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Introduction While Western countries commonly refer to substances like Meldonium as metabolic modulators, in Eastern countries, they are frequently classified as antihypoxic agents ( -oxidation (e.g., Meldonium, trimetazidine, ranolazine), succinate-based drugs (e.g., Mexidol, Cytoflavin), natural components of the respiratory chain (cytochrome C, ubiquinone), and artificial redox systems (Hypoxen) ( The World Anti-Doping Agency (WADA) classified Meldonium as a prohibited substance effective January 1, 2016