If a drug can turn you into a legend or a pariah overnight, that drug is meldonium. Back in 2016, tennis star Maria Sharapova took center stage for all the wrong reasons after a positive meldonium test. Suddenly, a medicine intended for heart patients was the buzzword for scandals, suspensions, and unanswered questions in pro sports. Yet, here’s the kicker—meldoium’s journey from heart therapy to controversial supplement goes way beyond tennis courts and Olympic tracks. So what is this stuff, why all the fuss, and do people really use it for a mythical burst of energy?
Meldonium, sometimes sold as Mildronate, isn’t just a shady energy pill. It was developed in Latvia in the late 1970s by chemist Ivars Kalviņš at the Latvian Institute of Organic Synthesis. The goal? Help cows grow faster, believe it or not. But soon after, scientists saw it had promise for humans, especially folks dealing with angina and heart attacks. Meldonium works as a metabolic modulator—meaning it tweaks how our bodies use and store energy, especially when oxygen is scarce. That feature is super useful for heart patients, whose hearts struggle for oxygen when blocked arteries come into play.
Latvia, Russia, and other surrounding countries quickly put meldonium on the market. Doctors prescribed it to treat heart failure, angina, and even brain circulation troubles. Western countries didn’t follow the trend, mostly because the FDA never approved it. The science behind meldonium is solid for its intended use, backed by studies usually out of Eastern Europe. Meldonium basically blocks a natural substance called carnitine, which your body uses to burn fat for fuel. If you can’t burn fat, your heart and muscles have to burn glucose, which uses less oxygen—handy during an oxygen crisis, like a heart attack. That’s how meldonium can help heart patients: by making their cells more efficient with the little oxygen they get.
But let’s not sugarcoat it. Meldonium isn’t magic. It doesn’t give you superpowers. It might boost how efficiently your heart works under specific conditions, but it doesn’t turn you into a pro athlete overnight. That said, people started speculating—if it can make sick hearts cope with stress, could it also help a healthy body handle more intense exercise? The stage was set for controversy.
The sports world loves a secret weapon, and by 2015 meldonium was showing up over and over in athlete doping tests. The World Anti-Doping Agency (WADA) took notice when about 500 positive meldonium tests popped up in a single year. In January 2016, WADA officially banned meldonium. But the mess didn’t stop there—weeks later, reports hit the news: Maria Sharapova failed a test for meldonium. She said she’d been taking it for a decade for heart problems, diabetes risk, and magnesium deficiency. Some called her a cheater, others thought it was an innocent mistake. Suddenly, meldonium was in the global spotlight.
The mystery was only fueled by confusion about how long meldonium stayed in the body. WADA had little idea. Athletes claimed they’d stopped months before their tests but still tested positive. WADA later admitted there wasn’t enough research about how quickly meldonium leaves your system, which made things awkward for athletes who swore by their innocence.
| Country | Number of Athletes |
|---|---|
| Russia | 172 |
| Ukraine | 13 |
| Georgia | 9 |
| Others | 56 |
Most of the positive tests came from countries where meldonium is sold over the counter. That’s not an accident. Meldonium is cheap and easy to buy in Russia and the Baltics. Some athletes, hoping to endure tough training or recover faster, turned to the drug even before it made global headlines. In Latvia, for example, meldonium was used by cyclists, rowers, and skiers for years. Some athletes swore by it, saying it helped them train harder with less fatigue. But scientific evidence for those claims is spotty at best, and big studies that might support its performance-boosting magic just don’t exist.
People toss around the words “performance enhancer” without understanding what meldonium really does. At its core, meldonium works by blocking the action of carnitine, a nutrient you consume in red meat and dairy. Carnitine is crucial for burning fatty acids in mitochondria—the cell’s energy power plants. When you block carnitine, your cells shift gears and use glucose instead, which is easier to burn but less potent. This shift helps the heart during an oxygen crunch, but in an average healthy person, the impact is subtle.
