Question-answer

How to take Mexidol® to ensure maximizing the therapeutic effect: injections of 5-10 ml per day for 14 days, with the subsequent transition to the tablet form Mexidol® 250 to 250 mg 3 times a day for 2 months.
The frequency of consistent therapy is 2-3 courses per year.

Mexidol® has a multimodal effect. Mexidol® consists of two related and functionally significant compounds: 2-ethyl-6-methyl-3-hydroxypyridine and succinate. This combination determines the multimodal properties and a wide range of pharmacological effects of the drug. Mexidol® is quickly absorbed from the gastrointestinal tract and with a blood flow enters organs and tissue, primarily to the brain. Once in the nerve cells of the brain, Mexidol® is concentrated in mitochondria (cellular “power plants”), where it realizes its pharmacological activity. The presence in the preparation of Mexidol® salt of amber acid (succinate) stimulates the formation of ATP molecules in the mitochondria (energy sources for processes in the body). Mexidol® stimulates the process of energy formation, prevents the development of acidification of the intracellular environment, which retains the functioning of neurons. Succinate stimulates tissue respiration, in conditions of a lack of oxygen, activating the Crebs cycle (a set of sequential reactions of the transformation of pyrovinoscular acid with the formation of energy sources for the cell) and, thus, increases the content of ATP and creative phosphate. The pyridine base and succinate in the molecule of the drug Mexidol® provide neutralization of free radicals and stimulate the cellular system of protection against them. They also provide stabilization of cell membranes. All this prevents the damage to cells and their death. Thus, Mexidol® increases the resistance of cells and tissues to hypoxia and oxidative stress. The main pharmacological effects of the drug include antioxidant, antihyplance and membrane -stabilizing, thanks to which such clinical effects as nootropic, anxiolytic, anti -amnestic and others are realized.

Mexidol® (ethylmethylhydroxypyridine succinate) includes the main document of the regulatory framework-clinical recommendations “ischemic stroke and transient ischemic attack in adults” (2021) with the highest level of persuasiveness of recommendations among neuroprotectors-A. The full text of the relevant recommendations is posted on the website of the Ministry of Health of the Russian Federation . Mexidol® (ethylmethylhydroxypyridine succinate) is also included in the standard of ambulance in acute cerebrovascular accident (Order of the Ministry of Health of No. 466N dated 05.07.2016), to the standard for the provision of specialized medical care for cerebral infarction (Order of MZ No. 1740N dated December 29, 2012).

Mexidol® has been successfully used in clinical practice for more than 25 years and has many studies confirming its effectiveness and high security profile. Including studies were conducted in children over 6 years old and the elderly older than 75 years. Of the last large randomized controlled studies, the following can be distinguished: Epica (ischemic stroke), memo (chronic brain ischemia), mega (ADHD, children over 6 years old). Read more with them on this site or on a professional resource Pubmed. Also at the moment, the study of the world (ischemic stroke) is being carried out, the results of which will be published next year. We offer you to watch the video “Mexol®. Evidence medicine: just about the complex ”in the section of the site“ Expert Opinion ”.

Mexidol® 125 mg tablets is the only drug containing ethylmethydlhydroxypyrididine of succinate, allowed for use in children from 6 years of age with syndrome of attention deficiency and hyperactivity (ADHD). Mexidol® children are prescribed to increase concentration, perseverance, reduce signs of hyperactivity and impulsiveness.

Mexidol® combines with all drugs used to treat somatic diseases. The combination of Mexidol® with anxiolytics, antipsychotics, antidepressants, sleeping pills, antiepileptic, antiparkinsonic, and sedatives enhances their effect. This allows you to reduce the doses of these drugs and reduce side effects. Mexidol® enhances the effect of antihypertensive agents, increases the antianginal activity of nitrates and nitrate -like products. Mexidol® increases the resistance of the body with alcohol poisoning and antipsychotics, reduces the toxic effect of ethanol.

The duration of the course of treatment depends on the form and severity of the disease, the prevalence of the process, options for the clinical course and is determined by the attending physician. In order to fully disclose the therapeutic potential of the drug for patients over 18 years, long -term consistent therapy is recommended: V/V or V/M injections for 14 days at a dose of 200-500 mg 1 time per day with the subsequent transition to tablet forms of Mexidol® 125 mg. Or Mexidol® Fort 250 mg on 1 tablet/day for 2 months. It is constantly not necessary to use Mexidol®, the duration of the course should not exceed the recommended by the attending physician.

