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Further, trimetazidine commonly causes nausea, vomiting, fatigue, dizziness, and myalgia, muscle pain — none of which are particularly conducive to athletics.

The most common early symptom reported is a scratchy throat, followed by nasal congestion, a dry cough and myalgia, or aches, manifesting in lower back pain.

The most common early symptom reported is a scratchy throat, followed by nasal congestion, a dry cough and myalgia manifesting in lower back pain.

“Alternatively, early neurologic manifestations such as myalgia, headache, or dizziness may have prompted earlier medical care. In contrast, encephalopathy was more frequent in older patients.”

Typically it starts with fever, dry cough, myalgia and flu-like illness, then progresses to shortness of breath and pneumonia in some patients.