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Meldonium
Meldonium is an anti-ischemia medication approved for sale in Eastern European countries
and Russia. In ischemia, the patient loses blood flow to parts of the body, particularly in
cases of angina or heart failure. The concept centers on the metabolism of the heart muscle
in the case of ischemia. In this condition, the result of coronary artery occlusion, patient
metabolism has to change from aerobic to anaerobic metabolism so as to supply the heart
muscle cells despite lack of oxygen still with the necessary energy. Since its abuse by some
Russian athletes as a performance enhancement drug, it has been banned by WADA for
use in sports. It is currently an unscheduled drug in the USA.
Meldonium is sold under the brand names Mildronate, Mildronāts among others.
Ivars Kalviņš at the USSR Latvia Institute of Organic Synthesis developed it in 1970 and is
now manufactured by the Latvian pharmaceutical company Grindeks and several generic
manufacturers.
Dosage and administration
Meldonium should be taken with food and water. Dosages and posology are set strictly by
the doctor, based on the need and the severity of the condition being treated. In general, the
prescribed adult dose for Cardiovascular disorders is around 500-1000mg, taken in one-two
daily, for a course lasting 4-6 weeks. For treating chronic cerebrovascular disorders, the
recommended dose is 500mg, taken once a day, for a course lasting 4-6 weeks, for treating
Psycho-physical stress, the dose is set at 250mg, take four times a day, for 10-14 days and
for Withdrawal syndrome in chronic alcoholism, the dose is set at 500mg, to be taken four
times a day, for 7-10 days. The dosage of this drug has to set or adjusted only by the doctor
and the patient should not alter the dose for self-convenience. Special care and doctor care
must be taken in case of hepatic impairment.
The price of Meldonium
On the global wholesale market, the price of 60 tablets of 500mg costs the consumer
$26.99. this price is much lower in the developing world, for example in India, the cost of one
the capsule of 250mg is less than USD 0.03 USD.
How does it work?
Meldonium’s main action inhibits l-carnitine biosynthesis. It does this by competitively
inhibiting BBOX, which converts GBB to l-carnitine. This results in the decreases l-carnitine
and the levels of its metabolites. It also inhibits OCTN2-mediated l-carnitine reabsorption in
the liver and brain thus providing the effects.
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