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By Jonathan Roseland

I'm not a doctor, medical professional, or trained therapist. I'm a researcher and pragmatic biohacking practitioner exercising free speech to share evidence as I find it. I make no claims. Please practice skepticism and rational critical thinkingYou should consult a professional about any serious decisions that you might make about your health. Affiliate links in this article support Limitless Mindset - spend over $150 and you'll be eligible to join the Limitless Mindset Secret Society.

Mildronate modulates and improves the function of the heart which has a number of downstream performance-enhancing effects both for our physical and mental capacities.

Meldonium, or Mildronate, is prescribed to treat “different heart and vascular diseases,” according to the Latvian manufacturing company’s website, though it also notes that the drug can improve the “physical capacity” of healthy people. It increases blood flow, which improves exercise capacity in athletes.

Performance Enhancer

Off – label use of Meldonuim in healthy people: increasing exercise tolerance, learning, memory, and even sexual function. One athletic Biohacker reported enthusiastically

"I play ice hockey, tennis and I do weights training and yoga. I have personally taken Meldonium... before weights and yoga training... before ice hockey, and the benefits are immediate : more energy, no hunger, feeling light, as if my body was not heavy, also feeling really concentrate and aware and brain's functions seems enhanced. I could also add that this drug, make you not wanna lose, seems like it has a mental effect that keep you pushing more and refusing to lose or giving up and makes you wanna give your best until the end even in a losing game/match up."

Banned from the Olympics

Wada (World Anti-Doping Agency) found “evidence of it's use by athletes with the intention of enhancing performance” by virtue of carrying more oxygen to muscle tissue.

The decision to add Meldonium to the banned list was approved on September 16th, 2015, and it came into effect on January 1st, 2016. Wada had spent the previous year monitoring the drug before adding it to the banned list.

Meldonium gained popularity after Maria Sharapova, a famous tennis player, from Russia, said that she has been taking this drug for the last 10 years for health reasons. Also, a number of other world and Olympic champions admitted to taking it...

  • World record holder in short track – Semen Elistratov
  • Olympic champion figure skater – Ekaterina Bobrova
  • Racing cyclist from team Katyusha – Eduard Varganov
  • World champion weightlifter Aleksey Lovchev
  • World champion runner from Sweden – Abeba Aregawi

Although professor Michael Joyner of the Mayo Clinic expressed some skepticism that it was a real hardcore athletic Biohack: 

"Evidence is lacking for many compounds believed to enhance athletic performance. Its use has a sort of urban legend element and there is not much out there that is clearly that effective. I would be shocked if this stuff [meldonium] had an effect greater than caffeine or creatine...”


On Pubmed, you can find 25 clinical trials which evaluated it in humans. To summarize the findings

  • The most recent trial done in 2016 evaluated it in healthy Chinese people. The study called Mildronate is an agent for cardioprotection and neuroprotection.
  • A study of 49 patients called it an Adaptogen and found that it made the Russian winter a bit more sufferable and improved quality of life.
  • It aids recovery from myocardial ischemia.
  • Another 2014 study of middle-aged and elderly evaluated the effect of oxidative stress on meldonium, hemodynamics and quality of life of patients with cardiovascular disease (CVD) in extreme climatic conditions (summer heat). It also concluded that it had an adaptogenic effect, it improved response to oxidative stress 
  • A recent trial of 140 patients Early use of meldonium decreases probability of emergence of fatal arrhythmias and improves prognosis of hospital stage of rehabilitation of patients with acute coronary syndrome.

The evidence is better for its physical performance enhancement effects, evidence of its potency as a cognitive enhancer is not significant. It won't be my go-to Russian smart drug.

Side Effects

The recent Chinese study reported No serious adverse events were observed. A 2015 trial of 67 Russians agreed No side effects were registered during the course of mildronate treatment.

Like Semax and Cerebrolysin, Mildronate is on the Russian List of Vital & Essential Drugs.

Country of origin: Latvia

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Suggested Use

For the purpose of increasing tolerance to mental and physical overload, it should be taken 250 mg 2 - 4 times per day. Before and during the athletic events, athletes should take up to 500-1000 mg prior to workouts, preferably in the morning.

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