The World Anti-Doping Agency (WADA) has issued a new Prohibited List of Substances and Methods which comes into effect on 1 January 2011. Changes to the Prohibited List are as a result of ongoing reviews by the WADA List Expert Group who review the list annually, taking into consideration submissions from stakeholders, advancements in science, doping practice etc. A substance or method is added to the List if it meets two of three criteria: It is performance-enhancing, poses a danger to athletes’ health and its use is against the spirit of sport.
From January 2011, there are a number of significant changes which prescribers should note:
1 The requirement for a Declaration of Use (DOU) has been removed from the List. This previously applied to inhaled salbutamol (at doses below 1600mcg/24 hours), inhaled salmeterol, and inhaled and intra-articular injections of glucocorticosteroids
2 While the use of inhaled salbutamol below 1600mcg over 24 hours remains permitted for use in sport, inhaled salmeterol is only permitted when used within the manufacturers’ recommended therapeutic regime. To use doses of salmeterol in excess of this threshold, to use inhaled salbutamol in excess of 1600mcg/24 hours or to use any other beta-2-agonist a Therapeutic Use Exemption (TUE) will be required.
3 Desmopressin has been added as an example of a masking agent and thus the use of desmopressin or similar substances will now require a TUE.
4 The 2011 List has been revised to more clearly explain that the use, as applicable, of any quantity of a substance subject to threshold limits (i.e. salbutamol, morphine, cathine, ephedrine, methylephedrine and pseudoephedrine) in conjunction with a diuretic or other masking agent requires a specific TUE for that substance in addition to the one granted for the diuretic or other masking agent.
5 While individual growth factors remain prohibited, the intramuscular injection of platelet-derived preparations (such as Platelet Rich Plasma or PRP, or ‘blood spinning’) has been removed from the List after consideration of the lack of any current evidence concerning the use of these methods for purposes of performance enhancement notwithstanding that these preparations contain growth factors.
Welcoming the 2011 Prohibited List, Dr Una May of the AntiDoping Unit of the Irish Sports Council, commented that “The Council is pleased with the continued streamlining by WADA of the list of prohibited substances and the medical exemptions process. Athletes with genuine medical conditions must be treated with the most appropriate medications and the new system allows that to happen.”
The January 2011 edition of MIMS has been updated to include all changes. Prescribers should ensure that they are using the most recent edition of MIMS Ireland. www.eirpharm.com, the Irish Pharmacy website where athletes can check online the status of medicines in sport and the athlete’s wallet card issued by The Irish Sports Council are also updated in accordance with the 2011 List.
More information is available from the Irish Sports Council at (01) 8608818. Fax: (01) 8608860. Website: www.irishsportscouncil.ie/Anti-Doping), www.eirpharm.com and National Governing Bodies of Sport.