Meldonium

In March 2016, Meldonium rose to notoriety when five-time tennis grand slam winner Maria Sharapova announced that she had failed a drugs test following use of the substance. Meldonium (also known as mildronate) originated in Latvia and was originally produced for use as an animal growth promoting agent in the late 1970s (1,2).

When applied in human clinical trials it was observed that its’ beneficial effects are anti-ischemic; meaning that it can allow a greater amount of blood to flow through the vessels to supply the body’s organs and tissues. The types of conditions that this substance can help with include; neurodegenerative disorders, immunomodulator and bronchopulmonary diseases, (3,4) in particular it can help with chronic heart disease, angina and has been used to treat stroke victims.

This substance is banned in several countries including the UK, USA and Australia. Meldonium was added to the WADA prohibited list on January 1st 2016 after being on the WADA monitoring list in 2015, citing that it was due to its performance enhancing abilities.

In sport it has been found that the benefits of this substance include increased working capacity, increased endurance capacity and protection against stress. It has been noted that many athletes have used it in the past before it was banned by WADA (5,6).

There are several athletes that have been banned from their respective sport since WADA added it to their prohibited list, they include:

• Abebe Aregawi (1,500m world champion)
• Endeshaw Negesse (2015 marathon champion)
• Olga Abramova & Artem Tyschenko (Biathletes)
• Eduard Vorganov (cyclist)
• Ekaterina Bobrova (ice dancer)
• Maria Sharapova (Tennis player)

1 – S. Aronovich, A. Vasilevich, I. Yanovich, V. Gavrilovna, E. Amilovich, Y. Yanovich. 3-(2,2,2-Trimethylhydrazine) propionate, method of obtaining it and use //. World Patent No. 80/01068 [29 May 1980].

2 – S.A. Hiller, A.V. Jeremeev, I. Kalvinsh, V.G. Semenihina, E.E. Liepinsh, Y. Y. Latvietis, A.A. Anderson, E.B. Astapenok, Y.Y. Spruzh, P. T. Trapentsier, P.I. Podoprigora. Le 3-(triméthyl-2,2,2-hydrazinium)-3 propionate, procédé de préparation et application. Belgian Patent No. 880831 (1980).

3 – B. Z. Simkhovich, Z. V. Shutenko, D. V. Meirena, K. B. Khagi, R. J. Mezapuķe, T. N. Molodchina, I. J. Kalviņs, E. Lukevics. 3-(2,2,2- trimethylhydrazinium) propionate (THP): A novel gammabutyrobetaine hydroxylase inhibitor with cardioprotective properties. Biochem. Pharmacol. 1988, 37, 195.

4 – N. Sjakste, I. Kalvinsh. Mildronate: An Antiischemic drug with multiple indications. Pharmacologyonline. 2006, 1, 1.

5 – Suzic Lazic, J., Dikic, N., Radivojevic, N., Mazic, S., Radovanovic, D., Mitrovic, N., … & Suzic, S. (2011). Dietary supplements and medications in elite sport–polypharmacy or real need?. Scandinavian journal of medicine & science in sports, 21(2), 260-267.

6 – Görgens, C., Guddat, S., Dib, J., Geyer, H., Schänzer, W., & Thevis, M. (2015). Mildronate (Meldonium) in professional sports–monitoring doping control urine samples using hydrophilic interaction liquid chromatography–high resolution/high accuracy mass spectrometry. Drug testing and analysis,7(11-12), 973-979.