Meldonium, trade-named as Mildronate among others, is a limited-market pharmaceutical, developed in 1970 by Ivars Kalvinsh at the USSR Latvia Institute of Organic Synthesis, and now manufactured by the Latvian pharmaceutical company Grindeks and several generic manufacturers. It is primarily distributed in Eastern European countries as an anti-ischemia medication. 

Mildronate is a structural analogue of gamma-butyrobetaine, a substance contained in every cell of the human body. Mildronate restores the balance between oxygen supply and demand in cells, and removes toxic metabolic products accumulated in cells protecting them from damage. It also possesses an invigorating stimulant effect. Oxygen delivery and utilization by both muscle & brain cells is enhanced. 

Meldonium, trade-named as Mildronate among others, is a limited-market pharmaceutical, developed in 1970 by Ivars Kalvinsh at the USSR Latvia Institute of Organic Synthesis, and now manufactured by the Latvian pharmaceutical company Grindeks and OlainFarm. It is primarily distributed in Eastern European countries as an anti-ischemia medication. 

Mildronate is a structural analogue of gamma-butyrobetaine, a substance contained in every cell of the human body. Mildronate restores the balance between oxygen supply and demand in cells, and removes toxic metabolic products accumulated in cells protecting them from damage. It also possesses an invigorating stimulant effect. Oxygen delivery and utilization by both muscle & brain cells is enhanced. 

Meldonium shifts the metabolism, so that it is geared more towards carbohydrate metabolism than fat metabolism. Using carbohydrate as a fuel requires less oxygen to produce energy, so this change can be beneficial in low oxygen conditions. In heart disease, the heart muscle is deprived of oxygen, and the effects of meldonium have been shown to be very beneficial in this disease state. There is also evidence to suggest that meldonium could be equally beneficial under the low oxygen conditions induced by intense endurance exercise.

One review of the effects of meldonium on exercise performance listed the following benefits:

• Decreased levels of lactate and urea in blood
• Improved economy of glycogen: level of glycogen increased in the cells during the long-lasting exercise
• Increased endurance properties and aerobic capabilities of athletes
• Improved functional parameters of heart activity
• Increased physical work capabilities
• Increased rate of recovery after maximal and sub-maximal loads
• Activates CNS functions and protects against stress
• Improves Mental Processes (Memory, Learning, Focus, Concentration, Processing of Information)
• Reduces Fatigue, Increases Motivation & Alertness
• Improves Athletic Training & Competitive Performance
• Improves Microcirculation & Oxygen Delivery
• Oxygen saturation, male potency gradually improves, and libido also increases in both women and men.

Meldonium is the leading agent of the cardiovascular group, antiischemic agent of a metabolic action:

Acts as antiischemic cell protector in patients with angina pectoris, chronic heart failure, brain circulation disorders. 
Improves physical capacity and mental function in the case of ischemia and in healhty people.

Due to its unique mechanism of action Meldonium, depending on the prescribed dose, is widely used for the treatment of different heart and vascular diseases, 

as well as for the improvement of work capacity of healthy people at physical and mental overloads and during rehabilitation period.

Mildronate is one of Latvia's most exported products. Original Meldonium Only produced in Latvia! Be afraid of fakes - especially Russian and Ukrainian!

“It would be reasonable to recommend them to use meldonium as a cell protector to avoid heart failure or muscle damage in case of unwanted overload,” the company said. Grindeks said that, in sports activity, the drug slows down how the body breaks down fatty acids to produce energy."

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Experts explain meldonium influence on athletes' achievements

Mildronate (aka Mildronat, Meldonium) is a nootropic, vasodilator and CNS stimulant that can unlock your intellectual and physical potential. 

Mildronate is a structural analogue of gamma-butyrobetaine, a substance contained in every cell of the human body. Mildronate restores the balance between oxygen supply and demand in cells, and removes toxic metabolic products accumulated in cells protecting them from damage. It also possesses an invigorating stimulant effect. Oxygen delivery and utilization by both muscle & brain cells is enhanced. Mildronate is one of Latvia's most exported products.

 Improves Mental Processes (Memory, Learning, Focus, Concentration, Processing of Information)
·         Reduces Fatigue, Increases Motivation & Alertness
·         Improves Athletic Training & Competitive Performance
·         Improves Microcirculation & Oxygen Delivery

Oxygen saturation, the male potency gradually improves, and libido also increases in women and men.

Meldonium is the leading agent of the cardiovascular group, antiischemic agent of a metabolic action:
    Acts as antiischemic cell protector in patients with angina pectoris, chronic heart failure, brain circulation disorders. 
    Improves physical capacity and mental function in the case of ischemia and in healhty people.

