Meldonium – what is it and why did Sharapova use it?

This morning we woke up to news of yet another doping incident in sport. However, this case was slightly different to others –  Maria Sharapova openly declared that she had failed a drugs test. The question is to whether her story adds up.

The Latvian company manufacturing meldonium (otherwise known as mildronate), Grindeks, claim that the normal course for the drug is four to six weeks. However, this can be repeated;

Depending on the patient’s health condition… treatment course can be repeated twice or thrice a year.”

This may not fully explain how she claims to have taken the drug for the first time 10 years ago, and whether her usage was consecutive throughout these years.

In an article from The Guardian, I found that;

  • Meldonium is used to treat ischaemia: a lack of blood flow to parts of the body, particularly in cases of angina or heart failure (another name for cardiac ischaemia is coronary heart disease).
  • 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.
  • According to PubMed it is also used in neurological clinics to treat brain circulation disorders.

So from this evidence we may conclude that Sharapova had some form of cardiovascular disease, however there is evidence that points in the other direction (the cheating one);

  • Meldonium increases blood flow, which improves exercise capacity in athletes
  • WADA (the world anti-doping agency) found “evidence of its use by athletes with the intention of enhancing performance” by virtue of carrying more oxygen to muscle tissue.

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