Mexidol® is an introduction intravenously. According to the instructions for medical use, the introduction of an intravenous drug Mexidol® occurs in a bravely slowly within 5-7 minutes. Intravenously drip - at a speed of 40-60 drops per minute. The administered doses depend on the form, severity and course of the disease.

How to breed Mexidol® for intravenous administration will tell you the instructions. According to it, a solution for intravenous administration of 50 mg/ml with an infusion method of administration should be diluted in a 0.9 % sodium chloride solution.

To maintain the qualities of the drug, proper storage is important. How to store Mexidol®: Keep the drug inaccessible to children, a place protected from light at a temperature of not higher than 25 ° C. Do not use the drug after expiration of the expiration date. The date of expiration date is the last day of the month indicated on the package. It is not recommended to store and subsequently use the open ampoule of the Mexidol® injection solution - this is unsafe.

Mexidol® has different output forms. Mexidol® and Mexidol® Forte preparations are the difference: Mexidol® Forte 250 is a unique drug dosage - 250 mg in one tablet. The usual Mexidol® is 125 mg of the active substance of ethylmethylhydroxypyridine succinate in one tablet. The main task of Mexidol® Fort 250 is to simplify the pharmacotherapy mode of patients and replace 2 tablets of 125 mg per 250 mg. Given the fact that Mexidol® has a pronounced dose -dependent effect (with an increase in dosage, the effectiveness of therapy increases, while the safety profile remains unchanged), Mexidol® Forte is a new basic dosage in the arsenal of doctors with acute and chronic diseases caused by ischemia and hypoxia of various genesis.

Eating does not affect the effectiveness of Mexidol®. You can take Mexidol® before or after meals. The main thing is not to forget about the recommended rate of administration - 3 times a day, according to the instructions for the medical use of the drug Mexidol®.

Mexidol® is an original drug, it is also called reference ¹⁵ . This term means such a drug that was first registered and allowed for use. Subsequently, the reference drug acts as a standard in studies of bioequivalence and therapeutic equivalence when registering reproduced drugs (generics).

Generic is a drug that contains an active substance identical to the original drug, but differing in production technologies, auxiliary components, dosages. To enter the market, a generic manufacturer does not conduct a full cycle of clinical trials and can sell generic after the patent protection of the original drug. Unlike generic, the original drug is the drug whose effectiveness and safety have been proven in preclinical and clinical studies. To go to the Russian market, the manufacturer of the drug is enough to conduct a study of bioequivalenia on healthy volunteers, and, deviations from the standard (original brand) are allowed very significant: from minus 20 % to plus 25 %, which cannot be compared with taking the drug in the conditions of pathology due to pathology decreased metabolism, severity and course of the disease. The advantage of original drugs is to pass the full phase of research confirming their effectiveness and safety.

Mexidol® is included in the ZhNVLP for 2024 (on the approval of the list of vital and most important drugs in 2024), the order of the Government of the Russian Federation of 10.10.2019 N 2406-r (as amended on 23.12.2023).

^* GUNLP is a list of vital and most important drugs.

Mexidol® after a stroke: in order to completely disclose the therapeutic potential of the drug, consistent long -term therapy with Mexidol (randomized clinical examination of Epic, 2017) : first injections of 500 mg/day for 14 days (saturation phase), with the subsequent transition to tablets 250 MG 3 times a day for 2 months (phase of maximization of the therapeutic effect). To consolidate the effect and prevent re -stroke, therapy courses are recommended 2-3 times a year.

The drug Mexidol® is available in two forms: injection and tablet. This allows for consistent therapy - to begin treatment with a solution, which can be administered both intravenously and intramuscularly (phase of saturation of the therapeutic effect), and continue treatment with tablets (phase of maximization of the therapeutic effect). With this approach, the therapeutic potential of the drug is fully revealed and the effectiveness of therapy with Mexidol is significantly increased.

The high security profile of Mexidol has been repeatedly confirmed in clinical research. So, according to the results of subanalysis of RCT MEMO in age populations, the effectiveness of Mexidol is comparable in all age populations, and safety is comparable to placebo, including in the population of patients over 75 years old - that group in which adverse adverse reactions of drug therapy are most often developed. Thus, Mexidol therapy is effective and safe in patients of various age groups, including patients over 75 years old.

