What Is Meldonium, Maria Sharapova’s Doping Drug?

The Russian tennis star faces uncertain consequences after failing a drug test.

On Monday, Russian tennis superstar Maria Sharapova, ranked seventh in the world by the Woman’s Tennis Association, announced that she failed a drug test at the Australian Open in January.

“I did fail the test and take full responsibility for it,” said Sharapova at a Los Angeles press conference.

But the 28-year-old Sharapova, who has won five Grand Slam singles tournaments and earned millions in endorsements, claimed that she wasn’t doping. Rather, she says she was treating medical conditions with meldonium, a drug she has been taking since 2006 and which was only banned by the World Anti-Doping Agency

“It is very important for you to understand that for 10 years this medicine was not on WADA’s banned list and I had been legally taking that medicine for the past 10 years,” Sharapova told the press. “But on January 1st, the rules had changed and meldonium became a prohibited substance, which I had not known.”

Sharapova said she did not open a Dec. 22 email from WADA that would have notified her of the change.

Meldonium, which Sharapova knew by the name Mildronate, is a Latvian drug used in Russia and throughout Eastern Europe to treat heart problems like angina, myocardial infarction, and heart failure. The drug is not approved for clinical use by the Food and Drug Administration in the United States, where Sharapova has lived since 1994.

Sharapova told reporters that she started taking the drug a decade ago because “[she] had several health issues going on at the time.”

“I was getting sick very often, I had a deficiency in magnesium, I had irregular EKG results, and I had a family history of diabetes,” she said. While meldonium is primarily used to treat cardiac problems, one animal study has indicated that meldonium has anti-diabetic effects on the metabolism of rats.

But because of meldonium’s metabolic effects, WADA considers the drug to be a “metabolic modulator.” It is listed in the same prohibited category as insulin, which can also be abused to boost athletic performance. A December 2015 study in the journal Drug Testing and Analysis argued that meldonium “demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions.”

WADA banned it, effective Jan. 1, 2016.

An apologetic Sharapova said that she didn’t want to retire, as many in the tennis world speculated she might when she first announced the press conference yesterday.

“I let my fans down, I let the sport down that I’ve been playing since the age of 4 that I have loved so deeply,” she said. “I know that with this, I face consequences.”

As the Associated Press reported, the penalties that Sharapova will face are still unclear and will vary depending on the extent to which the International Tennis Federation (ITF) believes her story. By telling her story, Sharapova seems to be hoping to avoid a long-term suspension.

“I made a huge mistake,” she said. “I don’t want to end my career this way.”

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