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The drug's Latvian manufacturer, JSC Grindeks, reports that it primarily targets individuals with heart disease, and During increased physical activity, it restores the oxygen balance of tissue cells as well as activating the metabolic processes that result in lower requirements of oxygen consumption for energy production , and also that Meldonium cannot improve athletic performance, but it can stop tissue damage in the case of ischemia ( Therefore, this narrative review aims to critically evaluate published scientific literature to determine whether Meldonium's unique metabolic mechanisms actually translate into documented performance-enhancing benefits for healthy athletes, or if its ergogenic reputation is largely unfounded