Meldonium (trade name Mildronate) is a small-molecule anti-ischaemic drug developed in Latvia and widely used in Eastern Europe and some other regions for cardiovascular and neurologic indications. It is prescribed as an adjunctive therapy to improve cellular tolerance to oxygen deficiency and to support recovery after ischaemic episodes.

Product Name: Meldonium (Mildronate)
CAS Number: 86426-17-7
Synonyms: Mildronate; THP; MET-88; 3-(2,2,2-Trimethylhydrazinium)propionate
Chemical Name (IUPAC): 3-(2,2,2-Trimethylhydraziniumyl)propionate
Molecular Formula: C6H14N2O2 (anhydrous; some suppliers list dihydrate variations)
Molecular Weight: 146.19 g/mol 

Physical & Chemical Properties

Meldonium modulates cellular energy metabolism by reducing L-carnitine levels and inhibiting long-chain fatty acid uptake into mitochondria. This shifts myocardial energy substrate use away from fatty acid β-oxidation toward glycolysis - a metabolic pattern that can be more oxygen-efficient during ischaemia. The result is reduced fatty acid oxidation, improved glucose utilization, and claimed cardioprotective effects in ischemic conditions.

Supports heart health: Helps protect the heart and improve blood flow, reducing ischemic damage.

Boosts energy efficiency: Shifts metabolism to use glucose instead of fatty acids, improving oxygen efficiency.

Enhances recovery & endurance: Speeds post-exercise recovery, reduces fatigue, and improves stamina.

Cognitive & stress support: May improve focus, mental clarity, and tolerance to physical or mental stress.

• Cardiovascular: adjunct treatment in chronic cardiac insufficiency, myocardial ischaemia/angina, and for improving exercise tolerance in certain cardiac patients.
• Neurology & rehabilitation: used in some countries for cerebrovascular insufficiency, dizziness, and as part of post-stroke/ischemic rehabilitation protocols.
• Metabolic / recovery: sometimes used to support recovery after intense physical stress and in some metabolic conditions (regional practice varies).

 

Typical formulations & dosing

Commercial products are commonly available as 250 mg or 500 mg capsules/tablets (meldonium dihydrate). Typical therapeutic dosing used in clinical practice and product leaflets is 500–1000 mg per day (often 500 mg twice daily or 500 mg once daily depending on product), with treatment courses often described as 4–6 weeks for many indications. Always follow local labeling and medical advice.

Reported adverse effects are generally described as mild and include:

• headache, dizziness, agitation or tachycardia;
• gastrointestinal upset (dyspepsia);
• rash or allergic skin reactions.

Serious adverse events are infrequently reported in the available literature, but clinical data are limited in scope. Dose adjustments may be recommended for elderly patients or those with significant renal/hepatic impairment. Always consult a qualified healthcare professional before use.

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