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UFC On FOX 19: Islam Makhachev's drug test violation was for meldonium

In the latest of a string of catastrophes to befall tomorrow night's snakebitten UFC on FOX 19 card, Islam Makhachev has been pulled from the lineup by the Florida AC due to a drug test violation for meldonium.

Joe Camporeale-USA TODAY Sports

Bloody Elbow has learned that Islam Makhachev has incurred a USADA drug test violation for the recently banned substance meldonium and has been removed from his UFC on FOX 19 bout with Drew Dober as a result.

Meldonium is a heart medication developed in Latvia primarily used for improving bloodflow in patients with ischemia or heart issues like angina and similar issues. It is not currently scheduled or available in the USA. It has been commonly used by athletes as a supplement in eastern Europe and Russia for several years. It was placed on the in and out of competition prohibited list by WADA on Jan 1st 2016 after previously being on the WADA watchlist in 2015. It was still legal under WADA/USADA guidelines as recently as December 31st 2015.

While meldonium has not undergone stringent testing to prove it enhances performance, WADA's 2016 summary said: ‘Meldonium (Mildronate) was added because of evidence of its use by athletes with the intention of enhancing performance.' A clinical trial did find it substantially increased exercise tolerance in patients with stable angina, but no trials examining athletic performance in healthy individuals have been published.

Over 170 athletes, primarily from the former U.S.S.R territories, including women's tennis superstar Maria Sharapova and several Russian wrestlers and judoka, have failed WADA tests for meldonium since the ban came into force on January 1st. Several athletes have appealed against their results, claiming the test showed traces of meldonium which was taken when the drug was still legal, and that there was no proof the tests did not simply show meldonium taken while it was still legal in 2015.

WADA released a statement this week addressing the issue of excretion times:

"In the case of meldonium, there is currently a lack of clear scientific information on excretion times. For this reason, a hearing panel might justifiable find (unless there is specific evidence to the contrary) that an athlete who has established on the balance of probabilities that he or she ingested meldonium before 1 January 2016 could not reasonably have known or suspected that meldonium would still be present in his or her body on or after 1 January 2016. In these circumstances, WADA considers that there may be grounds for no fault or negligence on the part of the athlete."

MMA fans may be familiar with this argument, as the relatively long lasting nature of marijuana metabolites have led to athletes failing in-competition drug tests for marijuana despite not actually using it for days or weeks beforehand. While no MMA athletes have successfully appealed a marijuana test failure on these grounds, the WADA statement suggests an appeal against a meldonium failure may be successful if the athlete can reasonably claim they only took the drug while it was still legal.

The ban has been controversial in some circles, as according to the WADA code a substance can be banned if it is found to meet two of three criteria (enhances performance, poses a threat to athlete health, violates the spirit of the sport). As there is no direct evidence meldonium enhances performance or poses a threat to athlete health, some, including Maria Sharapova's sponsor, Head, have claimed the ban is based purely on the fact primarily Russian athletes used it, rather than evidence that it fulfilled two of the three criteria required for a substance to be prohibited.