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Meldonium the dihydrate is a synthetic analog of a gamma butyrobetaine, substance which is in each cell of a human body.

Meldonium is a precursor to carnitine, a structural analogue of gamma-butyrobetaine (GBB), in which one carbon atom is replaced by a nitrogen atom. Its effect on the body can be explained in two ways.

Meldonium, inversely inhibiting gamma-butyrobetaine hydroxylase, reduces the biosynthesis of carnitine and therefore interferes with the transport of long-chain fatty acids through cell membranes, thus preventing the accumulation of highly oxidized non-oxidized cells in cells. This prevents damage to cell membranes.

By reducing the concentration of carnitine in ischemia conditions, β-oxidation of fatty acids is delayed and oxygen consumption in cells is optimized, glucose oxidation is stimulated, and ATP transport from its biosynthesis sites (mitochondria) to consumption sites (cytosol) is restored. Thus, cells are provided with nutrients and oxygen, and the use of these substances is optimized.

In turn, by increasing the biosynthesis of the precursor of carnitine, ie GBB, activated NO-synthetase, resulting in improved rheological properties of blood and decreased peripheral resistance of blood vessels.

As the concentration of meldonium decreases, the biosynthesis of carnitine is increased again and the amount of fatty acids is gradually increased in the cells.

It is believed that the basis of the effectiveness of meldonium is to increase tolerance to cell load (when changing the amount of fatty acids).

The use of Meldonium

In complex therapy in the following cases:

– heart disease and circulatory system: stable angina load, chronic heart failure (NYHA I-IIIfunctional class), cardiomyopathy, functional disorders of the heart and circulatory system;

– acute and chronic ischemic disorders of the blood supply to the brain;

– reduced performance, physical and psycho-emotional overload;

– during recovery from cerebrovascular disorders, head trauma and encephalitis.


– Hypersensitivity to meldonium or to any of the excipients.

– Increase in intracranial pressure (in violation of venous outflow, intracranial tumors).

– Severe hepatic and / or renal failure (insufficient data on safety of use).

Use at pregnancy and feeding by a breast

It is not recommended at pregnancy (safety of use is not proved). For the period of treatment it is necessary to stop breastfeeding (it is unknown whether gets into breast milk).

Side effects of the substance Meldonium

Meldonium, as a rule, is well transferred. However at susceptible patients and also in cases of excess of the recommended dose emergence of undesirable reactions is possible.