Allergy Season: Asthma Sprays in Sports

In spring, athletes are also often affected by allergies. Some also suffer from more pronounced forms, such as allergic asthma. A number of medicines are available for the non-doping treatment of this condition.

However, the use of asthma sprays occasionally leads to uncertainty. Many athletes and doctors believe that asthma sprays are generally prohibited in sport. There are some asthma sprays that are permitted in certain quantities and can be inhaled without a Therapeutic Use Exemption.

Asthma sprays containing cortisone (e.g. beclometasone, budesonide or fluticasone) or cromoglicic acid are allowed and can be used directly.

Asthma sprays containing salbutamol, salmeterol, formoterol and vilanterol are allowed and can be used. However, a certain permitted dosage must not be exceeded:

• Salbutamol up to 600 µg over 8 hours and a maximum of 1600 µg over 24 hours.
• Salmeterol up to 200 µg over 24 hours
• Formoterol up to 54 µg over 24 hours
• Vilanterol up to 25 μg over 24 hours

Thus, for example, an asthma inhaler containing salbutamol at the usual dose of 100 µg/puff may be inhaled 6 times in 8 hours. After 8 hours, another 6 puffs may be inhaled, and after another 8 hours, another 4 puffs (equivalent to 1600µg of salbutamol over 24 hours).

NoTherapeutic Use Exemption is required for the use of salbutamol, salmeterol, formoterol or vilanterol if the permitted dosage is observed. However, the use of these four active substances in any other form (e.g. as tablets or by injection) is prohibited.  

The use of these four active substances in any other form (e.g. as tablets or by injection) is prohibited.  

The use of other asthma sprays containing e.g. fenoterol, reproterol, indacaterol, olodaterol or terbutaline is also prohibited.

To support a doping-free treatment, the example list of permitted drugs can be used in addition to NADAmed. Both tools can be accessed via the NADA website www.nada.de or the NADA app NADA2go.

In the case of a doping test, all medicines used should always be declared. If you have any further questions, please contact our Medical Department by e-mail: medizin[at]nada.de.

The most important things at a glance:

The following medications are permitted and do not have to be reported to NADA Germany:

• Asthma sprays with salbutamol, salmeterol, formoterol, vilanterol up to the permitted dosage.
• Asthma sprays with cortisone
• Creams, eye drops, nasal sprays containing cortisone

The following medicines are prohibited. Please contact NADA Germany for further information:

• Asthma sprays with fenoterol, reproterol, indacaterol, olodaterol, terbutaline
• Asthma sprays with salbutamol, salmeterol, formoterol, vilanterol above the permitted dosage
• Tablets/syrup or injections with salbutamol, salmeterol, formoterol, vilanterol
• Cortisone, when administered by any injectable, oral or rectal route, in competition