What Exactly is Meldonium? - Chromatography Explores

Meldonium is well known in some athletic circles, as a substance to be avoided if you want to compete clean. It is the substance that caused one of the biggest tennis players in the world to be banned for two years after a failed drug’s test.  But the drug was originally developed for medicinal purposes and is still in use today. But what exactly is meldonium and why can’t athletes use it?

Mildronate and ischaemia

Mildronate is the trade name of meldonium, the substance discussed in this article. The drug was originally developed in 1970 by Ivars Kalvinš at the Latvia Institute of organic synthesis. One of the early uses of the drug was in Eastern Europe in animals where it was used to increase the sexual performance of boars and to improve their sperm motility. It was then licensed for use in humans in some countries including Russia, Ukraine, Latvia and Georgia along with other countries in Central Asia and Eastern Europe. It has not been licensed for use in the United States or the United Kingdom.

Meldonium was created to increase the oxygen capacity of the body and it is licensed to help treat coronary heart disease, especially where the heart disease can lead to ischemia. Ischemia is a condition where too little blood flows to the organs of the body. The drug can help to expand the arteries thus increasing both blood and oxygen flow through the body. But on 1 January 2016, meldonium was added to the World Anti-Doping Agency’s (WADA) list of banned substances.

Now a banned performance enhancer

The banning of the drug has not been without controversy. Before meldonium was used for cardiac health problems, large quantities of the drug were shipped to Afghanistan for use by Soviet troops. Soviet soldiers used meldonium to increase their endurance in the mountainous terrain with its oxygen-reduced air. So, by increasing blood flow, exercise capacity could be increased. It is listed as a hormone and metabolic modulator by WADA

The drug’s developer and several other researchers believe that the drug doesn’t offer any advantage to an athlete. It is contended that people take the drug to prevent damage to the heart and muscles due to a lack of oxygen reaching them. And to stop people protecting their bodies is in violation of their rights.

But whichever way you think, the drug is still banned and the primary testing for its use is carried out using chromatography. Of course, chromatography is used to dealing with difficult and complex samples as discussed in the article, Analysis of Fenfluramine and Norfenfluramine in Mouse Brain and Cerebellum by Liquid Chromatography Tandem Mass Spectrometry using a Novel Solid-Supported Liquid Extraction.

There are currently several athletes banned by sporting bodies due to use of meldonium - who will be next?