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Published:  10 December 2015

Prescribing Medicines to Athletes

Prescriber Update 36(4): 53-54
December 2015

Drug Free Sport NZ regards members of the medical profession as critical partners in their work. Athletes are encouraged to inform all medical professionals that they may be subject to doping control (drug testing).

Medical professionals are asked to check all medicines they wish to prescribe to athletes and not make assumptions about their status in sport. Although this can take extra time, the consequences of getting it wrong are serious for the athlete.

Drug Free Sport NZ has developed the following table to provide a quick and efficient reference that describes the status of commonly prescribed medications (Table 1). Permitted medicines are in green. An online version of this table can be found on the Drug Free Sport website (www.drugfreesport.org.nz/what-we-do/education/resources/).

Table 1: Drug Free Sport NZ status of commonly prescribed medicines

Asthma medications
Permitted
Salbutamol by inhalation
Salmeterol by inhalation
Formoterol by inhalation
Prohibited at all times (requires TUE)*
Terbutaline
Bambuterol
Glucocorticoids
Permitted
Glucocorticoids; non-systemic route of administration (eg, intra-articular, peritendinous, intra-bursal, epidural, subcutaneous injections)
Glucocorticoids inhaled
Glucocorticoid applied topically; eye/ear drops, nasal sprays or ointments for dermatitis
Prohibited in Competition (requires TUE)
Glucocorticoids; systemic route of administration (eg, intravenous, intramuscular, oral, rectal)
Glucocorticoid suppositories
Cold/Flu/Sore Throat Medications
Permitted
Phenylephrine (eg, Lemsip, Maxiclear)
Paracetamol
Prohibited in Competition (consider permitted alternatives)
Pseudoephedrine; stop taking 24 hours before competition
Morphine based cough syrup (Gees Linctus)
Pain/Inflammation
Permitted
Nonsteroidal anti-inflammatories (NSAIDs)
Ibuprofen
Diclofenac
Paracetamol
Tramadol
Prohibited in Competition (requires TUE)
Narcotics (eg, Fentanyl, Pethidine, Morphine, Oxycodone)
Antibiotics
Permitted
All antibiotics available in NZ

Note: Probenecid is prohibited
Diuretics and Masking Agents
Permitted All Diuretics and Masking Agents are Prohibited in Competition (requires TUE)
Furosemide
Probenecid
Thiazide
Hormone and Metabolic Modulators
Permitted Prohibited in Competition (requires TUE)
Tamoxifen
Clomiphene
Spironolactone
Insulin
Stimulants
Permitted Prohibited (requires TUE)
Methylphenidate
Pseudoephedrine

*TUE = Therapeutic Use Exemption

The status of all medicines can be checked in the New Zealand Formulary (www.nzformulary.org/) or MIMS.

If a prohibited medicine is necessary, a Therapeutic Use Exemption (TUE) application which meets the specific World Anti-Doping Agency (WADA) requirements accompanied by comprehensive medical supporting documentation will need to be submitted. This may be required in advance or following a test depending on the status of the athlete. Please see the Drug Free Sport NZ website (www.drugfreesport.org.nz) or contact 0800 DRUG FREE (0800 378 437) for more information.

To view the WADA prohibited list or to obtain TUE application paperwork go to the Drug Free Sport NZ website (www.drugfreesport.org.nz).

For all other information please contact Drug Free Sport NZ directly on 0800 DRUG FREE, info@drugfreesport.org.nz, or text 4365 (text the medication name and we will respond with its status in sport).

Sian Clancy
Drug Free Sport NZ

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