Mexidol® proved its effectiveness in the treatment of patients with cognitive disorders, including after Covid-19. According to the results of a prospective comparative open study in the conditions of the Red Zone (2021), consistent therapy with Mexidol® (10 ml/day, 14 days) and Mexidol® Forte 250 (250 mg 3 r/day, 2 months) It contributes to a reliable improvement and normalization of cognitive functions to the end of therapy: +5.2 points on the Mosa scale with a total score 26, corresponding to the norm. At the same time, in the control group, the increase in the average point on the MOCA scale is +1.1 points, and the total score is 23, which corresponds to cognitive violations. Also, against the background of the use of Mexidol, sleep normalizes, the severity of asthenic manifestations decreases, which leads to an improvement in the quality of life. To obtain more information, we also offer you to familiarize yourself with the article prof. Kovalchuk V.V.

According to the instructions for medical use, Mexidol® combines with all drugs used to treat somatic diseases. Moreover, Mexidol® has an additional stress-prototive effect, which will positively affect the condition of an alarming patient. Mexidol® enhances the effect of anxiolytics, which allows them to reduce their doses and reduce side effects. In order to completely disclose the therapeutic potential of the drug Mexidol®, consistent therapy is recommended: 14 days of injection (saturation phase), followed by switching to a tablet form from 6 weeks (phase of maximizing the therapeutic effect), repeated courses 2-3 times a year or during exacerbations.

In order to completely disclose the therapeutic potential of the drug Mexidol®, a consistent course of therapy is recommended: first the injection course is 14 days, followed by the transition to tablet forms - 8 weeks.

Recall that one of the frequent consequences of a viral infection is post -infectious asthenia. The causes of post -infectious asthenia are tissue hypoxia and metabolic acidosis arising from viral intoxication with a further violation of the processes of formation and consumption of cellular energy, which leads to the development of oxidative stress. Mexidol® effectively replenishes the energy deficiency necessary for the normal life of the body, while not causing drowsiness and does not have a muscle relaxant effect.

Cardiological indications are contained in the instructions for the medical use of the drug Mexidol®: coronary heart disease as part of complex therapy (tablets) and acute myocardial infarction as part of complex therapy (solution). The effectiveness and safety of the drug Mexidol® in therapy of chronic heart failure (CHF) has also been proven. According to the results of the latest randomized in parallel groups of cardiological research by V.V. Tolkacheva et al. Mexidol® in cardiology showed high efficiency in patients with XN II - III functional class (and coronary heart disease) as part of complex therapy. A significant improvement in the cognitive status of patients on the MOCA scale (+21 %), improvement of the health profile by the EQ-5D-5L questionnaire (a reliable improvement of mobility indicators, daily activities, reducing pain/discomfort by 34 %, as well as improving well-being by 25 %has been noted. Compared to the source indicators). In addition, this study showed the positive effect of Mexidol® on the quality of life-a reliable improvement in the Minnesotsky (MLHFQ) and KCCQ (KCCQ) questionnaires and the SF-36 questionnaire. In patients receiving Mexidol®, a reliable regression of the severity of asthenic manifestations (on the MFI-20 “-12 %” scale) and a significant decrease in the level of anxiety (on the Bek scale “-38 %”) were also noted. During the study of undesirable and serious undesirable phenomena, the Mexidol® was not registered with the use of the drug. Thus, prolonged sequential therapy with Mexidol® when adding to standard therapy in patients with XN II - III FC (according to NYHA) with moderate disorders of cognitive status, significantly improves cognitive functions, quality parameters, reduces the severity of asthenic syndrome and anxiety level. Mexidol® demonstrated high performance and safety indicators in the treatment of patients with a cardiological profile.

