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What is the banned drug trimetazidine taken by Russian skater Kamila Valieva?

Russian figure skater Kamila Valieva, a favorite to win gold in the women’s figure skating competition at the Beijing Olympics 2022, has been at the center of a doping controversy.

Valieva has been allowed to compete at the Olympics despite testing positive for a banned drug, but will have any medals withheld until her case is resolved. 

She came close to a perfect short program but stumbled on her triple axel on Tuesday, still scoring 82.16 points, good enough for first place.

She has reportedly argued that there was a mix-up with her grandfather’s medication after she tested positive for banned drug trimetazidine.

But what exactly does trimetazidine (TMZ) do?

Trimetazinine works by increasing blood flow to the heart and restricting rapid swings in blood pressure, Reuters reported.

“If you’re in a highly exertional sport, where you’re using a lot of energy and you’re putting your heart under significant stress, it certainly could help your heart function better theoretically,” MedStar Georgetown University Hospital medical toxicology physician Kelly Johnson-Arbor told the newswire.

The World Anti-Doping Agency has listed the drug as a “metabolic modulator” and prohibits its use at all times, both in and out of competition.

According to The New York Times, it was added to the list of substances banned for use during competition in 2014 and prohibited for use out of competition in 2015. It is not sold in the United States.

TMZ is typically taken once or twice a day, and is easy to detect in drug tests as it is a synthetic drug, Reuters added.

Other athletes who tested positive for trimetazidine 
 
Russian bobsledder Nadezhda Sergeeva was disqualified from the 2018 PyeongChang Olympics after testing positive for the drug. Chinese swimmer and Olympic gold medalist Sun Yang was also suspended in 2014 after testing positive for TMZ. Sun said he was prescribed the drug to treat his chest pains. 
 
Russian tennis star Maria Sharapova tested positive for meldonium, which according to The New York Times is a metabolic cousin of trimetazidine, leading to a 15-month ban from the sport. Russian curler Aleksandr Krushelnitckii was stripped of his bronze medal at the 2018 Winter Olympics in the mixed-doubles event after testing positive for meldonium.
 
What’s next for Valieva?
 
The 15-year-old will next be seen in the women’s long program on Feb. 18. However, should she keep her top spot, Valieva will have no flower ceremony and no medal ceremony, the International Olympic Committee announced.
 
The World Anti-Doping Agency announced on Sunday that it will investigate Valieva’s coaches, doctors and any other adults around her in connection to the case.