Beta-2 agonists
All beta-2 agonists (for example Terbutaline, Procaterol, Vilanterol), are prohibited at all times in sport and require permission for use.
This permission is in the form of a Therapeutic Use Exemption (TUE) which can be applied for via a medical committee. In Australia this committee is called the Australian Sports Drug Medical Advisory Committee (ASDMAC).
However, the following beta-2 agonists, when INHALED, can be used up to the limits listed below WITHOUT a TUE. If use is required above these levels then they also require a TUE.
- Salbutamol: Inhaled Salbutamol is permitted up to a maximum dose of 1600 mcg (16 puffs) per 24 hours, not to exceed 800mcg (8 puffs) in a 12 hour period
- Salmeterol: Inhaled Salmeterol is permitted up to a maximum dose of 200 micrograms (approximately 8 puffs when using Seretide MDI inhaler 250/25) over 24 hours
- Formoterol: Inhaled Formoterol is permitted up to a maximum dose of 54 micrograms (approximately 9 puffs when using Rapihaler 200/6) over 24 hours
Glucocorticoids
Inhaled and intranasal glucocorticoids, used in the management of asthma and hayfever, are permitted and a TUE is not required.
Systemic treatment (oral or intravenous) with glucocorticoids (for example prednisone) is prohibited in-competition* only and requires a TUE when used during or immediately prior to competition (within 5 to 7 days). An extended TUE for up to 12 months will be considered for chronic, unstable asthma, but further medical evidence regarding the severity and frequency of the asthma will be required.
*The definition of ‘in-competition’ does vary between sports and events but is generally considered to start 12 hours before the match/game and to end after any drug testing has been performed at the end of the competition.
Asthma medication quick reference guide—common medications
|
Substance |
Status in Sport |
|---|---|
|
INHALED Salbutamol (Ventolin, Asmol) |
TUE NOT Required - With specific conditions. Inhaled Salbutamol is permitted up to a maximum threshold of 1600 micrograms (16 puffs) over 24 hours, not to exceed 800 micrograms every 12 hours. This threshold is not valid in the presence of diuretics. If using a diuretic a TUE is required to use both the diuretic and salbutamol. If maximum threshold is exceeded a TUE is required. |
|
INHALED Formoterol (Symbicort) |
TUE NOT Required - With specific conditions. Inhaled Formoterol is permitted up to a maximum threshold of 54 micrograms (approx. 9 puffs when using Rapihaler 200/6) over 24 hours. This threshold is not valid in the presence of diuretics. If using a diuretic a TUE is required to use both the diuretic and formoterol. If maximum threshold is exceeded a TUE is required. |
|
INHALED Salmeterol (Seretide/Serevent) |
TUE NOT Required - With specific conditions. Inhaled Salmeterol is permitted up to a maximum threshold of 200 micrograms (approx. 8 puffs when using Seretide MDI inhaler 250/25) over 24 hours This threshold is not valid in the presence of diuretics. If using a diuretic a TUE is required to use both the diuretic and salmeterol. If maximum threshold is exceeded a TUE is required. |
|
INHALED Terbutaline (Bricanyl) |
TUE Required. Prohibited both in and out of competition. See ‘medical evidence needed for TUEs’. |
|
INHALED Vilanterol (Breo) |
TUE Required. Prohibited both in and out of competition. See ‘medical evidence needed for TUEs’. |
|
INHALED Budesonide (Symbicort, Pulmicort) |
TUE Not Required. Permitted in and out of competition. |
|
INHALED Ciclesonide ( Alvesco) |
TUE Not Required. Permitted in and out of competition. |
|
INHALED Fluticasone (Flixotide, Seretide) |
TUE Not Required. Permitted in and out of competition. |
|
ORAL or INJECTED Salbutamol |
TUE Required. Prohibited both in and out of competition. See ‘medical evidence needed for TUEs’. |
|
ORAL Formoterol |
TUE Required. Prohibited both in and out of competition. See ‘medical evidence needed for TUEs’. |
|
ORAL Prednisolone/Prednisone |
TUE Required In-Competition Only. Permitted out-of competition. If taking Prednisolone/Prednisone out-of competition (not competing), allow 5-7 days once ceasing medication before competing. TUE required if taking oral Prednisolone in competition. See ‘medical evidence needed for TUEs’. |
Note1: Use of Asthma medications with Diuretics or Masking Agents. If you are taking a diuretic or masking agent (for which a TUE is required) then the use of a threshold substance such as Salbutamol or Formoterol requires an additional TUE to the one granted for the diuretic or masking agent.
Note2: The updated WADA Prohibited List comes into effect from 1 January each year. Please ensure that you check the status of your medications.
