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Pharmacological effects of meldonium: biochemical mechanisms and biomarkers of cardiometabolic activity

This means they have to cross the mitochondrial membranes

[16] As a third method, there is a method for preparing L-carnitine, involving synthesis of a (R)-4-chloro-3-hydroxybutyrate derivate from 4-chloro-3-oxobutyrate derivative via the stereoselective reduction using a ruthenium catalyst, followed by preparation of L-carnitine by a conventional method (U.S