MILDRONĀTS GRINDEKS 250 mg hard capsules, 60 pcs.

Meldonium (Mildronāts-Grindeks) is a structural analogue of gamma-butyrobetaine (GBB), the precursor of carnitine, in which one carbon atom is replaced by a nitrogen atom. Its effects on the body can be explained in two ways. ▪ Influence on carnitine biosynthesis Meldonium, by reversibly inhibiting gamma-butyrobetaine hydroxylase, reduces carnitine biosynthesis and therefore disrupts the transport of long-chain fatty acids across cell membranes, preventing the accumulation of powerful detergents — activated, non-oxidised fatty acids — inside cells. This helps prevent damage to cell membranes. As carnitine concentration decreases under ischemic conditions, β-oxidation of fatty acids is suppressed and oxygen consumption in cells is optimised, glucose oxidation is stimulated, and ATP transport from sites of biosynthesis (mitochondria) to sites of utilisation (cytosol) is restored. In essence, cells are supplied with nutrients and oxygen, and their utilisation becomes more efficient. At the same time, increased biosynthesis of the carnitine precursor GBB activates NO-synthase, which improves blood rheology and reduces peripheral vascular resistance. As the concentration of meldonium decreases, carnitine biosynthesis gradually increases again, and the amount of fatty acids in cells is restored. It is believed that the effectiveness of meldonium is based on increasing the tolerance of cells to load when fatty acid levels fluctuate. ▪ Mediator function in the hypothetical GBB-ergic system A hypothesis has been proposed that a neural signalling system — the GBB-ergic system — exists in the body, responsible for transmitting nerve impulses between somatic cells. The mediator of this system is the ester of GBB, the last precursor of carnitine. Through the action of GBB-esterase, the mediator donates an electron to the cell, transmitting the electrical impulse, and is converted into GBB. The hydrolysed GBB is then actively transported to the liver, kidneys, and testes, where it is transformed into carnitine. In response to stimuli, somatic cells synthesise new GBB molecules, ensuring further signal propagation. As carnitine concentration decreases, GBB synthesis is stimulated, increasing the concentration of GBB ester. Meldonium, being a structural analogue of GBB, is capable of acting as a “mediator.” However, GBB-hydroxylase does not recognise meldonium; therefore, carnitine concentration decreases rather than increases. By replacing the mediator and promoting an increase in GBB concentration, meldonium enhances the development of the body’s adaptive responses. As a result, overall metabolic activity increases in other systems as well, including the central nervous system (CNS). Influence on the CNS Animal studies have demonstrated the antihypoxic effect of meldonium and its ability to improve cerebral circulation. Meldonium optimises redistribution of blood flow in favour of ischemic areas of the brain and increases neuronal resistance under hypoxic conditions. Meldonium also exhibits CNS-stimulating properties — increased motor activity, enhanced physical performance, stimulation of behavioural responses, and anti-stress effects. Effectiveness in cerebrovascular and neurological disorders The influence of meldonium on the rehabilitation process in patients with neurological disorders (after cerebrovascular diseases, brain operations, trauma) has been studied. Results of clinical evaluation of meldonium demonstrate a positive effect on patients’ physical performance and the restoration of functional independence during the recovery period, depending on the dose used. Analysis of individual and overall cognitive function changes after treatment showed a positive effect on cognitive recovery during rehabilitation.