trimetazidine

Trimetazidine is a piperazine derivative classified as a metabolic agent used primarily for the symptomatic treatment of stable angina pectoris in patients who are inadequately controlled or intolerant to first-line therapies. Its mechanism of action involves inhibition of long-chain 3-ketoacyl-CoA thiolase (LC 3-KAT), an enzyme involved in the beta-oxidation pathway of fatty acids. By inhibiting this enzyme, trimetazidine reduces fatty acid oxidation and promotes glucose oxidation—a process that requires less oxygen—thereby optimizing cellular energy production under ischemic conditions such as reduced blood flow to the heart muscle. This helps preserve intracellular ATP levels and maintain cellular homeostasis during episodes of myocardial ischemia. Trimetazidine may also improve mechanical resistance of cardiac cell membranes and restore mitochondrial function after ischemic injury[1][2][5][6]. It is not approved for use in the United States but is widely available in Europe and other regions. Developed and manufactured by Servier.

Brand names

VastarelIdaptanPreductalMetacard MRFlavedon MR

Other names

1-(2,3,4-trimethoxybenzyl)piperazine