Medical Powder Mildronate for Remedy Ischemic Top Effect cas: 76144-81-5
Mildronate, an approved drug with multiple indications besides its anti‐ischemic properties, is known to have a positive effect on the endurance performance of athletes, improves rehabilitation after exercise, protect against stress and activates CNS functions. So far, Mildronate is not part of WADA's Prohibited List. Effects on the human organism similar to those exhibited by the prohibited substance Trimetazidine are given, as both substances cause a significant inhibition of the β‐oxidation of free fatty acids.1, 31 Originally included in Section S6.b of the WADA Prohibited List, Trimetazidine was categorized under sub‐section S4.5.3 in January 2015 due to its function of a metabolic modulator of the cardiac metabolism.
Based on a growing body of evidence concerning Mildronate misuse in sport and the inclusion of the substance into the 2015 WADA monitoring program, adequate test methods for both initial testing and confirmation of the analyte were established. The molecule's specific physico‐chemical properties and the fact that the drug is mostly excreted unchanged via renal route makes Mildronate an ideal analyte for the presented ‘dilute‐and‐inject’ HILIC‐HRMS approach. The reduced sample preparation, the flexibility of the present approach and the compatibility of the initial testing assay with existing analytical protocols enables the simple implementation of Mildronate into screening assays of fellow anti‐doping laboratories for utmost comprehensive monitoring of the substance's misuse.
Furthermore, the present study indicates the wide prevalence of Mildronate in international elite sports and demonstrates the alarming extent of administered dosages, finding more than 180 cases of Mildronate use within numerous different sport disciplines and urinary concentration levels of more than 1 mg/mL. Additionally, the easy access to Mildronate from numerous online shops certainly plays an important role for the widespread use in international elite sports. Under medical and pharmacological aspects as well as to preserve the integrity of sport the ban of Mildronate from sport is deemed indicated.
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