Due to its unique mechanism of action Meldonium, depending on the prescribed dose, is widely used for the treatment of different heart and vascular diseases, as well as for the improvement of work capacity of healthy people at physical and mental overloads and during rehabilitation period. 

Suggested Use:

·         As a general nootoropic take two 250 mg tabletes each morning. 
·         For improved athletic performance take 2 to 4 - 250 mg tablets twice daily.
·         Do not take within 8 hours of planned bedtime.
·         Maximum daily dose is 2000 mg (8 tablets)

Comentary of the inventor of Mildronate, I.Kalvins:

„I’m indignant that sportsmen are being represed and that mildronate is incuded in this list of banned drugs, that sportmen are prohibited to use. In reality it was their only help in situations when they train with the maximum load and any moment can come with an acute lack of oxygen in the heart that usually ends with microstroke, big stroke or death. If this [drug] is banned then we will quite often see instances of deaths on field of highly trained sportsmen or men in their prime years, ” says Kalvins.

„They look at the name, see that this drug is found in the blood of many sportsmen and rejoice that it obviously need to be banned. That is it! This has got no substantiation, because there haven’t been made any researches that would prove that, for instance, such sportsmen who have received Mildronate injections before start  could suddenly run faster. There is none.”

Kalvins points out that Mildronate hase never been doping substance: „It has been used by patients and healthy persons, by athletes and non-athletes for 32 years, but suddenly turns out it’s doping.”
Mildronate restores the level of natural substances in organism and for the moment these substances aren’t there, the protection that Mildronate offers helps the human to overcome the lack of oxygen.

"That is why it is ment both for heart patients, who have damaged artery and for sportsmen, when he has violated the maximum permissible load and blood no longer provides oxigen in the same ammount, which makes the heart muscle to start dying. There is no discussion about him running slower or faster. With such a ban, human rights are violated and for sportsman, they are the same as for everyone else. He also wants to live.” says Kalvins. 

There are no alternatives to Mildronate  and it is the only agent in its class, Kalvins points out.

But what do we know about the substance, why was the Russian taking it and why was it banned only this year?

• Meldonium is used to treat ischaemia: a lack of blood flow to parts of the body, particularly in cases of angina or heart failure.
• It is manufactured in Latvia and only distributed in Baltic countries and Russia. It is not approved by the Food and Drug Administration for use in the United States and is not authorised in the rest of Europe.
• It increases blood flow, which improves exercise capacity in athletes.
• Wada found “evidence of its use by athletes with the intention of enhancing performance” by virtue of carrying more oxygen to muscle tissue.
• The decision to add meldonium to the banned list was approved on 16 September 2015, and it came into effect on 1 January 2016. Wada had spent the previous year monitoring the drug before adding it to the banned list.
• The drug was name-checked in the latest investigative documentary on Russian doping reforms by the German Hajo Seppelt on Sunday. The documentary referred to a 2015 study in which 17% of Russian athletes (724 of 4,316) tested were found to have meldonium in their system. A global study found 2.2% of athletes had it in their system.
• L’Equipe reported that the scientific advisor to the French Agency Against Doping (AFLD), Professor Xavier Bigard, said in interviews with athletes at last year’s European Games in Baku that a wide proportion of athletes admitted taking meldonium.
• It is classed as an S4 substance under the Wada code, which addresses hormone and metabolic modulators.
• The standard ban under the World Anti-Doping Code is four years.
Meldonium company says normal course of treatment is four to six weeks
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• A memo was sent out to athletes by Russia’s anti-doping agency last September informing them of the decision to ban its use.
• Sharapova says she has been taking the drug for 10 years after she was regularly falling ill. She had a magnesium deficiency and family history of diabetes.
• Several athletes have been suspended since the turn of 2016 after testing positive for the dug. Abebe Aregawi, the 2013 women’s 1,500m world champion, has been provisionally suspended after meldonium was found in a sample she provided. Endeshaw Negesse, the 2015 Tokyo marathon champion, was also banned after reportedly testing positive for the same substance. Others include Olga Abramova and Artem Tyschcenko, two Ukrainian biathletes, Eduard Vorganov, a Russian cyclist and Ekaterina Bobrova, a Russian ice dancer.

It is not doping, it is not narkotic!

It can't be ruled out that banning Mildronate (Meldonium) produced by Latvian pharmaceutical company «Grindeks» is a political order, said Alexander Kondratieff representative of «Grindeks».

Considering that sport is a continuation of policy, can't rule out version, what said the main shareholder of  «Grindeks»  Kirov Lipman, that he is sure about 100% and 120% that the Russian tennis player Maria Sharapova's doping scandal is a political order.

Kondratieff explained that currently there are included instructions in «Mildronate» instructions for athletes. "However, no one will give data how many athletes use "Mildronate". It isn't followed, and the company doesn't spread official information," marked the representative of «Grindeks».