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    Beta-2 agonists

    All beta-2 agonists, such as terbutaline and procaterol, are prohibited in sport at all times unless prior approval is granted. 

    This approval must be obtained through a Therapeutic Use Exemption (TUE), which is issued by a designated medical authority. In Australia this authority is the Australian Sports Drug Medical Advisory Committee (ASDMAC).

    However, certain beta-2 agonists may be used with a TUE if administered by inhalation and only the permitted dosage limits outlined below. If usage exceeds there limits, a TUE is required. 

    • Salbutamol: Inhaled Salbutamol is permitted up to a maximum dose of 1600 mcg (16 puffs) per 24 hours, not to exceed 600mcg (6 puffs) in an 8-hour period.
    • Salmeterol: Inhaled Salmeterol is permitted up to a maximum dose of 200 micrograms (approximately 8 puffs when using Seretide MDI inhaler 250/25) over 24 hours. Not to exceed 100 micrograms in a 8 hour period starting from any dose.
    • Formoterol: Inhaled Formoterol is permitted up to a maximum delivered dose of 54 micrograms (12 puffs when using Rapihaler 200/6) over 24 hours (6mcg inhaled = 4.5mcg delivered). Not to exceed 36 micrograms (8 puffs when using Rapihaler 200/6) in a 12hour period starting from any dose.
    • Vilanterol: Inhaled Vilanterol is permitted up to a maximum dose of 25 micrograms over 24 hours (1 puff when using Breo Ellipta 100/25 or 200/25).

    Glucocorticoids

    Inhaled and intranasal glucocorticoids, used in the management of asthma and hay fever, are permitted and a TUE is not required.

    Systemic treatment (oral or intravenous) with glucocorticoids (for example prednisone) is prohibited in-competition* only and requires a Therapeutic Use Exemption when used during or immediately prior to competition (within 3 days).

    An extended Therapeutic Use Exemption for up to 12 months will be considered for chronic, unstable asthma, but further medical evidence regarding the severity and frequency of the asthma will be required.

    *The definition of ‘in-competition’ does vary between sports and events but is generally considered to start at 11.59 pm on the day before the match/game and ends after any drug testing has been performed at the end of the match/game.

    Asthma medication quick reference guide - common medications

    Substance Status in sport
    INHALED Salbutamol (Ventolin, Asmol)
    • Therapeutic Use Exemption NOT Required – with specific conditions
    • Inhaled Salbutamol is permitted up to a maximum threshold of 1600 micrograms (16 puffs) over 24 hours, not to exceed 600mcg (6 puffs) in an 8-hour period. This threshold is not valid in the presence of diuretics
    • If using a diuretic, a Therapeutic Use Exemption is required to use both the diuretic and salbutamol
    • If maximum threshold is exceeded, a Therapeutic Use Exemption is required.
    INHALED Formoterol (Symbicort)
    • Therapeutic Use Exemption NOT Required – with specific conditions
    • Inhaled Formoterol is permitted up to a maximum delivered dose of 54 micrograms (12 puffs when using Rapihaler 200/6) over 24 hours (6mcg inhaled = 4.5mcg delivered). Not to exceed 36 micrograms (8 puffs when using Rapihaler 200/6) in a 12 hour period starting from any dose
    • If using a diuretic, a Therapeutic Use Exemption is required to use both the diuretic and formoterol
    • If maximum threshold is exceeded, a Therapeutic Use Exemption is required.
    Salmeterol
    • Inhaled Salmeterol is permitted up to a maximum threshold of 200 micrograms (approx. 8 puffs when using Seretide MDI inhaler 250/25) over 24 hours
    • Not to exceed 100 micrograms in a 8 hour period starting from any dose.
    INHALED Terbutaline (Bricanyl)
    INHALED Vilanterol (Breo)
    • TUE NOT Required – with specific conditions
    • Inhaled Vilanterol is permitted up to a maximum dose of 25 micrograms over 24 hours (One (1) puff when using Breo Ellipta 100/25 or 200/25). This threshold is not valid in the presence of diuretics
    • If using a diuretic, a TUE is required to use both the diuretic and vilanterol. If maximum threshold is exceeded, a TUE is required.
    INHALED Budesonide (Symbicort, Pulmicort)
    • Therapeutic Use Exemption Not Required
    • Permitted in and out of competition.
    INHALED Ciclesonide (Alvesco)
    • Therapeutic Use Exemption Not Required
    • Permitted in and out of competition.
    INHALED Fluticasone (Flixotide, Seretide)
    • Therapeutic Use Exemption Not Required
    • Permitted in and out of competition.
    ORAL or INJECTED Salbutamol
    ORAL Formoterol
    ORAL Prednisolone/Prednisone
    • Therapeutic Use Exemption Required In-Competition Only
    • Permitted out-of-competition. If taking Prednisolone/Prednisone out-of-competition (not competing), allow 3 days once ceasing medication before competing
    • Therapeutic Use Exemption required if taking oral Prednisolone in competition
    • See: medical evidence needed for Therapeutic Use Exemptions

    Note 1: Use of Asthma medications with Diuretics or Masking Agents. If you are taking a diuretic or masking agent (for which a Therapeutic Use Exemption is required) then the use of a threshold substance such as Salbutamol or Formoterol requires an additional Therapeutic Use Exemption to the one granted for the diuretic or masking agent.​

    Note 2: The updated WADA Prohibited List comes into effect from 1 January each year. Please ensure that you check the status of your medications.

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