Metacard MR

Quick links to important sections

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

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 Metacard MR

Quick Facts

Property Description
Active Ingredient Trimetazidine Hydrochloride
Form Modified-Release Tablet (MR)
Pharmacological Class Anti-Ischaemic, Metabolic Regulator
General Purpose Provides cellular support to the heart muscle
Origin Synthetic compound (piperazine derivative)

What is Metacard MR? Definition and Purpose

Metacard MR is a commercial pharmaceutical preparation containing the active substance Trimetazidine Hydrochloride, which is classified as an Anti-Ischaemic drug and a unique Metabolic Regulator for heart muscle cells. The drug is often used as an add-on therapy.

The general purpose of Trimetazidine is to provide cytoprotective support to the heart by optimizing how cardiac cells generate energy, particularly when oxygen supply is restricted. This specific therapeutic focus aids the heart muscle when it is under physical stress; Trimetazidine can improve exercise tolerance in patients. Unlike traditional anti-anginal medications that alter heart rate or blood pressure, Trimetazidine operates at the cellular level to enhance the efficiency of oxygen use, a mechanism that helps preserve cellular integrity.


Trimetazidine: Composition and Pharmacological Class

The active component, Trimetazidine, is a synthetic compound derived chemically from the piperazine family, defined by the chemical structure 1-(2,3,4-trimethoxybenzyl)piperazine. It is formally classified as a Cytoprotective Anti-Ischemic Agent.

This classification relates to its precise mechanism, which involves shifting the heart's energy production. Trimetazidine selectively inhibits the enzyme long-chain 3-ketoacyl CoA thiolase. By inhibiting this enzyme, the drug encourages the cell to rely more on glucose oxidation, an inherently more oxygen-efficient process for generating energy. This metabolic switch is crucial for preserving the cell's energy reserves and function when the heart is under ischemic stress.


Understanding the "MR" in Metacard MR: The Formulation Type

The abbreviation “MR” in Metacard MR denotes a Modified-Release Tablet, signifying a specialized oral solid form intended for systemic administration. This formulation is engineered to release the Trimetazidine Hydrochloride slowly and consistently over a prolonged duration, distinguishing it from immediate-release tablets.

As a single-ingredient medicine, the Modified-Release design maintains a stable therapeutic concentration of the metabolic agent in the bloodstream throughout the day. This steady-state delivery is crucial for sustained cellular protection and metabolic support for the heart muscle, offering a convenience factor for adult patients by simplifying the required dosing frequency.

What side effects are possible with Metacard MR?

Possible Side Effects and Safety Information

The safety profile for Metacard MR (Trimetazidine modified release) is primarily established through clinical trials and post-marketing surveillance, with regulatory bodies having issued specific warnings and restrictions.

Adverse Reactions

Adverse reactions are classified by frequency as follows:

Frequency Examples of Adverse Reactions (by System Organ Class)
Common (up to 1 in 10 patients) Dizziness, headache, gastrointestinal symptoms (abdominal pain, nausea, vomiting, diarrhea), skin rash, itching (pruritus), hives (urticaria), and general feeling of weakness (asthenia).
Rare (up to 1 in 1,000 patients) Palpitations, extra heartbeats, faster heart rate (tachycardia), and orthostatic hypotension (fall in blood pressure upon standing) which may lead to dizziness or falls.
Not Known (cannot be estimated) Parkinsonian symptoms (e.g., tremor, slow movements, rigid posture, gait instability), restless legs syndrome, other related movement disorders, sleep disorders, constipation, and serious skin reactions (e.g., Acute Generalized Exanthematous Pustulosis or AGEP).

Key Safety Restrictions and Warnings

  • Contraindications: The medicine is strictly contraindicated in patients with a known hypersensitivity to the active substance, Trimetazidine. It is also contraindicated in patients with existing Parkinson's disease, parkinsonian symptoms, tremors, or severe renal impairment (creatinine clearance < 30 mL/min).
  • Serious Adverse Events: The onset or worsening of Parkinsonian symptoms should lead to the definitive withdrawal of the medicine. These neurological symptoms are usually reversible after discontinuation.
  • Special Populations: Caution is advised, and a dose adjustment may be necessary for elderly patients and those with moderate renal impairment (creatinine clearance 30–60 mL/min), as their increased exposure to the drug raises the risk of movement disorders. The use of Metacard MR is generally advised to be avoided during pregnancy and breastfeeding.
  • Context of Use: Due to the potential for dizziness and drowsiness, patients should exercise caution regarding activities requiring high alertness, such as driving or operating machinery.

Overdose and Emergency Response

Overdose and When to Seek Help

This section outlines the officially documented descriptions of Trimetazidine overdose and regulatory guidance on when medical assistance is required, based strictly on government-authorized prescribing information.

Official Regulatory Summary

Domain Statement Regarding Overdose
Documented Manifestations Very limited information is available regarding the specific symptoms or clinical signs of a Trimetazidine overdose.
Antidote Status No specific antidote for Trimetazidine overdose is documented or known in official regulatory labeling.

Required Emergency Actions

In the event of a suspected overdose—that is, if a patient has taken more of the Metacard MR tablet than prescribed—immediate action is required as stated in the regulatory labeling.

  • Seek Immediate Help: The patient must immediately inform a doctor or pharmacist following an overexposure.
  • Treatment Approach: The official approach to management is to provide symptomatic and supportive treatment. The absence of a specific antidote necessitates this supportive care strategy.

Severe Outcomes and Monitoring

Official regulatory documents do not explicitly list specific severe or life-threatening manifestations exclusively tied to an overdose, nor do they detail specific requirements for hospital monitoring or observation. However, due to the nature of the medication, any over-ingestion must be treated as a scenario requiring professional medical evaluation as mandated by regulatory authorities.

Therapeutic Uses of Metacard MR

Metacard MR: Main Uses and Benefits

Quick Facts
Therapeutic Domain Stable angina pectoris (chest pain)
Key Role Add-on treatment when initial therapies are insufficient or not tolerated
Benefit Helps in the symptomatic management of the condition

Metacard MR (Trimetazidine) is used for the management of stable angina pectoris, a condition characterized by chest discomfort resulting from reduced blood flow to the heart muscle. It is utilized as an additional treatment option when first-line anti-anginal medications, such as beta-blockers or calcium channel blockers, do not provide sufficient control or are not tolerated by the patient.

The medication works by helping the heart muscle maintain essential energy metabolism during periods of limited oxygen supply. This action contributes to a reduction in the frequency of angina episodes and helps minimize associated discomfort. By supporting cellular function within the heart, the treatment addresses the underlying symptoms of myocardial ischemia.

Metacard MR is one part of a comprehensive approach to cardiovascular health. It is important to note that this medication is not intended for the relief of acute angina attacks. The primary objective of its use is to assist in the long-term symptomatic management of stable angina.

Eligibility and Restrictions for Use

Metacard MR (Trimetazidine) eligibility is strictly defined by regulatory bodies and is generally limited to the adult population (aged 18 years and above). Use is formally contraindicated and absolutely prohibited for several population groups, primarily those with pre-existing movement disorders and severe organ impairment.

Eligibility Scope

Category Regulatory Status Status Detail
Movement Disorders Contraindicated Patients with Parkinson’s disease, Parkinsonian symptoms, tremors, restless legs syndrome, or other related movement disorders [Source 1.2, 3.5].
Severe Renal Impairment Contraindicated Patients with severe renal failure, defined by a Creatinine Clearance (CrCl) of less than 30 mL/min [Source 1.2, 3.1].
Pediatric Population Not Recommended Safety and efficacy have not been established in children and adolescents below 18 years of age [Source 2.1].
Moderate Renal Impairment Restricted/Caution Use requires caution, and a dose adjustment may be necessary when CrCl is between 30 and 60 mL/min [Source 2.1].
Older Adults Restricted/Caution Caution should be exercised for patients over 75 years due to expected increased drug exposure from age-related changes in kidney function [Source 2.1].
Pregnancy/Lactation Avoidance Preferable The medicine is not recommended during breastfeeding, and avoidance is preferable during pregnancy [Source 3.1].

