Meldonium

Meldonium (INN; trade name Mildronate, among others) is a pharmaceutical developed in 1970 by Ivars Kalviņš at the USSR Latvia Institute of Organic Synthesis. It is now manufactured by the Latvian pharmaceutical company Grindeks and various generic producers. Primarily distributed in Eastern Europe, meldonium is used as an anti-ischemia medication. Meldonium is prescribed for cardiovascular, neurological, and metabolic conditions due to its anti-ischaemic and cardioprotective effects, achieved by inhibiting β-oxidation and activating glycolysis. Athletes have used meldonium to enhance recovery and (controversially) performance, though these claims lack robust scientific support. Since 1 January 2016, meldonium has been listed as a banned substance by the World Anti-Doping Agency (WADA). It functions as a metabolic modulator, altering enzymatic reactions in the body. While some athletes, including Maria Sharapova, used meldonium before its ban, its effectiveness as a performance enhancer remains controversial. Numerous athletes have since been suspended or disqualified for its use.