AIIMS heart failure warning: Cardios warn against misuse of BP-raising drug that Haryana wrestler took as ‘stamina shot’

In reality, doctors say the drug induces the release of norepinephrine, a stress hormone that stimulates the central nervous system and the heart. This leads to a temporary rise in blood pressure, heart rate and cardiac output (the volume of blood pumped by the heart per minute), creating a false sense of energy and strength. “The body feels powerful but it’s borrowed power,” says Dr Ambuj Roy, professor of cardiology at AIIMS Delhi. “You are pushing the heart beyond its safe limits, damaging it in the process.”

Why drug dependence is easy

The wrestler began using the injection in the months leading up to a competition, starting with small doses and soon escalating them. “People start with half a millilitre. Then go up one millilitre, then more. I went up to several millilitres daily for months,” he admits. Worse, he injected the drug directly into his veins, another dangerous practice reported by doctors. Over time, his body began to break down. He experienced extreme fatigue, bloating, headaches, gas and an inability to train without the drug.

Then, last December, everything collapsed. “I didn’t think anything was wrong that day,” he recalls. “But later, I passed out. I was in pain. I ended up in the ICU. The medicine takes control of your mind.”

Mephentermine sulphate is a licensed medicine and is not a scheduled narcotic drug, so it does not come under Narcotic Drugs and Psychotropic Substance (NDPS) Act. Although technically prescription-only, over-the-counter sale is common due to inadequate monitoring of pharmacies and informal sales channels. Compared with anabolic steroids or narcotics, mephentermine’s risks to heart health are under-recognised, so it has not attracted strict regulatory attention. Despite being banned by the World Anti-Doping Agency, anti-doping rules do not regulate community-level access, allowing continued misuse outside elite sports.

What performance drugs do to the heart

The wrestler was told his heart function had dropped to around 20%, a level typically seen in severe cardiac failure. Doctors warned him of a possible heart attack. After multiple scans, including CT and MRI, they began connecting the dots — Long-term stimulant misuse, cardiac stress, possible clot formation and reduced heart efficiency.

According to Dr Sourabh Agastam, assistant professor, cardiology at AIIMS Delhi, the wrestler’s echocardiogram showed his heart muscles had weakened and a large blood clot in his leg. “Clots originating in the left side of the heart are pumped into the arteries, which can carry them to the legs. He was started on treatment for heart failure and blood thinners and showed significant clinical improvement,” he says. For Dr Agastam, this is the third case of mephentermine abuse he is dealing with only a few cases being reported in literature.

This is precisely the risk, according to Dr Roy. “Mephentermine can cause severe hypertension, arrhythmias, strokes, heart failure and sudden death, especially when used repeatedly or during intense physical exertion. It can lead to heart problems in young individuals with an otherwise low cardiovascular risk,” he adds.

Why we need stricter regulations

Under sports regulations, mephentermine is a banned substance. Its presence in urine samples can lead to disqualification, fines and multi-year bans from competition. Yet enforcement struggles to keep pace with informal access through local pharmacies. “It stays in the system long enough to be detected,” the wrestler acknowledges. “If it comes in the test, your career can be finished.” Despite knowing this, many athletes continue to gamble, often unaware of the medical consequences.

Today, the wrestler says his health has improved, but his career and body have been permanently altered. Doctors have advised him to rely on natural nutrition, rest and gradual recovery, warning that further stimulant use could be fatal. “If I had used this earlier,” he reflected, “I would not have been able to wrestle for 20 years.”

Dr Roy argues for stricter regulation by sports authorities. “There must be stricter scheduling, pharmacy audits and targeted education for athletes, trainers and clinicians. Seeing the rampant abuse of this drug, it may be a case of moving from Schedule H to Schedule X,” he says. Other well-known commonly abused drugs are anabolic steroids, painkillers (opioids), stimulants like amphetamines, diuretics, hormones/recovery drugs, anti-anxiety and sleep medications.