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 The World Anti-Doping Agency (WADA) has published the 2010 Prohibited List which will come into effect on 1 January 2010. The Prohibited List is an international standard that outlines the substances and methods that are prohibited in sport. WADA's mission is to promote, coordinate and monitor the fight against doping in sport in all its forms.
Competitors are encouraged to familiarise themselves with the new Prohibited List to ensure they are ready for the change on 1 January 2010.
Please find attached a summary of significant changes for your convenience. Please pay particular attention to the following key changes:
- The status of salbutamol and salmeterol (used for the treatment of asthma). Therapeutic use of inhaled salbutamol and salmeterol (maximum 1600 micrograms per day) will not be prohibited as of 1 January 2010 with a declaration of use. Make sure you check your asthma medication at www.asada.gov.au or by calling 1300-27232.
- Supplemental oxygen (hyperoxia) will no longer be prohibited.
- The status of platelet-derived preparations (such as Platelet Rich Plasma (PRP), 'blood spinning') has been clarified by WADA. It will be prohibited when administered by intramuscular route, but other routes of administration will require a declaration of use.
- Pseudoephedrine will be reintroduced to the Prohibited List and will be prohibited above blood concentrations of 150 micrograms per millilitre.
These changes are effective from 1 January 2010. If you have any questions regarding the new Prohibited List, please contact ASADA by calling 13 000 ASADA (13 000 27232).
It is often difficult to interpret the changes in relation to "what doses of medications will allow me comply with the new regulations?" For example, "how many puffs of my asthma inhaler per day is 1600 micrograms? Is that a small or large dose?"
Or "what sort of dose gives a blood concentration of 150 mcg/ml for pseudoephedrine? Is that equal to one, two or three (or more) cold tablets?" This will give you an idea of how the prohibitions relate to normal use of these medications.
CAMS has sought clarification in consultation with members from the National Medical Committee Advisory Committee to these changes to help shed light on the content. In regard to the WADA banned list, CAMS offers the following feedback for competitors in conjunction with the document Key Changes to the Prohibited list 2010 - What this means for you: Australian Sports Anti-Doping Authority (ASADA) www.asada.gov.au.
Each dose of inhaled salbutamol or salmeterol is 100 micrograms. The daily limit therefore equates to 16 inhaled doses. Most guidelines for treating adult asthma would recommend two inhaled doses at a time, so this would be eight treatment doses.
Medical advice suggests this is quite a high dose in one day, and anyone using more than this ought to be seeking medical assessment of his or her asthma. The WADA limit, therefore, seems entirely reasonable.
Key changes to the 2010 Prohibited List - summary for sports athletes and other stakeholders
Any competitor using these drugs in excess of the WADA limit should be medically assessed with a view to improving the management of their asthma.
With regard to pseudoephedrine, the guidelines contain details of the dose of pseudoephedrine in common cold and flu preparations. The common dose is 30-60 mg per tablet, and dosing guidelines on use of the medication indicate a maximum dose of 240 mg per 24 hours.
There are also two antihistamine preparations available in Australia that contain 120 mg of pseudoephedrine per tablet - Telfast Decongestant and Clarinase Repetabs. Both these medications are taken 12 hourly, again giving a dose of 240 mg of pseudoephedrine in 24 hours.
The guidelines recommend that all of these medications are to be ceased a minimum of 24 hours prior to competition to allow plasma concentrations to fall below the limit of 150 mcg/ml at the time of competition.
There have been a raft of new cold and flu medications that have become available recently (due to the increasing use of pseudoephedrine to manufacture illicit drugs) that contain phenylephrine instead of pseudoephedrine - phenylephrine is not on the banned list. Many of these preparations contain the suffix "PE" in their name. If competitors require clarification regarding these medications, they can check with their pharmacist at the time of purchase.
Around the time of competition, competitors should only use cold and flu preparations that contain phenylephrine, and avoid Telfast Decongestant and Clarinase Repetabs. There is no issue with competitors using pseudoephedrine out of competition.
Please note CAMS is not aware of any cases of competitors in motor sport having used platelet-rich plasma (PRP) injections to treat muscle injuries, but the fact that intramuscular PRP injections have been added to the banned list should be noted by competitors.
Find out more information on anti-doping that affects you by reading the Anti-Doping Update: December 2009
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