Meldonium( Mildronate): use in medicine and doping scandal

"Meldonium makes a man more enduring", "Mildronate is prescribed for heart problems", "Meldonium can not be taken even by the doctor's order - the athletes are banned" - such statements recently can not only be read on the forums and in the comments to the news, But also to hear in the bus, cafes and parks.No wonder - the doping scandal, the basis for which was the very Mildronate, embraced virtually everyone.

What is actually known about Mildronate?What does the founder of meldonia insist on?

Table of Contents: What is the meldonium: indications for use? Opinion of the maker of meldoniya? Opinion of scientists about meldoniya? Doping scandal - chronology of events

What is meldonium( mildronate): indications for use

Meldonium( Mildronate) belongs to a group of metabolic agents thatAre able to normalize metabolic processes of an energetic nature in cells that have suffered from a lack of oxygen, ischemia.Meldonium has established itself as an effective drug for normalizing and stabilizing the energy metabolism of the heart.

In 2012, the drug in question was included in the list of Essential and Essential Drugs( VED) and only on January 1, 2016, was banned from its use by athletes: Mildronate( meldonium) was recognized as doping.It is in connection with this "runaway" over time that many questions are connected with the legitimacy of statements that meldony is doping.However, in the US, for example, Mildronate was not approved for use in the same 2012 - all 4 years there was no time to test it for a "doping component"? But these are all rhetorical questions, but it is important for us to note that there are a lot of "official" indications for use in milledonia, in particular, Mildronate:

• is used as part of the complex therapy of angina pectoris, myocardial infarction, chronic heart failure;
• is prescribed for the diagnosis of strokes of hemorrhagic and ischemic, cerebrovascular insufficiency;
• is suitable for admission in case of excessive physical exertion;
• is recommended for use during the rehabilitation period after surgery;
• is included in the complex of therapeutic measures for diabetic and hypertensive retinopathy;
• is actively used in the work of ophthalmologists - it is prescribed for patients with central vein thrombosis of the retina, acute circulatory disturbance in the retina of the eye, hemorrhage into the retina.

Millionaire creator

Mildronata creator Ivar Kalvinsh( professor of the Latvian Institute of Organic Synthesis) does not consider the substance created by his laboratory as a doping in 1975 and is sure that there is no scientific agrerration regarding the ban on the use of meldonia and its recognition as doping.it can not be.Ивар confidently declares also that preparations with such милдронату action in the world pharmacological market are not present and are not foreseen - there are no any data that similar medicinal preparations at least pass laboratory or clinical tests.

If WADA claims that this is doping, then it should have at least one article to show or one study to conduct that would prove that this is so.If there is no such research, there is no such thing - I have not seen any such article, and we have not received any arguments from WADA, and in general they did not inform us about their decision and the reasons for this - we can only accept one thing, the underlying reason is the lobbyism of something- or purely political, or sports political, or pharmaceutical business - explained Ivar Kalvinsh

Ivars Kalvinsh suggested that the doping scandal is just another attempt to take over technology and business in productionMeldonia, although the political underpinnings should not be ruled out.

Opinion of scientists on meldonia

The question of how appropriate it is to talk about mildronate as a dope, worries not only the townsfolk, but also scientists. There are many opinions, just a few of them:

