H. K. Greenblatt and D.J. Greenblatt, 2016 (in press). Meldonium (Mildronate): A Performance-Enhancing Drug? Clinical Pharmacology in Drug Development.
Here is the article's conclusion:
In sum, there is minimal evidence from North America and Western Europe regarding meldonium’s role in the treatment of disease, or whether it can produce meaningful performance enhancement in highly trained athletes. Extrapolations and recommendations based in in vivo or animal data should be weighed critically. There is also insufficient evidence to establish the temporal sensitivity of currently-used analytic screening procedures to detect meldonium use in the context of athletic competition.17 As such, the athletes’ claims described above cannot be refuted. Further study is necessary to determine meldonium’s clinical effects, if any, upon trained athletes, as well as to determine what conclusions may be drawn from positive screening results. Given that meldonium is not used clinically, experimentally, or recreationally in Western countries, satisfactory evidence seems unlikely to emerge in the near future.The state of the science is such that Meldonium will continue to present challenges for evidence-based anti-doping. WADA reports that 288 athletes have now tested positive for the drug. Here is my recent perspective in Newsweek on the challenges posed for anti-doping by letting regulation get out ahead of evidence.