Meldonium decreases the diet‐increased plasma levels of trimethylamine N‐oxide, a metabolite associated with atherosclerosis

The role of trimethylamine N-oxide as a mediator of cardiovascular complications in chronic kidney disease

“…49 Oral meldonium, a synthetic structural analogue of L-carnitine precursor γ-butyrobetaine, limited elevations in plasma TMAO after a fish-rich diet and increased urinary TMAO excretion by 35% in human test subjects. 50 It is not clear if this effect was due to inhibition of reabsorption or enhanced secretion of TMAO by the tubule. If a tubular TMAO transporter is confirmed, targeted therapeutic strategies to enhance urinary TMAO clearance may be feasible.…”

Structure and Function of CutC Choline Lyase from Human Microbiota Bacterium Klebsiella pneumoniae

“…In addition, the cardioprotective drug meldonium, an inhibitor of L-carnitine biosynthesis and transport (22), has been shown to lower TMAO levels in both rats and humans (21,23) through inhibition of TMA production by the intestinal microbiota.…”

Associations of current diet with plasma and urine TMAO in the KarMeN study: direct and indirect contributions

“…Trimethylamine-N-oxide (TMAO) is present in various types of fish and seafood [1], probably due to adaptation to hydrostatic/osmotic pressure and low temperatures [2][3][4]. In several investigations, including metabolomics studies, a link between fish consumption and urine TMAO concentrations was observed [5][6][7][8][9][10]. Consequently, TMAO has been proposed as a biomarker for the intake of fish and seafood.…”