of stable angina pectoris. It is designed to help manage symptoms and support the heart's function, but it is not a curative treatment for angina attacks or the underlying condition.


Q: Are there any specific foods or drinks that should be avoided while taking Intervein?

Official prescribing information states that no drug interactions with foodstuffs have been identified. However, the manufacturer's instructions indicate that the modified-release tablets are generally taken during meals.


Q: What are the long-term safety data or known risks of Intervein?

A known risk documented in the safety profile is the potential occurrence of movement disorders, such as Parkinsonian symptoms. While these are usually reversible upon stopping the medication, official information notes that symptoms may persist for more than four months in some cases. Research regarding the relationship of the drug with major long-term cardiovascular outcomes is limited.


Q: Why is pre-screening or specific testing required before starting Intervein?

Regulatory guidelines mention specific considerations for the use of this drug due to how it is processed by the body. The medication is generally contra-indicated for patients with severe kidney problems, and special consideration is given to the dose for moderate kidney problems. Additionally, official documents describe the need for movement disorders to be regularly assessed, particularly in older patients.


Q: How long does the effect of a single Intervein dose typically last?

The medication is manufactured as a Modified-Release tablet, which means the active ingredient is released slowly over time. This design relates to the standard adult regimen which involves taking the drug twice daily—morning and evening—to help maintain consistent therapeutic levels throughout a 24-hour period.


Q: Has the FDA issued any specific warnings or alerts about Intervein?

Regulatory authorities globally have issued specific safety warnings concerning the potential of the drug to cause or worsen movement disorders, such as Parkinsonian symptoms. These warnings have led to the establishment of contraindications (who should not use the drug) based on neurological status.


Q: Do studies suggest Intervein is more effective for some patient groups than others?

Official documents confirm that research included studies on various patient groups, such as those with coexisting health issues like Type 2 Diabetes Mellitus. However, the regulatory documentation does not contain definitive claims stating greater efficacy for these groups over other patient populations.


Q: What is the expected long-term course of treatment with Intervein?

The use of the treatment is guided by regulatory instructions. The clinical benefit of the treatment is described as being formally assessed after three months of use. If a patient does not show an adequate response to the therapy during this time, official guidelines indicate that the medication may be discontinued.


Q: Are allergic reactions to Intervein common?

A severe allergic reaction, known as hypersensitivity, is listed as an absolute contraindication for this medicine. However, less severe skin reactions like rash, pruritus (itching), and urticaria (hives) are documented as Common side effects.


Q: What is the potential impact of Intervein on kidney or liver function?

The medication's safety profile describes an impact on kidney function, which is why special consideration is given to the dose based on the degree of impairment. Official prescribing information also lists symptoms related to liver disease as an adverse reaction of 'Not known' frequency (meaning the frequency cannot be estimated from the available data).


Q: What is the main difference between Intervein and other similar treatments?

Intervein is classified as a metabolic agent that is non-haemodynamic. This means it protects the heart muscle by changing the way heart cells use energy, achieving its anti-ischemic effects without significantly affecting heart rate or blood pressure.


Q: Can Intervein affect fertility in men or women?

The official regulatory documents, such as the Summary of Product Characteristics (SmPC), include a section that addresses fertility. These documents generally discuss the available data regarding specific long-term impact on fertility in humans and advise on the appropriate use during reproductive years.


Q: What is the difference between Intervein and a biologic drug?

Intervein contains the active substance Trimetazidine, which is a synthetic small-molecule drug classified as a piperazine derivative. This is different from biologic drugs, which are large, complex molecules typically produced using living cells or organisms.


Q: Is Intervein considered an immunosuppressant?

According to regulatory classification, Intervein is officially categorized as an Anti-ischemic Agent and a Metabolic Modulator (a drug that modifies the body's energy use). It is not classified as an immunosuppressant.


Q: Does Intervein show up on standard drug tests?

Although not for general medical drug screening, the active ingredient Trimetazidine is listed as a prohibited substance by the World Anti-Doping Agency (WADA). This is due to its classification as a metabolic modulator.


Q: Can taking Intervein increase the risk of getting certain infections?

The safety profile lists a severe reduction in the number of white blood cells, known as agranulocytosis, as an adverse reaction. This reaction is classified with a 'Not known' frequency, meaning it is rare and its actual occurrence rate cannot be accurately estimated from available data.


Q: Does Intervein have a black box warning?

Official regulatory documentation, such as the Summary of Product Characteristics (SmPC), does not include a Boxed Warning. A Boxed Warning (often called a black box warning) is the most stringent type of warning required by regulatory bodies when a drug has a serious safety risk.

How should Intervein be stored and disposed of?

How to Store and Dispose of Intervein

The storage and disposal of Intervein (Trimetazidine Modified-Release Tablets) must strictly follow the conditions specified in official regulatory labeling.

Storage Conditions

Intervein must be stored at a temperature that does not exceed 30^circC (86^circF) to ensure the chemical stability of the medication. The tablets must be kept in the original container or blister packaging to protect them from moisture until the time of use. This storage requirement helps maintain the integrity of the modified-release formulation throughout its labeled shelf-life. As with all prescription medicines, keep this product out of the sight and reach of children.

Disposal Instructions

Unused or expired Intervein tablets should not be discarded via wastewater (e.g., flushing them down a drain) or placed into general household trash. The product must be disposed of according to local pharmaceutical waste requirements, often by utilizing a medication take-back program or returning the product to a pharmacist.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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