Meldonium is an analog of gamma-butyrobetaine, it suppresses gamma-butyrobetaine hydroxinease,reduces the synthesis of carnitine and the transport of long chain fatty acids through the cell membranes, prevents the accumulation of activated forms of unoxidized fatty acids - the derivatives of acylcarnitine and acylcoenzyme A. As a result of a decrease in the concentration of carnitine, gamma-butyrobetaine is strongly synthesized, which has vasodilating properties.
Under conditions of ischemia, it restores the equilibrium of the processes of oxygen delivery and its consumption in cells, prevents the violation of ATP transport; simultaneously, it activates glycolysis, which proceeds without additional consumption of oxygen.
The mechanism of action determines the variety of its pharmacological effects: increasing efficiency, reducing the symptoms of mental and physical overstrain, the activation of tissue and humoral immunity, cardioprotective effect. In the case of acute ischemic damage, the myocardium slows the formation of the necrotic zone, shortens the rehabilitation period. With heart failure increases myocardial contractility, increases exercise tolerance, reduces the incidence of angina attacks.In acute and chronic ischemic disorders of cerebral circulation improves blood circulation in the ischemic focus, promotes redistribution of blood in favor of the ischemic site. Effective in the case of vascular and dystrophic pathology of the fundus. Characteristic is also a tonic effect on the central nervous system, the elimination of functional disorders of somatic and autonomic nervous systems in patients with alcoholism during the period of abstinence.