Maria Sharapova. Credit: Victoria,

Pro tennis player Maria Sharapova left fans and the sports community stunned after she failed a routine drug test during the Australian Open. Sharapova revealed in an announcement yesterday (March 7) that she had tested positive for a banned substance called meldonium and as a result, has been banned provisionally by the International Tennis Federation (ITF). Given the circumstances, the one question that’s understandably on everybody’s mind is what is meldonium?

Surprisingly, Sharapova is very much aware of meldonium effects, because she has actually been taking the drug for the past 10 years—it was only just added to the World Anti-Doping Agency’s (Wada) list of banned substances on January 1 of this year. Although athletes were reportedly advised of the change via e-mail, Sharapova admitted that neither her nor her team double checked before heading to this year’s Australian Open. Many people are questioning why the tennis pro was using the drug in the first place, and is she actually guilty of meldonium doping? This all goes back to the original question at hand—what is meldonium?

On the most basic level, meldonium is a metabolic drug that helps with blood flow and is often used for patients who suffer from cardiac problems. Maria Sharapova says she first started taking it back in 2006 to help with “several health issues going on at the time.” While this may or may not have been true, the drug has been shown to contribute to improved athletic performance, like increasing endurance and improving aerobic abilities. The fact that athletes can abuse the drug, or engage in meldonium doping, to unnaturally enhance their performance is what ultimately led to Wada banning it. Keeping all this in mind, here are 15 more facts about the drug, including meldonium effects, long-term risks, and where Maria Sharapova stands in all this:

1. Meldonium is sold using its brand name Mildronate and is manufactured by the Latvian pharmaceuticals firm called Grindeks.

2. The meldonium drug is not approved by the U.S. Food and Drug Administration (FDA) or its U.K. equivalent, the European Medicines Agency.

3. Up until now, Sharapova hasn’t been breaking any rules by taking the drug, because it wasn’t on Wada’s list of banned substances till January 2016. She says she also didn’t realize the drug she was taking (remember, the brand name was Mildronate) was the same as meldonium.

4. Meldonium is actually synthetically derived chemical relative of the natural biochemical L-carnitine.

5. Meldonium was originally developed by colleagues at the Latvian Institute of Organic Synthesis for the purpose of serving as a growth promotor (non-antibiotic) for poultry and other livestock.

6. According to manufacturer of the meldonium drug, the common course of treatment is usually four weeks to six weeks, and the course may need to be repeated twice or even three times a year. This then raises concerns about why Maria Sharapova has been using it for health-related concerns over the past 10 years. The company says that “only physicians can follow and evaluate a patient’s health condition” and then determine whether or not they should be taking the drug for longer periods of time.

7. In Moscow, you can buy meldonium over the counter in the form of tablets or vials, at least as of today. It’s also available with a prescription throughout Eastern Europe. There’s no word on whether or not accessibility to the drug will change over time.

8. Unexpected meldonium effects (side effects) may include an irregular heartbeat, changes in blood pressure, irregular skin conditions, an allergic reaction, and/or indigestion.

9. The sports minister of Russia suspects that Maria Sharapova isn’t the only athlete using meldonoium. In fact, he’s expecting many more Russian athletes to test positive for the drug.

10. A Russian cyclist by the name of Eduard Vorganov also tested positive for meldonium last month.

11. According to the National Library of Medicine, meldonium works by helping the user be more active: “They become more active, their motor dysfunction decreases, and asthenia, dizziness and nausea become less pronounced.”

12. A study published in the journal Drug Testing and Analysis last year revealed that the meldonium drug showed an endurance increase in athletes, as well as “improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system functions.”

13. According to the meldonium wiki page, other athletes who have been banned for meldonium doping include Turkish runner Gamze Bulut, Ethiopian runners Endeshaw Negesse and Abeba Aregawi, and speedskater Pavel Kulizhnikov.

14. According to the World Anti-Doping Code, the standard duration of a ban is four years.

15. So, what’s next for Maria Sharapova? She’s been provisionally suspended for meldonium doping, but her penalty hasn’t yet been decided. It could range anywhere from a minimum sanction without suspension to a full four-year ban. However, the most probably punishment for Sharapova will likely be a one-year suspension.

Photo: Instagram/mariasharapova