Studies done in heart patients and animals show that meldonium reduces cell damage, shrinks dead zones after a heart attack, and improves blood flow. More blood to the brain can mean better focus and reaction time, which might help athletes. But do you get more speed, more muscle, or a bigger VO2 max? That’s where things get murky. Small studies with healthy volunteers show only mild improvements in endurance or recovery, and often the effect is so minor it gets lost in the noise. The hype around meldonium in sports comes more from rumor than rock-solid evidence.
Then there’s the question, is it safe for anyone to use meldonium just to push through a workout? The answer is a little complicated. Meldonium isn’t toxic in normal doses. Most people who use it for approved reasons feel okay. But the science stops short of saying it’s safe for everyone, especially for long-term or high-dose use in healthy people. The package insert for meldonium actually warns against unsupervised use. There are also reports of mild side effects like headaches, tummy upset, or sleep problems. Rarely, it can mess with your blood pressure or trigger an allergic reaction. But risks are way higher if you have liver or kidney issues, or mix it with other meds.
If you’re asking whether meldonium is worth the hype, let's talk about what could actually go wrong. Meldonium’s top side effects sound almost boring: you might feel dizzy, notice a flushed face, or have trouble sleeping. Some people get a faster or irregular heartbeat. Others notice headaches, nervousness, or an upset stomach. It’s rare, but meldonium can affect blood pressure, especially if you take it with other drugs for heart conditions.
People with kidney or liver disease really need to be careful. Meldonium is broken down and flushed out mostly by your kidneys, so if they’re not working well, the drug can build up in your system. There are warnings for kids, pregnant women, and people with brain bleeds—doctors generally say avoid it in those cases unless absolutely necessary. Mixing meldonium with blood pressure meds or other heart drugs can lead to unwanted surprises, and combining it with performance enhancers or stimulants could make your heart race dangerously.
Another weird fact: there’s almost no legitimate use for meldonium in the US. The FDA never approved it, so you won’t find a prescription at Walgreens or CVS in Austin, Texas, or anywhere else in the States. Yet overseas, especially in Russia, Latvia, and Lithuania, meldonium sits on pharmacy shelves like aspirin. This gap in regulation means some people buy it online from sketchy suppliers, which opens a can of worms about purity, safety, and legal risk. There have been cases where imported meldonium was cut with who-knows-what, raising extra red flags for users.
A basic tip? Stick to proven, legal ways to manage fatigue and exercise recovery: smart nutrition, sleep, and proper training. There’s way more research backing up a plate of veggies and eight hours in bed than any banned heart drug.
You might think meldonium faded from view after the sports scandals. Nope. As of 2025, meldonium is still popular in some countries, especially among older adults who need a little cardiac support. Russian pharmacies sell it under names like Mildronate, Idrinol, and Cardionate. For them, meldonium isn’t just for athletes—it’s a trusted heart drug with a decades-long history. Doctors there often prescribe it for angina, recent heart attacks, stroke recovery, and even chronic fatigue, especially in patients over 45.
But in the US, meldonium is mainly talked about in one context: banned substances in sports. Some folks try to smuggle it in or order it online, betting on the drug’s reputation for stamina and quick recovery. In the military, there are rumors (unconfirmed) that meldonium has been quietly used to keep soldiers fresh on long missions, especially in regions where it's legal. Weekend warriors and fitness enthusiasts rarely come across meldonium unless they travel internationally or fall deep into Reddit rabbit holes about "secret performance hacks." For the average person, there are way better (and safer) options for energy and endurance that don’t come with travel bans, legal drama, and doping headaches.
One weird quirk: meldonium’s popularity online jumped after every sports scandal. The 2016 Sharapova incident drove thousands of searches on Google and Russian Yandex. After big Olympic bans, Google Trends still shows spikes in searches for “meldonium online,” “meldonium side effects,” and “where to buy meldonium.”
| Month | Worldwide Search Volume |
|---|---|
| January | 17,000 |
| March | 125,000 |
| July | 38,000 |
| September | 19,000 |
The lesson? Every health trend, or scandal, brings new waves of curiosity and confusion. Meldonium still lives in that gray zone between everyday medicine overseas and infamous performance enhancer in the US. Whether it works as well as stories claim, or it’s just wishful thinking, depends on whose story you believe—and whether you’re willing to risk breaking the law (and maybe your body) to find out.