What Is Meldonium? The Banned Substance Found In Mykhailo Mudryk’s Doping Test

Athletes testing positive for banned substances is hardly a new phenomenon. From Diego Maradona to Lance Armstrong, some of the most iconic figures in sports history have returned adverse results in doping tests, driven by their pursuit of gaining an edge over the competition.

However, it remains rather rare to hear of a Premier League footballer testing positive for a drug listed on the World Anti-Doping Agency’s (WADA) prohibited substances list. So, when news emerged last week that Chelsea’s Mykhailo Mudryk had allegedly failed a routine drug test, the sporting world was understandably stunned.

The substance under scrutiny is meldonium, a drug banned since early 2016. Back then, it made headlines when several athletes were caught using it, as it can linger in the body for weeks or even months. But since that flurry of controversy, it has largely faded from the spotlight. So, what exactly is meldonium, and what edge does it offer athletes?

What is Meldonium? 

Meldonium is a Latvian-made drug that is readily available over the counter across Eastern Europe, including countries such as Russia and Ukraine. Interestingly, it can often be obtained in these countries without a prescription, making it relatively easy for anyone to get their hands on. 

Before delving into the intriguing ways meldonium can enhance athletic performance, let’s tackle the essential, somewhat boring, background information. Created in 1970 by Ivarks Kalvins at the USSR Latvia Institute of Organic Synthesis, meldonium is now produced by the Latvian pharmaceutical company Grindeks.

Commonly recognised by the brand name Mildronate, though also marketed under other names, meldonium is primarily prescribed for heart-related conditions such as angina and chronic heart failure. However, it’s also commonly used to address issues with brain circulation and has been noted for its potential to boost mood, alleviate motor symptoms and reduce dizziness and nausea.

Why is Meldonium Banned?

Now for the nitty gritty. WADA classifies meldonium as a “metabolic modulator”, which is a drug that can either slow down or speed up certain enzymes in the body, regulating things like energy production. 

Meldonium is said to boost athletes’ energy levels in two key ways.

Firstly, the drug shifts the body’s energy production from fatty acids to glucose. This sounds innocent, but glucose is actually a much more efficient fuel, especially during intense exercise when oxygen supply becomes limited.

Secondly, meldonium reportedly reduces lactic acid buildup during exercise, helping to combat fatigue and speed up recovery.

It consequently comes as absolutely no surprise that Soviet soldiers in the 1980s, according to Ivar Kalvins, relied on meldonium during the Afghanistan conflict to enhance their endurance. 

However, meldonium offers more than just a boost in energy production. Evidence suggests that by enhancing oxidation, it can sharpen brain activity, helping athletes make smarter decisions when it matters most (yes, the irony isn’t lost on us).

So, with athletes on meldonium gaining enhanced endurance and sharper thinking skills, it’s hardly surprising that WADA chose to ban it.

Can Meldonium Be Consumed Through Food?

Time and time again, we have seen athletes caught with prohibited substances in their system claim that it’s the result of them eating contaminated food of some sort. It really is a tale as old as time itself. But could this genuinely be the case when it comes to meldonium?

A 2020 Russian study revealed that some products containing meldonium were used to inject cows and added to the drinking water of chickens. The study found that, as a result, this substance occasionally ended up in cows’ milk and chicken sold to everyday consumers.

Firstly, this is the case in very few countries, including the UK, and secondly, meldonium presents no risk to human health. Plus, even if you’re an athlete in a country where meldonium is used in raising livestock, there’s still no cause for concern.

Indeed, a German study found that even when people repeatedly drank meldonium-spiked milk the concentration of the drug in their system remained well below WADA’s threshold of 100 nanograms per millilitre. It’s, therefore, almost impossible for an athlete to accidentally test positive for meldonium as a result of consuming contaminated food.

What Athletes Have Been Caught Using Meldonium?

Besides Mudryk’s alleged case, numerous athletes before him have been caught using meldonium. Most of these incidents occurred shortly after the ban was enforced, as meldonium stays in the body for weeks, even months, unlike most substances that clear within a few days. As a result, many athletes tested positive, even though they had ceased using it after the ban.

One of these athletes was Russian tennis star Maria Sharapova. The former world number one and five-time grand slam champion was caught with the substance in her system during the 2016 Australian Open. 

While she claimed that she had been taking the drug for ten years due to having a magnesium deficiency and a family history of diabetes, it didn’t stop the International Tennis Federation from banning her from the sport for a staggering two years.

Following an appeal to the Court of Arbitration for Sport, the ban was reduced to 15 months; however, it served as a stark warning to all athletes that the use of meldonium would well and truly no longer be tolerated.