Angimed Special Precautions

This medicinal product is not a curative treatment for angina attacks, nor an initial treatment for unstable angina pectoris or myocardial infarction, nor in the pre-hospital phase or during the first days of hospitalization.
In the event of an angina attack, the coronaropathy should be reevaluated and an adaptation of the treatment considered (medicinal treatment and possibly revascularization). This medicinal product can aggravate or cause symptoms similar to those of Parkinson's disease (tremor, difficulty in making movements, rigidity of limbs) which should be investigated and reported to the doctor, especially in elderly patients. In doubtful case, patients should be referred to a neurologist for appropriate investigations. The occurrence of movement disorder such as parkinsonian symptoms, restless leg syndrome, tremors, gait instability should lead to definitive withdrawal of trimetazidine hydrochloride. These cases have a low incidence and are usually reversible after treatment discontinuation. The majority of the patients recovered within months after trimetazidine hydrochloride withdrawal. If parkinsonian symptoms persist more than 4 months after drug discontinuation, a neurologist's opinion should be sought.
Falls may occur following a drop in blood pressure or a loss of balance, in particular in patients taking antihypertensive treatment. Caution should be exercised in patients with moderate renal impairment and elderly (>75 years old).