This eligibility profile confirms that only non-contraindicated adults without severe kidney impairment or movement disorders are generally eligible for use.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The regulatory profile for Metacard MR (Trimetazidine) is characterized by a general absence of officially identified drug-drug interactions.

Official Regulatory Interaction Status

Entity Official Regulatory Finding
Documented Drug-Drug Interactions None identified. Official sources state that no drug interactions have been reported, including with common cardiovascular agents such as beta-blockers, calcium antagonists, nitrates, and digitalis.
Metabolic Interactions Not an Inducer or Inhibitor. Trimetazidine is formally documented to be neither an inducer nor an inhibitor of drug hydroxylation, eliminating metabolic concerns in co-administration.
Interactions with Food None found. No interactions with foodstuffs have been identified or reported in official regulatory documents.

Population-Specific Pharmacokinetic Caution

While no drug-drug interactions are documented, caution is formally required when prescribing Metacard MR in specific populations due to a pharmacokinetic factor of expected increased plasma exposure.

  • Elderly Patients: Caution is required for patients over 75 years old due to anticipated increased exposure stemming from reduced renal clearance.
  • Moderate Renal Impairment: Caution is required for patients with a creatinine clearance between 30 and 60 mL/min, also due to the expected increase in the plasma concentration of Trimetazidine.

No timing-based administration rules or contraindicated combinations due to interaction risk are listed in the official regulatory documents.

Mechanism of Action

Molecular Action: Targeting Fatty Acid Metabolism

The mechanism of Metacard MR, delivered by Trimetazidine, centers on a selective interaction within the heart muscle cells. The compound acts by inhibiting the mitochondrial enzyme, long-chain 3-ketoacyl CoA thiolase (LC 3-KAT). This molecular suppression reduces the rate of fatty acid beta-oxidation, initiating a crucial shift in cellular energy production toward the glucose oxidation pathway.

Cascading Effect: Affecting Oxygen Efficiency

This metabolic redirection is relevant because glucose oxidation requires less oxygen to synthesize the same amount of cellular energy (ATP) compared to the fatty acid pathway. This enhancement in myocardial oxygen consumption efficiency affects the production of ATP when the oxygen supply is limited. The resulting sustained ATP supports the function of critical ionic pumps in the cell membrane, which influences the balance of ions like calcium and reduces the buildup of intracellular protons.

️ Physiological Consequence: Cytoprotection and Function

The cumulative effect of enhanced energy efficiency and stabilized ion balance establishes a state of myocardial cytoprotection—a functional mechanism that affects the preservation of cell integrity. This physiological consequence affects the myocardial contractile function under metabolic stress by modulating the destructive effects of ion overload and severe acidosis on the cells.

Dosage and Administration Information

How to Use Metacard MR — Official Administration Guidelines

Metacard MR (Trimetazidine 35 mg Modified-Release) is intended for oral administration as a component of long-term treatment. The usage instructions define a fixed schedule and specific intake conditions to ensure the medicine is applied as studied in clinical practice.


Administration Scope

Rule Category Official Instruction
Route of administration Oral administration only.
Standard Dosing Schedule One 35 mg tablet per dose, leading to a total daily dose of 70 mg.
Frequency and Timing Twice daily (b.i.d.), with one tablet taken during the morning meal and one during the evening meal.
Tablet Integrity The tablet must be swallowed whole and must not be chewed or crushed.
Missed-dose rules If a dose is missed, treatment should be resumed with the next scheduled dose; do not take a double dose to compensate.
Pediatric Use Not recommended for children and adolescents under 18 years of age.

Special Procedural Conditions

Official instructions mandate specific adjustments for certain patient populations, reinforcing the standardized application of the medicine:

  • Renal Impairment: For patients with moderate kidney impairment (Creatinine Clearance 30-60 mL/min), the recommended dose is reduced to one 35 mg tablet once daily, taken in the morning.
  • Treatment Duration: The benefit of the treatment must be formally assessed after three months of use. If a response is not observed after this period, the treatment must be discontinued.

