Maria Sharapova was on Wednesday banned from tennis for two years after failing a drugs test at this year’s Australian Open, once again putting meldonium under the spotlight.
Meldonium is also known as mildronate, the name by which Sharapova knew the drug, having taken it since 2006.
But what do we know about the substance, why was the Russian taking it and why was it banned only this year?
Meldonium is used to treat ischaemia: a lack of blood flow to parts of the body, particularly in cases of angina or heart failure.
It is manufactured in Latvia and only distributed in Baltic countries and Russia. It is not approved by the Food and Drug Administration for use in the United States and is not authorised in the rest of Europe.
It increases blood flow, which improves exercise capacity in athletes.
Wada found “evidence of its 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 16 September 2015, and it came into effect on 1 January 2016. Wada had spent the previous year monitoring the drug before adding it to the banned list.
The drug was name-checked in the latest investigative documentary on Russian doping reforms by the German Hajo Seppelt on Sunday. The documentary referred to a 2015 study in which 17% of Russian athletes (724 of 4,316) tested were found to have meldonium in their system. A global study found 2.2% of athletes had it in their system.
L’Equipe reported that the scientific advisor to the French Agency Against Doping (AFLD), Professor Xavier Bigard, said in interviews with athletes at last year’s European Games in Baku that a wide proportion of athletes admitted taking meldonium.
It is classed as an S4 substance under the Wada code, which addresses hormone and metabolic modulators.
The standard ban under the World Anti-Doping Code is four years.
A memo was sent out to athletes by Russia’s anti-doping agency last September informing them of the decision to ban its use.