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Moreover, a study in a piglet model showed that APAP reduces mRNA expression of NLRP3 inflammasome, IL-1 and IL-18 [266]

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Consequently, the decision to ban Meldonium was driven primarily by this alarming prevalence data and theoretical mechanistic concerns, rather than convincing human performance trials ( The fallout from the ban was massive: between 2016 and 2024, Meldonium consistently ranked as the first or second most common Adverse Analytical Finding (AAF) in annual WADA reports (Table 2)

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While not ideal, a single two-hour exposure to room temperature is unlikely to ruin the entire vial, but it will shorten its overall lifespan