Trimetazidine

Key facts

• Trimetazidine is an anti-anginal medicine that helps heart muscle cells use oxygen more efficiently. It's used as an add-on treatment for stable angina when other angina medicines aren't enough on their own or aren't tolerated.
• It's taken as tablets, usually twice daily with meals. It does not relieve a sudden angina attack and is not a substitute for your fast-acting nitrate spray or tablets.
• Trimetazidine can cause or worsen parkinsonian symptoms, tremor, restless legs and an unsteady gait. It must not be used by people with Parkinson's disease, and should be stopped if these symptoms appear.
• Seek urgent care for chest pain that doesn't ease with your usual treatment, or for new tremor, muscle rigidity or difficulty walking.

What trimetazidine treats

Trimetazidine treats stable angina pectoris, the chest pain caused by reduced blood flow to the heart during exertion. It is used alongside, not instead of, first-line anti-anginal medicines such as beta-blockers, nitrates or calcium channel blockers.

How trimetazidine works

Heart muscle normally burns fatty acids for energy, a process that needs a lot of oxygen. Trimetazidine shifts the cells' energy production toward burning glucose instead, which needs less oxygen for the same amount of energy. This helps the heart keep working when its blood supply is reduced.

Before you take it

• Do not start trimetazidine if you have Parkinson's disease, tremor, restless legs syndrome, or another movement disorder.
• Tell your prescriber about kidney problems; reduced kidney function raises drug levels and may require a lower dose or avoiding the drug in severe impairment.
• It is not for treating an acute angina attack; keep using your prescribed fast-acting nitrate for sudden chest pain.

Side effects

Common effects include dizziness, headache, and mild stomach upset.

Stop and seek urgent medical care for any of these:

• New tremor, muscle rigidity, or an unsteady walk.
• Fainting or a sudden drop in blood pressure.
• Severe skin rash or swelling of the face, lips or throat.
• Chest pain that does not settle with your usual treatment.

Safety essentials

• Do not take trimetazidine if you have Parkinson's disease. If tremor, rigidity, restless legs or unsteady walking develop while you're on it, stop the medicine and see your doctor; these symptoms usually improve after stopping but can take time to resolve.
• This medicine does not relieve an acute angina attack; always carry and use your fast-acting nitrate for sudden chest pain.
• Kidney function affects how the drug is cleared, so tell your prescriber about any kidney disease before starting and at follow-up reviews.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.