Trikat MR is used to treat angina pectoris by protecting heart cells from reduced oxygen supply. It works by inhibiting fatty acid oxidation and increasing glucose oxidation, allowing the heart to function more efficiently during ischemia. The recommended dosage is one 35 mg tablet twice daily with meals. Common side effects include dizziness, headache, and abdominal pain. Trikat MR is contraindicated in patients with movement disorders or severe renal impairment.

1. TRIKAT MR

2. The human heart weighs
less than 1 pound.
However, a man’s heart, on
average, is 2 ounces heavier
than a woman’s heart.

3. Everyday Heart
• Beats 100,000 times
• Pumps 7,000 liters of blood
through the body
• Needs 6 kg of ATP

4. INTRODUCTION
Trikat MR (Trimetazidine Tablets) is used to treat angina pectoris or
chest pain caused by coronary disease in adult patient, in combination
with other medicines. Angina Pectoris is pain arising from the heart
muscle when it does not receive enough oxygen Trikat MR protects the
heart cells from the effects of a reduced oxygen supply during an episode
of angina.

5. EPIDEMIOLOGY OF ANGINA
The prevalence of angina in
community studies increases
sharply with age and sex
0.1-1% in women aged 45-54
10-15% in women aged 65-74

6. EPIDEMIOLOGY OF ANGINA
2 - 5% in men aged 45-54
10 - 20% in men aged 65..
According to an estimate
20,000 — 40,000 individuals in of
the population per million suffer
from angina.

7. Angina pectoris is a syndrome characterized by sudden
severe pressing substernal chest pain or heaviness
radiating to the neck, jaw, back and arms
The primary cause is an imbalance between myocardial
oxygen demand and oxygen supplied by coronary vessels,
due to:
• Decrease in myocardial oxygen delivery
• Increase in myocardial oxygen demand
• Both
WHAT IS ANGINA

8. WHAT IS ANGINA
Angina is not a disease, a symptoms of an underlying heart
problem, normally coronary heart disease (CHD).
There are different types of angina.
•Stable Angina / Angina Pectoris
•Unstable Angina
•Variant (Prinzmetal) Angina

9. WHAT IS ANGINA
Stable Angina / Angina Pectoris
Angina pectoris is the medical term for chest pain
or discomfort due to coronary heart disease. It
occurs when the heart muscle doesn't get as much
blood as it needs.

10. WHAT IS ANGINA
Unstable Angina
Unstable angina or sometimes referred to as acute
coronary syndrome causes unexpected
chest pain, and usually occurs while resting.

11. WHAT IS ANGINA
Variant (Prinzmetal) Angina
Unlike typical angina – which is often triggered by
exertion or emotional stress - Prinzmetal’s angina
almost always occurs when a person is at rest, usually
between midnight and early morning. These attacks
can be very painful.

12. CAUSES OF ANGINA
The major causes of Angina:
High cholesterol levels
High blood pressure
Smoking
Diabetes
Inactivity
Unhealthy diet
Overweight or obesity
Older age (The risk increases for men after 45
years of age and for women after 55 years of
age.)
Family history of heart disease

13. ANGINA TREATMENT GOAL
The goals of treatment in angina pectoris are to relieve the
symptoms, slow the progression of disease, and reduce the
possibility of future events, especially MI and premature
death.

14. ANTIANGINAL AND ANTI-ISCHEMIC THERAPY
• Nitrates
• B-blockers
• Calcium Antagonists
• ACE Inhibitors
• Metabolic Agents

15. NITRATES
Nitrates, increase the flow of blood and oxygen to the heart. While dilation of
the arteries lowers the pressure in the arteries against which the heart must
pump. As a consequence of both effects, the heart works less and requires less
blood and oxygen.

16. BETA-BLOCKERS
Beta blockers primarily block β1 and β2 receptors
and thereby the effects of norepinephrine and
epinephrine. By blocking the effects of
norepinephrine and epinephrine, beta blockers reduce
heart rate, reduce blood pressure by dilating blood
vessels.

17. CALCIUM CHANNEL BLOCKERS
Calcium channel blockers or CCBs reduce the pressure
in the arteries. This makes it easier for the heart to
pump blood, by reducing the heart's need for oxygen,
calcium channel blockers relieve or prevent angina.
Calcium channel blockers decrease the excitability of
heart muscle and are therefore used for treating certain
types of abnormally rapid heart rhythms.

18. ANGIOTENSIN CONVERTING ENZYME INHIBITORS
Angiotensin converting enzyme inhibitors (ACE inhibitors)
are medications that slow (inhibit) the activity of the
enzyme ACE, which decreases the production of
angiotensin II. As a result, blood vessels enlarge or dilate,
and blood pressure is reduced. This lower blood pressure
makes it easier for the heart to pump blood and can improve
the function of a failing heart. In addition, the progression of
kidney disease due to high blood pressure or diabetes is
slowed.

19. METABOLIC AGENT
Maximize the use of oxygen to make more ATP available
Metabolically acting agents protect from ischemia by
increasing glucose metabolism relative to that of fatty
Acids.

20. • Agents like beta blockers , CCBs and nitrates have
their limitations.
• Beta blockers-absolute or relative contraindication
in asthma ,COPD and peripheral vascular disease.
• Nitrates- long term use associated with tolerance
UNMET NEEDS OF THERAPIES

22. Trimetazidine inhibits beta-oxidation of fatty acids by
blocking long-chain 3-ketoacyl-CoA thiolase, which
enhances glucose oxidation. In an ischaemic cell, energy
obtained during glucose oxidation requires less oxygen
consumption than in the beta-oxidation process.
TRIKAT MR
Mode of Action

23. • Lowers fatty acid oxidation, increase glucose & lactate
oxidation
• Selective KAT-3 inhibitor
• Optimize use of oxygen, reduce acidity in tissue, improve
cardiac function & contractility during ischemia while
maintaining cell membrane homeostasis
Mode of Action
TRIKAT MR

24. Glucose oxidation 1 molecule
creates
6.4 molecules of ATP
FFA Oxidation creates only
5.6 ATP Molecules.
TRIKAT MR

25. The recommended adult dose is one tablet
of 35 mg of Trikat MR twice daily during
meals.
Not recommended in children aged below 18 years.
TRIKAT MR
Dosage

26. This medicine is contraindicated in patients with
Parkinson Disease,
Parkinsonian Symptoms,
Tremors, Restless Leg Syndrome, and other related movement
disorders and in cases of
Severe Renal Impairment
TRIKAT MR
Contraindications

27. Common:
Dizziness, Headache, Abdominal Pain, Diarrhea, Indigestion,
Feeling Sick, Vomiting, Rash, Itching, Feeling Of Weakness.
TRIKAT MR
Side Effects

28. TRIKAT MR
Side Effects
Rare:
Fast Or Irregular Heartbeats (Also Called Palpitations), Extra
Heartbeats, Faster Heartbeat, Fall In Blood Pressure On
Standing-up Which Causes Dizziness, Light Headiness Or
Fainting, Malaise (Generally Feeling Unwell), Dizziness, Fall,
Flushing..