Trimetazidine

What trimetazidine is and how it works

Trimetazidine is an anti-ischaemic metabolic agent used for angina (chest pain from reduced blood flow to the heart). Following a 2012 European Medicines Agency safety and effectiveness review, its use is restricted to add-on symptomatic treatment of stable angina pectoris in adults who remain inadequately controlled by, or who are intolerant of, first-line anti-anginal therapies. (1) (3)

Trimetazidine is not a first-line angina treatment and is not a treatment for an acute angina attack. A currently marketed product is verified only in Spain; it is not an FDA-approved medicine in the United States, and this page does not confirm current availability in the United Kingdom or Australia. Do not assume trimetazidine is available in your country without checking with a local prescriber or pharmacist.

Mechanism of action: how trimetazidine works

Trimetazidine inhibits fatty-acid beta-oxidation and increases glucose oxidation. Further mechanism-of-action detail is not established in the sources reviewed for this dossier. (3) (1)

What trimetazidine is used for

Before taking trimetazidine

Do not take / not appropriate for

• Do not take trimetazidine if you have Parkinson's disease, parkinsonian symptoms (such as tremor, muscle stiffness, or slowed movement), restless legs syndrome, tremors, or another related movement disorder. (all trimetazidine products) (3) (2)
• Do not take trimetazidine if you have severe kidney impairment (creatinine clearance below 30 mL/min). (all trimetazidine products) (3) (2)
• Do not take trimetazidine if you have a known hypersensitivity to trimetazidine or an ingredient of the specific product. (the verified Spanish product (Trimetazidina Davur)) (3)

Tell your clinician about

• Any current diagnosed movement disorder or current movement symptoms (such as tremor, restless legs, or Parkinson's disease).
• Your kidney function, especially if you are older or have moderate kidney impairment, since the dose may need adjustment.
• Your age, since regular review for movement symptoms is recommended, particularly in older adults.
• Every other anti-anginal or heart medicine you take, since trimetazidine is add-on therapy, not a replacement.
• Whether you live in, or are travelling from, a country where trimetazidine is not authorised, so your prescriber can confirm continuity of supply and monitoring.

How to take trimetazidine

• Take trimetazidine exactly as your prescriber has instructed, as an addition to your other prescribed anti-anginal treatment.
• Trimetazidine is not a rescue treatment and must not be used to treat a sudden angina attack; follow your prescriber's guidance and emergency services for any acute chest pain.
• Do not change your dose or stop taking trimetazidine without talking to your prescriber first.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4)

Missed dose

This page does not provide a missed-dose rule for trimetazidine, since it is not established in the sources reviewed. Follow the instructions in your specific product's patient information leaflet, or ask your prescriber or pharmacist.

Overdose

Overdose may cause low blood pressure from reduced peripheral resistance, which is treated symptomatically. If too much trimetazidine may have been taken, contact your prescriber, pharmacist, or a poison-control/emergency service urgently, or attend an emergency department. (3)

Side effects

Effects vary between individuals. The movement-disorder risk described below in Serious warnings is separate from, and more serious than, the common effects listed here.

Serious warnings

Interactions

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Confirm the diagnosis of stable angina and that first-line anti-anginal therapy has been tried or is not tolerated.
• Confirm there is no current diagnosed movement disorder, and check kidney function.
• Confirm the exact country-specific product and formulation, since trimetazidine is not available or authorised everywhere.

During treatment

• Watch for new or worsening movement-disorder symptoms, especially in older adults, and review regularly.

Storage

Store below 30°C in the original container.

Frequently asked questions

References

1. Trimetazidine referral - safety and effectiveness reviewEuropean Medicines Agency · European Union · dated 2012-09-03 · accessed 2026-07-23 · source 1
2. Trimetazidine product information approved by CHMPEuropean Medicines Agency · European Union · dated 2012-06-21 · accessed 2026-07-23 · source 2
3. Trimetazidina Davur 20 mg tablets - official product informationSpanish Agency of Medicines and Medical Devices (AEMPS) · Spain · dated 2026-07-22 · accessed 2026-07-23 · source 3
4. Trimetazidine has never been approved by the U.S. FDA and is not an approved product in the United StatesConvergent secondary clinical/toxicology sources (National Capital Poison Center 'Poison Control' and a peer-reviewed PMC review), used only to corroborate the absence of a US regulatory approval, not as primary evidence of any clinical claim · United States · accessed 2026-07-23 · source 4

Brand names by country

Single-ingredient trimetazidine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries