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Current medical advice

Are you currently suffering from hay fever and bronchial asthma? Do you intend to donate blood plasma? Are you taking nutritional supplements? And do you plan a trip to China or Mexico?

Caution: Meat products in those countries can be contaminated by clenbuterol. Contamination or adulteration can happen in nutritional supplements, too. When donating blood plasma, please, observe that according to the anti-doping rules it is permitted to draw blood, but forbidden to administrate or reintroduce any quantity of blood or blood products. Thus, athletes have to observe some crucial rules before donating blood or receiving plasma. For the treatment of allergies and hay fever, both permitted and prohibited medicines are available, and in the polling season the NADA receives more and more inquiries.

Below, you will find a number of important instructions on questions like the above. In addition, you will find information on all changes to the current WADA Prohibited List.

The List is revised once a year. We have prepared a German translation. On the right hand side, there is a summary of the main changes for 2018.

Selected topics

According to findings by the Manfred-Donike-Institute and the Center for Preventive Doping Research (ZePraeDo) at the German Sport University Cologne there is an actual risk of accidental anti-doping rule violations by consuming meat in China and Mexico that can contain the prohibited beta-2-agonist clenbuterol.

Therefore, NADA Germany advises athletes to be extremely careful in terms of diet when travelling to Mexico and China. At major sports events in those countries, the relevant international sports federations should be able to inform participants whether secure catering and contamination-free products will be provided. Meat consumption should possibly be reduced or avoided as far as feasible. For hints on alternative, safe protein sources, please, refer to the recommendations of the German Olympic Sports Confederation (DOSB) and contact your nutritional expert at your local / regional Olympic training site (OSP).

Supposed cause of the contaminations in China and Mexico is the illegal use of clenbuterol as growth enhancer in in cattle and livestock. Due to much stricter legal provision in Europe and Northern America meat and meat products are considered safe.

Some athletes are regular or irregular donors of blood or blood plasma. As methods like the administration or reintroduction of any quantity of blood or blood products as well as intravenous infusions are considered forbidden by the WADA Prohibited List, athletes who are subject to the anti-doping rules should observe some substantial provisions to avoid unintended doping rule violations. We have prepared helpful information on TUEs and/or medical certificates for donors and recipients below:

  • Donation (withdrawal) of blood: Neither TUE (for testing pool athletes) nor medical certificate (for non-testing pool athletes) required. Where applicable, list the donation in the Athlete Biological Passport.
  • Donation of blood plasma: As the blood is filtered repeatedly for plasma during the donation process and thus reintroduced intravenously, TUEs are required from testing pool athletes and medical certificates, at least, from non-testing pool athletes or, under certain circumstances, retro-active TUEs.
  • Dialysis: TUEs are required from testing pool athletes and medical certificates, at least, from non-testing pool athletes or, under certain circumstances, retroactive TUEs.
  • When receiving blood transfusions: TUEs are required from testing pool athletes and medical certificates, at least, from non-testing pool athletes or, under certain circumstances, retroactive TUEs.
  • When receiving plasma donations: Plasma is one component of blood that does not transport oxygen. Thus, in case of testing pool athletes no TUE is necessary and no medical certificate or retro-active TUE, respectively, from non-testing pool athletes, as long as the intravenous administration of plasma is performed at a hospital. HOWEVER: TUEs are required from testing pool athletes and medical certificates, at least, from non-testing pool athletes or, under certain circumstances, retroactive TUEs, when the infusion is NOT administered at a hospital.
  • Receiving permitted substances by intravenous infusion at a hospital: Permitted substances with a total liquid quantity of MORE than 50 ml within a six hours' period AT A HOSPITAL, DURING surgical procedures OR clinical investigations: Neither TUE (testing pool athletes) nor medical certificate (non-testing pool athletes) or retro-active TUE required. · Receiving permitted substances by intravenous infusion out of hospitals: Infusions with a total liquid quantity of MORE than 50 ml within a six hours' period administered OUT OF HOSPITALS or beyond surgical procedures or clinical investigations - even of permitted substances - are prohibited. They require TUEs from testing pool athletes and medical certificates, at least, from non-testing pool athletes or, under certain circumstances, retroactive TUEs.
  • Receiving intravenous infusions of prohibited substances, even at a hospital: TUEs are required from testing pool athletes and medical certificates, at least, from non-testing pool athletes or, under certain circumstances, retroactive TUEs AT ALL TIMES, irrespective of WHERE the infusion occurs.

Antihistaminics are allowed. Asthma sprays, eye drops, nasal sprays and skin creams with active ingredients from the group of glucocorticoids (cortisone) are also permitted. In addition, three bronchodilatory active ingredients (so-called beta-2 agonists) may be used by inhalation, according to the following daily maximum doses:

  • salbutamol: maximum 1600 micrograms over 24 hours, not to exceed 800 micrograms every 12 hours;
  • formoterol: maximum delivered dose of 54 micrograms over 24 hours;
  • salmeterol: maximum 200 micrograms over 24 hours.

Allowed medications must be indicated in doping controls.

For the use of permitted medicines, a Therapeutic Use Exemption (TUE) or a medical certificate is not required. Any TUE-applications and medical certificates for authorized medicines are returned to the sender immediately. For further information, please visit www.nadamed.de.

Relevant changes in the 2018 Prohibited List

New in category "S2 peptide hormones, growth factors, related substances and mimetics" are the growth factor modulators thymosin beta-4 and its derived TB-500. Both substances are not approved as medicinal products, thymosin beta-4 is in clinical trials for the treatment of certain eye diseases.

Tulobuterol is cited as another example of banned beta-2 agonists in the category "S3 beta-2 agonists".

Glycerol was previously banned as a plasma expander in the category "S5. Diuretics and sequestering agents" and will no longer be included in the Prohibited List 2018.

In the category "M2.2. Chemical and physical manipulation" it is redefined that intravenous infusions in a total volume of 100 ml are allowed within 12 hours if the contained substances are allowed.

Newly added to the category "S6.b: Specific Stimulants" is the substance 1,3-dimethylbutylamine. In its structure and effect, 1,3-dimethylbutylamine resembles the methylhexanamine (= 1,3-dimethylamylamine) already mentioned in the Prohibited List for several years and, like this, can likewise be contained in nutritional supplements. The NADA advises a reflected approach to nutritional supplements.

From 1. January 2018, alcohol will no longer be part of the WADA Prohibited List.

Important Documents

Medical information sheet 2018

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Fact sheet "Disease and Sport"

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Example list of permitted pharmaceuticals 2018

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WADA Prohibited List 2018

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