• March 7, 2016: Maria Sharapova( the first racket of the world) admitted at a press conference that she did not pass the tests, her mildonia was found in her blood - this drug was taken by the athlete on the prescription of the doctor for 10 years.
• March 7, 2016: Ekaterina Bobrova( sports dancing on ice) declares not to undergo doping tests and to find meldonia in her blood.
• Temporary disqualification of Ababa Aregavi, Gamze Bulut( runners for medium distances), Indasho Negesse( runner for long distances), Olga Abramova and Artem Tishchenko( Ukrainian biathletes).
• March 8, 2016: meldonia is found in the blood of skater Pavel Kulizhnikov, volleyball player Alexander Markin, and Semen Elistratov is forced to skip the World Short Track Championship because of Mildronate.
• March 9, 2016: Mildronate is revealed in the blood of two more Russian athletes Eduard Lapytov( biathlon) and Ekaterina Konstantinova( short track).
• March 10, 2016: WADA head Reedy makes statements about her fears that Sharapova will be assigned too light punishment.In this case, Readie threatens to appeal to the Sports Arbitration Court.
• March 11, 2016: WADA data have been published, according to which meldonium was found in the blood of 60 athletes, it is stated that this is not the limit.
• March 14, 2016: The Ministry of Sport of Russia requested from WADA the results of scientific research meldonia.
• March 15, 2016: The United Nations suspended Sharapova's activity as a goodwill ambassador.
• March 20 - April 3, 2016: traces of meldonia found in doping tests taken in the winter championship of Russia athletes N. Kotlyarova, G. Fazletdinova, A. Minzhulina, O. Vovk;Several tens of Russian wrestlers of the Greco-Roman style, including S. Semenov and E. Saleev;Water polo player A. Bugaychuk;Champion of the Russian Federation in artistic gymnastics N. Kuksenkov.
• April 8, 2016: due to the discovery of meldonia in the doping tests of the players of the junior Russian national ice hockey team, the team was replaced at the World Championships.
• April 13, 2016: WADA stated that the concentration of meconium in 1 μg in the doping test of an athlete surrendered before 01.03.2016 is admissible.After this statement, all athletes stated that they can count on amnesty, becauseThey had a lower concentration of the drug in their blood.
• April 15, 2016: WADA amnestied S. Semenov and E. Saleev.
• April 18, 2016: Juris Bundulis, chairman of the board of the manufacturer Mildronate, said that their company will seek to eliminate muldonia from the list of banned WADA drugs from January 1, 2017.
• April 22, 2016: FINA withdrew a temporary suspension from Shepelev, sinceThe concentration of meconium in its doping test is below acceptable.
• May 12, 2016: The New York Times referring to the ex-head of the Moscow Anti-Doping Laboratory Grigory Rodchenkov accused 15 medalists of the 2014 Olympics in Sochi in the use of doping.After the relevant statement, the FBI launched an investigation.
• May 12, 2016: WADA stated that 47 samples of Russian athletes in the mills from 18.11.2015 to 05.05.2016 were positive.
• May 15, 2016: because of the previously discovered meldonia traces in A. Povetkin's doping tests, the fight between the Russian boxer and Wilder for the WBC heavyweight champion title, previously scheduled for May 21, was postponed.
• May 16, 2016: The Federation Council was proposed to criminalize coaches, sports doctors and sellers of banned drugs for doping.The punishment may be imprisonment for up to 5 years or imposing a fine of up to half a million rubles.
• May 22, 2016: WADA president Craig Reedy said that if there are traces of meldonia in the case of re-testing Russian Olympians from the 2012 Olympics, athletes will not be admitted to the 2016 Olympics.
• May 24, 2016: The International Olympic Committee( IOC) stated that 14 Russian athletes from the 2014 Olympic Games had found traces of meldonia during the recheck.
• May 24, 2016: The Presidium of the All-Russian Athletics Federation( VFLA) banned athletes who previously had been found doping to be a member of the Russian national Olympic team at the 2016 Games in Rio de Janeiro.
• May 27, 2016: rechecking of doping tests A 23 athletes from the Summer Olympics 2012 gave a positive result.
• June 08, 2016: The International Tennis Federation( ITF) disqualified Sharapova for 2 years for using meldonia.However, the American company Nike decided to resume cooperation with the Russian tennis player.
• June 08, 2016: 8 out of 10 Lossa doping tests "B1" of the Russian participants of the 2008 Olympics were positive.
• June 15, 2016: WADA published a report stating that 49 of 52 doping tests taken from Russian athletes between February 15, 2016 and May 29, 2016 were positive.
• June 17, 2016: in accordance with the decision of the International Association of Athletics Federations( IAAF), which refused to restore the membership of the All-Russian Athletics Federation, Russian athletes will not compete in Rio de Janeiro for the Olympics under the flag of their country.The decision of the IAAF on 21.06.2016 will be considered by the International Olympic Committee( IOC).
• June 22, 2016: The International Weightlifting Federation( IWF), because of doping scandals, deprived 2 quotas for the Olympic Games in the Russian Federation of Weightlifting Federation( FTAR).
• June 23, 2016: the IOC press service said that Russian athletes could compete under the Russian flag at the Olympic Games in Rio de Janeiro if they prove their non-participation in the doping scandal and they will be admitted by the International Association of Athletics Federations( IAAF).Athletes must submit applications by July 4, 2016.
• June 24, 2016: For the first time, the traces of meldonia are found in a doping test of the Russian Paralympic athlete( a positive result was given by N. Polukhin's test).

1. The drug is actively used in the treatment of heart disease and neurology.100% effectiveness can be challenged, but doctors often prescribe Mildronate to their patients.
2. About the fact that the meldoon is able to increase the endurance and performance of a person, you can argue for a long time.There is only one known fact: at the present time, no large clinical studies have been carried out on groups of people regarding the ability of mildronate to increase endurance.And this is asserted by Professor, Doctor of Medical Sciences, Head of the Department of Myocardial Disease and Heart Failure of the Institute of Clinical Cardiology.AL Myasnikova Sergei Tereshchenko - agree that scientists of this level are always up to date with the latest research.Most likely, there were some minimal studies, the so-called "pilot", which can not be the basis for such serious conclusions.
3. The same Sergey Tereshchenko admits the probability that the additional effect of mildronate in the form of increased endurance still exists.But the professor insists that no clinical studies in this direction have been carried out - by the way, it is for this reason that mildronate did not enter the world pharmacological market and is used only in the territory of the Russian Federation and in some CIS countries.
4. There are no analogues of Mildronate in the world!Pharmacists know preductal, which also improves metabolic processes in the heart tissues, but the mechanism of its action is completely different.And he, by the way, was included in the list of banned drugs for athletes( that is, was recognized as doping) much earlier.
5. It is not recommended for healthy people to take meldonia - interference to the work of the heart from the outside does not lead to anything good .
6. Those patients who take mildronate according to the prescription of the attending physician should not worry - harm to the body is not done.
7. For athletes, Mildronate is necessary to prevent heart attacks on the background of excessive training, the drug only preserves the health of the athlete, but does not guarantee him victory in competitions.

A doping scandal is the chronology of events

If you trace the chronology of the doping scandal associated with the use of meldonia, you can find many curious:

According to March 2016, sales of Mildronate increased several times, which was the reason for the releaseIn the light of another version - Maria Sharapova specifically gave confessions to increase sales meldonia, so to speak, worked on advertising.

As the events of the doping scandal will develop, it is unknown to anyone.But already now the contradiction between representatives of the anti-doping committee and the founder of meldonia, scientists and doctors is clearly traced.

Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category