WADA and IFF calls on athletes, entourage and all stakeholders to note major modifications concerning the use of salbutamol and injectable glucocorticoids – starting from 1st January 2022
The World Anti-Doping Agency (WADA) has published the 2022 List of Prohibited Substances and Methods List as well as the 2022 Summary of Major Modifications and Explanatory Notes. The 2022 List was approved by WADA’s Executive Committee (ExCo) during its meeting on 14 September 2021 and comes into force on 1 January 2022.
The List is one of the eight International Standards that are mandatory for all international Federations and major events of the World Anti-Doping Code (Code). It designates what substances and methods are prohibited both in- and out-of-competition and which substances are banned in particular sports. These lists are determined yearly through an extensive consultation process and involved the most qualified experts in the fields of science and medicine from around the world.
As outlined in the 2022 Summary of Major Modifications and Explanatory Notes, the Major Modifications for 2022 include the following:
All injectable routes of administration will now be prohibited for glucocorticoids during the in-competition period. Examples of injectable routes of administration include: intravenous, intramuscular, periarticular, intra-articular, peritendinous, intratendinous, epidural, intrathecal, intrabursal, intralesional (e.g. intrakeloid), intradermal, and subcutaneous. For clarification: oral administration of glucocorticoids, which remains prohibited in-competition, includes, in particular, oromucosal, buccal, gingival and sublingual routes.
Other routes of administration (including inhaled and topical: dental-intracanal, dermal, intranasal, ophthalmological and perianal) are not prohibited when used within the manufacturer’s licensed doses and therapeutic indications.
It is strongly recommended that athletes follow the minimum washout periods, expressed from the time of administration to the start of the in-competition period. These washout periods, which are highlighted in the Summary of Major Modifications and Explanatory Note (page 4) are based on the use of these medications according to the maximum manufacturer’s licensed doses. If there is a legitimate medical need for the use of a glucocorticoid, the athlete may apply for a Therapeutic Use Exemption (TUE). All the information on the process and application for IFF events can be found from this link here.
For further information regarding WADA’s approach to the routes of administration of glucocorticoids and washout periods, please refer to the Summary of Major Modifications and Explanatory Note.
S3. Beta-2 Agonists – Dosage of Salbutamol
Regarding salbutamol, the daily dosing time intervals are modified to 600 micrograms over eight hours starting from the time any dose is taken (previously 800 micrograms over 12 hours). This is to reduce the risk of any potential Adverse Analytical Finding (AAF) arising after high doses are taken at once. The total permitted daily dose remains at 1,600 micrograms over 24 hours. A TUE should be sought for doses in excess of these limits. All the information on the process and application for IFF events can be found from this link here.
For further information on the permitted dosage of salbutamol, please refer to the Summary of Major Modifications and Explanatory Note.
The TUE Program
It should be noted that for athletes who have a legitimate medical reason for using a prohibited substance or method that is on the List, they can apply for a TUE to determine whether they meet the criteria outlined in the International Standard for Therapeutic Use Exemptions (ISTUE). The TUE Program is a rigorous and necessary part of elite sport which has overwhelming acceptance from athletes, physicians and anti-doping stakeholders. All the information on the process and application for IFF events can be found from this link here.
Sources from WADA