Connection to the Overall Use Protocol

This administration protocol establishes a fixed, twice-daily oral regimen where the integrity of the modified-release formulation is crucial for proper drug delivery. The instructions govern the use of the medicine across different patient states through mandated dose reduction for moderate kidney impairment. This structure culminates in a required three-month review period to confirm the standardized use is meeting its intended treatment purpose.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Metacard MR

This section summarizes the types of studies that have investigated Metacard MR and the patterns observed in the evidence for its main uses. The goal is to provide context about the research, not to offer clinical advice or personal predictions. Findings describe group patterns, not personal outcomes.


Evidence for use in Chronic Stable Angina (Chest Pain Due to Reduced Blood Flow to the Heart)

Metacard MR was studied in research settings involving stable angina, a condition where symptoms may vary in intensity and reflect functional limitations. Research explored patients with this condition, where outcomes related to physical discomfort and outcomes reflecting daily functioning were monitored.

Studies explored outcomes reflecting daily functioning or activity level. Findings describe patterns observed in the studies where research monitored outcomes reflecting daily functioning and patient-reported outcomes describing perceived discomfort. Data show patterns related to how frequently patients reported episodes of discomfort.

The evidence quality varies across studies; comparative evidence is lacking. Follow-up durations were limited in some research exploring short-term symptom changes, meaning long-term effects are not fully established for this condition.


Evidence for use in Meniere’s Disease (Disorder of the Inner Ear Causing Vertigo, Tinnitus, and Hearing Loss)

Metacard MR was evaluated in the context of Meniere’s disease, a condition characterized by fluctuating or episodic manifestations. This research examined temporary physiological imbalance in studies focusing on episodes where symptoms become more noticeable.

Research has explored outcomes describing episodic or acute changes and outcomes related to systemic or functional imbalance. Studies report how symptoms evolved in the observed populations over defined time intervals. Findings help contextualize how symptoms evolved in the observed populations.

Evidence appears to be limited regarding the consistency of findings across different research settings, and sample sizes were modest in some of the studies. Data for certain groups remain insufficient, and more research is needed.


Long-term Studies and Follow-up

Research has also explored patterns of Metacard MR use beyond short-term treatment periods. This evidence contributes to the broader evidence landscape by addressing questions about the duration of observed patterns.

While some observational settings and extended-duration studies are available, there is limited information for long-term outcomes. This section will outline what has been observed regarding longer-term patterns over prolonged time intervals. Currently, long-term effects are not fully established, and research is ongoing.


What is Still Uncertain about Metacard MR

This section clarifies the main areas where more research is needed. Research so far has contributed to a broader evidence landscape, but also shows limitations.

Findings were mixed or inconsistent in some studies, particularly regarding certain outcomes related to systemic or functional imbalance. Comparative evidence is lacking against all alternative options, and follow-up durations were limited across many trials. The research does not determine whether an individual will respond similarly to the group patterns observed, and data are still emerging.

Frequently Asked Questions (FAQ)

Common questions about Metacard MR (FAQ)


Q: What is the difference between Metacard MR and other heart medicines I've seen?

Metacard MR (Trimetazidine) is officially described as a metabolic agent. Official documents describe that it functions by changing how heart cells use energy, primarily to support oxygen efficiency at the cellular level.

Unlike some traditional anti-anginal medications, official product information indicates that the drug's effect is achieved without primarily affecting the heart's rhythm or systemic blood pressure.


Q: How quickly should I expect Metacard MR to start working?

Pharmacokinetic data from regulatory sources show that the medicine typically reaches a stable concentration in the blood within approximately 60 hours of starting treatment.

However, official instructions advise that the therapeutic benefit of the treatment, meaning whether it is helping with symptoms, should be formally assessed by a healthcare professional after three months of use.


Q: How do I know if the Metacard MR is actually working?

Metacard MR is indicated for the symptomatic treatment of stable angina pectoris.

Official instructions require that the benefit of the treatment be formally assessed by a healthcare professional after three months of use to determine its effect on your symptoms.


Q: Is it normal to feel dizzy when first starting Metacard MR?

Official safety documents classify dizziness as a common side effect, meaning it may affect up to 1 in 10 patients. You should be aware of this possibility.

The regulatory information does not specify whether this side effect is more likely to occur when you first start the treatment compared to later use.


Q: Can Metacard MR cause problems with sleep?

