PeptideCompareEmoxypine succinate (Mexidol) — EU research guide.
Emoxypine succinate, sold in Russia as the prescription medicine Mexidol, is a 3-hydroxypyridine antioxidant used mainly for cerebral circulation disorders. Clinical evidence is mostly Russian and CIS, with no independent international replication.
What is Emoxypine succinate (Mexidol)?
Three related names are easily confused. 'Emoxypine' is the free base, 2-ethyl-6-methyl-3-hydroxypyridine. 'Emoxipin' is the Russian product name for the hydrochloride salt, sold as eye drops and reportedly also listed as a solution for injection. 'Emoxypine succinate' is the succinate salt, sold in Russia as the prescription medicine Mexidol (ethylmethylhydroxypyridine succinate); this is the substance research vendors usually mean. It was developed in Russia as an antioxidant (ATC N07XX in the Mexidol label). Proposed actions are membrane-protective and antioxidant effects plus a role for the succinate part in cell energy metabolism, resting largely on Russian and animal work. The formula, weight and CAS shown are for the succinate salt, from a supplier catalogue. A vendor research vial is not the licensed Mexidol product.
What does the research show?
Clinical evidence is mostly Russian and largely in ischemic stroke. EPICA (2017) was a randomised, double-blind, placebo-controlled study of 150 patients aged 40-79 with hemispheric ischemic stroke, with about 10 weeks of treatment: the modified Rankin Scale at the end was lower with Mexidol (p=0.04), NIHSS at visit 5 was lower (p=0.035) and adverse events did not differ significantly between groups. The larger multicentre MIR trial (2025) randomised 304 patients at 13 centres in Russia, Uzbekistan and Kazakhstan: mRS change p=0.003, NIHSS p<0.001, and adverse events in 35 patients (23%) in each arm. A 2024 meta-analysis of 10 mostly small trials in patients with chronic cerebral ischemia / cognitive impairment (per the research file; the paper's title refers to mild to moderate cognitive impairment) found a MoCA gain of 2.06 points (95% CI 0.98 to 3.14; p=0.0002) over baseline therapy. Anxiety, ADHD and alcohol-withdrawal uses appear on the Russian label, but trials for them were not verified. No independent replication outside Russia and neighbouring countries was found, and sponsor involvement was not verified.
EU legal status
No EU-authorised medicine containing emoxypine or Mexidol was found: no EMA EPAR or centrally authorised product was located and national registers were not searched exhaustively, so this is unverified. In Russia, Mexidol is a prescription medicine (registered 30 October 2020, unlimited validity) and is on the Essential and Vital Medicines list; the hydrochloride (Emoxipin eye drops) is registered separately. Emoxypine was not found in a copy of the 2026 WADA Prohibited List; this was read with a page-reading tool, not by a manual search. No controlled-substance scheduling was found.
Molecular information
Pharmacokinetics
Potency retained over time
Each line is one storage condition: it starts at 100% and falls as potency is lost. Above the dashed 80% line the material is considered reliable — hover for exact values.
⚠ A structural estimate, derived from each compound's sequence length, cyclisation and oxidation-, deamidation- and light-sensitive residues. Indicative only — not lab-measured per batch.
Emoxypine succinate (Mexidol) across EU suppliers
COA-verified EU vendors · Updated monthly
References
- EPICA trial (Russian-language paper): 150 patients, randomised double-blind placebo-controlled, favourable mRS and NIHSS results and comparable safety; only p-values are quoted because sources conflicted on the share of patients reaching mRS 0-2. Stakhovskaya LV, Shamalov NA, Khasanova DR, Melnikova EV, Agafina AS, Golikov KV, et al. Results of a randomized double blind multicenter placebo-controlled, in parallel groups trial of the efficacy and safety of prolonged sequential therapy with mexidol in the acute and early recovery stages of hemispheric ischemic stroke (EPICA). Zh Nevrol Psikhiatr Im S S Korsakova 2017;117(3-2):55-65. DOIPubMed 28665371
- English translation of EPICA: mRS p=0.04, NIHSS at visit 5 p=0.035, no significant difference in adverse events. Stakhovskaya LV, Shamalov NA, Khasanova DR, et al. Results of a randomized, double-blind, multicenter, placebo-controlled, parallel-group study of the efficacy and safety of Mexidol in prolonged sequential therapy of patients in the acute and early recovery stages of hemispheric stroke (the EPICA study). Neurosci Behav Physiol 2018;48(8):929-938. DOI
- MIR trial: 304 patients randomised in Russia, Uzbekistan and Kazakhstan; mRS p=0.003, NIHSS p<0.001, adverse events 23% vs 23%. Read on the manufacturer's evidence page, not on PubMed. Shamalov NA, Fedin AI, Rakhimbayeva GS, Nurguzhaev ES, Khasanova DR, et al. Results of an international multicenter, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of sequential therapy with ethylmethylhydroxypyridine succinate in patients in the acute and early recovery periods of ischemic stroke (MIR). Zh Nevrol Psikhiatr Im S S Korsakova 2025;125(8, issue 2):40-53. Source
- Meta-analysis of 10 trials in chronic cerebral ischemia / cognitive impairment (482 vs 455 patients): MoCA effect size 2.06 (95% CI 0.98 to 3.14; p=0.0002). Zakharov VV, Vakhnina NV. The use of Mexidol in patients with mild (moderate) cognitive impairment: results of a meta-analysis. Neurosci Behav Physiol 2024;54:612-616. DOI
- Manufacturer's instructions and Vidal monograph: Russian registration, indications, contraindications, adverse reactions, human pharmacokinetics (half-life 2.0 to 2.6 hours) and storage. Mexidol (ethylmethylhydroxypyridine succinate) tablets: instructions for medical use and Vidal drug monograph. FARMASOFT NPK LLC, Russia (registration LP-(000086)-(RG-RU), 30.10.2020). Source