What question did this study set out to answer?

This analysis aims to identify drug-drug interactions involving Mexidol in patients suffering from ischemic stroke.

April 17, 2026

Drug-drug interactions with Mexidol in patients with ischemic stroke: Analysis of data from randomized clinical trials

Key Result

Mexidol showed no statistically significant change in adverse events (p>0.05) when co-administered with standard therapies in 454 patients with ischemic stroke.

Key Points

This analysis aims to identify drug-drug interactions involving Mexidol in patients suffering from ischemic stroke.
Data from randomized controlled clinical trials (RCTs) were analyzed.
Participants included 304 from RCT MIR and 150 from RCT EPICA.
Common medication classes were identified, such as antihypertensives, antiplatelets, and lipid-lowering drugs.
Drug interaction models were analyzed for frequency of adverse events.
No significant drug interactions were found with Mexidol and concomitant therapies (p>0.05).
High rates of antihypertensive (94.1% in MIR, 98.0% in EPICA) and antiplatelet drug use (90.1% in MIR, 94.0% in EPICA) were observed.
Mexidol showed high safety and tolerability despite concurrent medication.

Structured PICO

Does Mexidol have significant drug-drug interactions with concomitant therapies in patients with ischemic stroke?

Population

454 patients with ischemic stroke from two randomized controlled clinical trials (304 from MIR RCT and 150 from EPICA RCT).

Intervention

Mexidol administered with concomitant medications (antihypertensives, antiplatelets, lipid-lowering drugs, electrolyte solutions, anticoagulants)

Outcome

Frequency of adverse events (drug-drug interactions)safety

Mexidol demonstrates high safety and good tolerability without significant drug-drug interactions when used with standard concomitant therapies in patients with ischemic stroke.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Objective. Identification of drug-drug interaction of Mexidol when used in patients with ischemic stroke. Material and methods. The data from randomized controlled clinical trials (RCTs) of the efficacy and safety of Mexidol, EPICA and MIR, in patients with ischemic stroke were analyzed. Results. The analysis included data from 304 participants of RCT MIR and 150 participants of RCT EPICA. In both studies, antihypertensive drugs were most often used as concomitant therapy (94.1% of participants in the MIR RCT and 98.0% of EPIC RCT). In patients receiving Mexidol, antihypertensive drugs with INN were more often prescribed: enalapril (24.0%), bisoprolol (16.7%), amlodipine (11.8%), lisinopril (8.4%), indapamide (7.9%). In addition to antihypertensive drugs, almost all participants in RCTS MIR and EPIC received antiplatelet drugs (90.1% and 94.0% respectively), lipid-lowering drugs (78.0% and 78.7% respectively) and electrolyte solutions (77.3% and 75.3% respectively). Anticoagulants were prescribed in 24.0% of participants in the MIR RCT and in 34.0% of participants in the EPIC RCT. Analysis of drug interaction models, taking into account the total number of adverse events and the systemic organ class to which they belong, did not reveal a statistically significant change in the frequency of adverse events in patients receiving concomitant therapy along with Mexidol (p>0.05 in all comparison pairs). Conclusion. The analysis did not reveal drug interactions when using Mexidol and all types of concomitant therapy in patients with ischemic stroke. This study confirmed the high safety and good tolerability when using Mexidol in patients receiving multiple medications at the same time.

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