Sleep disorders, including both insomnia (difficulty sleeping) and drowsiness (somnolence), are listed as potential effects in the safety information.

However, the frequency of these side effects is officially classified as 'Not Known,' meaning it cannot be reliably estimated from available data.


Q: Is Metacard MR used for anxiety?

No. According to official regulatory documents, Metacard MR is indicated only for the symptomatic treatment of stable angina pectoris in adults.

Anxiety is not listed as one of the approved therapeutic uses for this medicine.


Q: Can Metacard MR be taken on an empty stomach?

Official administration instructions clearly state that the tablet should be taken with meals, specifically during the morning and evening meals.

It should be taken according to this instruction.


Q: Can Metacard MR be split in half if the tablet has a line?

Official administration guidelines state that the Modified-Release tablet should not be crushed, chewed, or split, as this could compromise the drug's specialized sustained-release design and affect how it works.

The tablet must be swallowed whole.


Q: Does Metacard MR affect blood pressure?

Official documents state that the drug’s anti-ischemic effects are achieved without primarily affecting systemic blood pressure.

However, a rapid fall in blood pressure upon standing (orthostatic hypotension) is listed as a rare side effect in the safety profile.


Q: What are the most common reasons a doctor might prescribe Metacard MR?

Metacard MR is officially indicated as an add-on therapy for the symptomatic treatment of stable angina pectoris.

Regulatory documents state that it is indicated for patients whose angina is not adequately controlled by, or who are intolerant to, other first-line antianginal therapies.


Q: Is Metacard MR considered a blood thinner?

No. Metacard MR is classified as an anti-ischemic drug and a metabolic regulator, which supports the heart cell energy.

Its mechanism of action does not involve affecting blood clotting factors or coagulation.


Q: Is Metacard MR the same as Metacard?

Metacard MR refers specifically to the Modified-Release formulation, which is usually a 35 mg tablet.

The active ingredient, Trimetazidine, is also available in an immediate-release formulation (which may be marketed as 'Metacard' or similar), which is a different product with a different dosing schedule.


Q: Are there different strengths of Metacard MR available?

The Modified-Release (MR) tablet strength is typically 35 mg.

However, the active ingredient, Trimetazidine, is also available in different immediate-release (non-MR) strengths, such as a 20 mg tablet.


Q: What research evidence supports the use of Metacard MR for its intended purpose?

Clinical studies reviewed by regulatory bodies have demonstrated the drug’s intended effects.

Research findings describe patterns related to a reduction in the frequency of angina attacks and a decrease in the use of symptomatic nitrate medication, while also monitoring outcomes related to improved exercise tolerance.


Q: Does Metacard MR have any known interactions with herbal teas?

Official safety information states that no drug-drug or food interactions have been reported for Trimetazidine.

This conclusion covers common cardiovascular agents and other co-administered substances.


Q: Is Metacard MR used to prevent heart attacks?

Official warnings state that Metacard MR is not a curative treatment for angina attacks.

It is also specifically not indicated for the initial treatment of unstable angina pectoris or myocardial infarction (heart attack).


Q: What are the possible signs of an overdose of Metacard MR as described in official sources?

Official documents advise that if a patient takes more of the tablet than instructed, they should immediately inform a doctor or pharmacist.

Detailed signs of overdose are generally addressed by official documents for healthcare professionals.


How should Metacard MR be stored and disposed of?

Metacard MR (Trimetazidine dihydrochloride) must be stored strictly according to official regulatory specifications to maintain its stability and effectiveness.

Official Storage Requirements

Condition Requirement
Temperature Store below 30 C and away from heat.
Protection Keep in a dry place; protect from light.
Child Safety Keep out of the sight and reach of children.
Stability Do not use the tablets after the expiry date (EXP) printed on the packaging.

Disposal Instructions

Official disposal guidance mandates that unused or expired Metacard MR must not be discarded via wastewater or household waste. Disposal of any waste material must be carried out in accordance with local requirements for pharmaceutical waste. Individuals should consult a pharmacist for guidance on how to properly dispose of the medicine.

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

Available in countries:

Equivalent of Metacard MR found in:

A-Z Index: