Pain relief medications
Narcotics (e.g. morphine, pethidine, fentanyl) are on the WADA Prohibited List. They are only prohibited DURING competition. The clearance of these drugs from the body is relatively rapid but they can remain in the system for a few days. A Therapeutic Use Exemption is therefore required if the athlete is competing within 5 days of taking this medication.
Prednisolone, hydrocortisone
Prednisolone, hydrocortisone may be given to treat severe allergy, anaphylaxis, asthma and other inflammatory conditions. When given systemically (i.e. Intravenous, intramuscularly, orally) these medications are WADA prohibited but only DURING competition. The clearance of these medications from the body is usually fairly rapid but can be variable and will remain in the system for a few days. A Therapeutic Use Exemption is therefore required if the athlete is competing within 5 days of taking this medication.
Adrenaline
Adrenaline may be given for anaphylaxis and an epipen may be given to take home for any future events. It is WADA prohibited DURING competition. These substances both require a Therapeutic Use Exemption if used within 5 days of competition. If an athlete needs to carry an epipen a Therapeutic Use Exemption is required at all times.
Intra-venous (IV) fluids
No Therapeutic Use Exemption is required, regardless of the volume, if the IV fluid is given while the athlete is in hospital, either the ward, emergency department, in surgery or on the way to hospital in an ambulance. If it is given at a doctor’s rooms or any place other than those listed above and the volume is >100ml then a Therapeutic Use Exemption is required.
Blood transfusions
Any transfusion of blood, in or out of hospital requires a Therapeutic Use Exemption.
Ventolin (Salbutamol)
During an acute asthma attack you may be given salbutamol via an inhaler (and possibly a spacer) or nebuliser. Inhaled salbutamol is permitted by WADA but only up to 8 “puffs” in a 12 hour period. Salbutamol via a nebuliser will exceed this threshold so a retroactive Therapeutic Use Exemption should be applied for if a nebuliser or more than 8 puffs in 12 hours are given.