Of all cardiovascular diseases, it is arterial hypertension that is most closely associated with damage to the brain of vascular genesis: the development of a stroke, chronic brain ischemia and cognitive disorders (KN). According to the laboratory of epidemiology and the prevention of diseases of the scientific center of neurology of the Russian Academy of Sciences, where they studied the state of cognitive functions in middle-aged patients and “uncomplicated” arterial hypertension of the 1–2th degree of increase in blood pressure (without suffered strokes, heart attacks, without atherosclerotic narrowing of the main vessels of more than 30 %, without arrhythmia and diabetes), cognitive disorders were detected in 74 % of the examined. The results of subanalysis of the study of memo (studying the effect of consistent therapy with Mexidol® and Mexidol® 250 Fortes on cognitive status, the severity of asthenia, anxiety, autonomic, motor disorders and the quality of life in patients with arterial hypertension (hypertension) give reason Consider the prolonged consistent use of Mexidol® and Mexidol® Fort 250 in the complex treatment of patients with hypertension and KN against the background of Khim as effective protection of the brain as an organ-canal and means of comprehensive therapy of cognitive, emotional, asthenic, vegetative and motor disorders (Zakharov V.V., Ostroumova O. D., Kochetkov A. I., Klepikova M.V., Fedin A. I. International multicenteric randomized double-blind, placbox-controlled study of the evaluation of the effectiveness and safety of consistent therapy of patients with chronic brain isidol preparations ® and Mexidol® Fort 250 (Study of Memo): Subanalysis results in patients with arterial hypertension. Journal of therapy. 2023; 9 (1): 145–159) . We offer you to watch the video “Mexidol® for arterial hypertension (AH). AG and cognitive disorders, effective correction methods .

According to the instructions for medical use/OKLP, Mexidol®/Mexidol® Fort 250 is combined with all drugs for the treatment of somatic diseases. In particular, in patients with coronary ischemic heart disease and type 2 diabetes, the addition of mexidol to basic therapy (statins, nitrates, etc. Medicines) led to a significant increase in the effectiveness of coronary heart disease: the frequency of acute myocardial infarction decreased by 3.1 times, 3.1 times, unstable angina pectoris - 1.5 times, hospitalization - 2.7 times, and the deadlines for patients in the hospital were also reduced. You can familiarize yourself with information on the combination of the drug Mexidol® with other drugs in the article on the link below: https://mexidol.ru/news/2019/statya-kombinirovannoe-primenenie-s-izvestnymi-lekarstvennymi- Sredstvami

Mexidol ^® in ophthalmology is successfully used for many years, the indication of the primary open -angle glaucoma (as part of complex therapy) is present in the instructions for the medical use of Mexidol (solution). According to the OKLP information, Mexidol ^® helps to preserve ganglion cells of the retina and optic nerve fibers with progressive neuropathy, the causes of which are chronic ischemia and hypoxia. Improves the functional activity of the retina and optic nerve, increasing visual acuity.

In 2024, Mexidol ^® (ethylmethylhydroxypyridine succinate) was included in the clinical recommendations of Glaucom Glaucoma Primary open -angle (URU A, UDD 1) and primary glacoma glacome (Uur C, UDD 5).

According to the study of E. A. Egorov et al., The use of Mexidol ^® as part of the complex therapy of patients with primary open -angle glaucoma of the I - III stages leads to an increase in visual acuity (according to visionometry without correction in patients with II and III stage of glaucoma , visionometry with correction - with the I - II stage of glaucoma), a decrease in an increased threshold of electrical sensitivity, an increase in the reduced electrical lability of the optic nerve in patients with the I - II and III stage of glaucoma. Also confirmed good tolerance and high safety profile of the drug ¹³ . Mexidol ^® (ethylmethylhydroxypyridine succinate) is included in the National Glaucomic Guide for practitioners (edited by Egorova E.A., 4th ed.).

Мексидол® в психиатрии с успехом применяется не одно десятилетие, в инструкции по медицинскому применению присутствуют следующие показания: тревожные расстройства при невротических и неврозоподобных состояниях, купирование абстинентного синдрома при алкоголизме с преобладанием неврозоподобных и вегетативно-сосудистых расстройств, постабстинентные расстройства, острая интоксикация антипсихотическими средствами.

The main clinical effects of Mexidol with alcoholic withdrawal syndrome are as follows: nootropic, detoxification, anti -aircraft, vegetostabilizing, anticonvulsant. More detailed information is presented in the video prof. Kurasova E. S.: Https://mexidol.ru/ekspertnoe-mnenie-video/mnenie-spetsialistov/kurasov-es-primenenie-meksidola-pri-lkogolnom-bstinentnom-sindrome-pochomele

Mexidol® is allowed in children from 6 years of age and is successfully used in therapy of small patients with hyperactivity, impaired attention, impulsivity and ADHD (attention deficiency syndrome). The application scheme according to the instructions for medical use: 125 mg 2 r/day for 6 weeks. This scheme based on the results of RCT MEGA (2021) demonstrated high efficiency and safety.