From the Guidelines
Trimetazidine is associated with minor headaches as a side effect, according to the most recent and highest quality evidence. This is based on a study published in Nature Reviews Cardiology in 2018, which states that treatment-related adverse effects of trimetazidine are mild and well-tolerated, mostly comprising gastrointestinal disturbances such as nausea, vomiting, and minor headaches 1.
Key Points to Consider
- Trimetazidine is a metabolic modulator that improves the metabolic efficiency of ischaemic myocytes, and its antianginal effects have been confirmed in clinical settings 1.
- The medication is generally well-tolerated, but it is not recommended in patients with Parkinson disease, parkinsonism, and other related movement disorders, or in patients with severe renal impairment (creatinine clearance <30 ml/min) 1.
- If headaches persist or are severe, it is essential to consult a healthcare provider for guidance on adjusting medication dosage, timing, or recommending a different treatment approach.
Important Considerations for Patients
- Patients experiencing headaches while taking trimetazidine should not self-medicate, but instead consult their healthcare provider for proper evaluation and guidance.
- Acetaminophen (Tylenol) may be a safer option for headache relief than NSAIDs like ibuprofen, especially for patients with heart conditions, but this should be confirmed with a doctor.
- It is crucial to follow medical guidance when taking trimetazidine, especially if combined with other medications like ISMN (isosorbide mononitrate), to minimize potential side effects and ensure optimal treatment outcomes.
From the FDA Drug Label
ADVERSE REACTIONS ... Headache 15% (0%) 38% (5%) 51% (8%) 42% (5%) 57% (8%) ... Since headache appears to be a dose-related adverse effect and tends to disappear with continued treatment, it is recommended that ISMN treatment be initiated at low doses for several days before being increased to desired levels.
The drug Trimetazidine (Ismn) is not mentioned in the provided text, instead Isosorbide mononitrate is discussed. However, based on the information provided for Isosorbide mononitrate, it can be inferred that Ismn might be associated with headaches if it is indeed Isosorbide mononitrate.
- Headache is a common adverse event, with frequencies ranging from 15% to 57% in the studied doses.
- Headache is described as a dose-related adverse effect.
- It is recommended to initiate treatment at low doses to minimize the occurrence of headache 2.
From the Research
Association of Trimetazidine with Headaches
- There are no direct studies provided that investigate the association of Trimetazidine (Ismn) with headaches.
- However, studies 3, 4 discuss the occurrence of headaches in patients with stable angina pectoris treated with isosorbide-5-mononitrate (5-ISMN), which is related to but not the same as Trimetazidine.
- These studies found that starting on a low dosage of 5-ISMN was associated with reduced frequency and severity of headache 3, 4.
- Other studies 5, 6, 7 focus on the effectiveness and tolerability of Trimetazidine and isosorbide mononitrate in patients with stable angina pectoris, but do not specifically address the association with headaches.
- Study 7 mentions that headache was the only adverse effect observed in some patients, but this was in the context of isosorbide mononitrate treatment, not Trimetazidine.
Adverse Effects of Related Treatments
- Headache was reported as an adverse effect in some patients treated with isosorbide mononitrate 7.
- Studies on Trimetazidine 5, 6 report that adverse effects are mild and infrequent, but do not specifically mention headaches.
- The provided studies do not offer conclusive evidence on the association between Trimetazidine and headaches, as they either focus on related treatments or do not address the topic directly 3, 4, 5, 6, 7.