Rankings / Metabolic Health

Meldonium

Metabolic Health · Carnitine-pathway metabolic modulator

Tier C-

wadametabolic-modulatorendurancebanned-sport
4.3 / 10
Tier C-
Ev 4 Bn 3.5 Sf 5

Bottom line

Read Off Label grades Meldonium as C- (4.3/10) based on mixed evidence, low-med benefit magnitude, and a med-risk safety profile.

Added from WADA S4.

Studied, labeled, or reported-use context: Clinical dosing varies by country/indication; no approved performance dose — Rx in parts of Eastern Europe; not FDA-approved; WADA S4 prohibited; not individualized guidance.

What the evidence says

Added from WADA S4.4.3. The Sharapova case made meldonium famous, but the human performance evidence remains much less decisive than the doping notoriety.

Mechanism

Meldonium shifts cardiac and skeletal-muscle energy metabolism by inhibiting carnitine synthesis/transport; athletes have used it for perceived endurance and recovery benefits.

Studied, labeled, or reported dose & route

Clinical dosing varies by country/indication; no approved performance dose

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about Meldonium's effects?
Read Off Label rates the evidence for Meldonium as Mixed and the benefit magnitude as low-med, producing an overall grade of C- (4.3/10). Added from WADA S4.
What safety findings are reported for Meldonium?
Meldonium has a med risk profile in the database. Med (cardiovascular/metabolic uncertainty, interactions, legal/sport risk) Legal status: Rx in parts of Eastern Europe; not FDA-approved; WADA S4 prohibited.
What doses or routes are reported for Meldonium?
Clinical dosing varies by country/indication; no approved performance dose This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does Meldonium work?
Meldonium shifts cardiac and skeletal-muscle energy metabolism by inhibiting carnitine synthesis/transport; athletes have used it for perceived endurance and recovery benefits.

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.