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Mildronate® is an anti-ischemic metabolic agent. Due to its unique mechanism of action Mildronate® is widely used for treatment of different heart and vascular diseases, for the improvement of work capacity of generally healthy people at physical and mental overloads and during rehabilitation period. Its active pharmaceutical ingredient (active substance) is meldonium which is responsible for the pharmacological and therapeutic effects of Mildronate®.
Proffesor Dr. chem. hab. Ivars Kalvins is the scientist behind Mildronate®, who invented this anti-ischemic drug back in 1970’s. Ivars Kalvins is a former director of the Latvian Institute of Organic Synthesis and is recognized as one of the leading Latvian and European scientists. Currently he is acting as a Chairman of Scientific Council of Latvian Institute of Organic Synthesis.
Mr Kalvins’s interests of inventing include new physiologically active substances for CNS, cardiovascular and oncologic diseases, heterocyclic compounds and amino acid analogues in chemistry, biochemical mechanisms of action for new medicinal substances, immunochemistry.
Meldonium is a cytoprotective substance, which is used to prevent death of ischemic cells. Its mechanism of action is based on the regulation of energy metabolism pathways thorough L-carnitine lowering effect. L-carnitine biosynthesis enzymes gamma-butyrobetaine hydroxylase and carnitine/organic cation transporter type 2 (OCTN2) are the main known drug targets of meldonium, and through inhibition of these 2 targets meldonium optimizes cellular energy homeostasis. Free fatty acid inhibition is not a direct pharmacological target of meldonium. However, since L-carnitine is involved in metabolism of fatty acids, the decline in its levels stimulates glucose metabolism and decreases concentrations of potentially harmful L-carnitine related metabolites, such as long-chain acylcarnitines and trimethyl-N-oxide.
This is important in the treatment of pathologies associated with ischemia (stenocardia, heart failure, stroke), as in these cases the tissues and cells are not getting enough oxygen and nutrients.