5. Particular information with regard to Glucocorticoids, Beta-2 Agonists against Asthma and Injections (“No Needle Policy”)
A. Glucocorticoids
Authorized Routes of Administration
The following routes of administration (i.e. how the medication is administered or taken) are authorized and hence do not require a TUE for the use of glucocorticoids :
• Dermatological – on the skin;
• Auricular - in or on the ear;
• Buccal – inside the mouth (without swallowing);
• Gingival - on the gums;
• Nasal - inside the nose, either by topical application or nasal spray;
• Ophthalmic – on or in the eye;
• Perianal – on or around the anus;
• Inhalation – through the mouth via an inhaler or “puffer”;
• Intradermal injection – into the skin;
• Epidural injection – into the spine;
• Intra-articular injection – into a joint capsule;
• Periarticular injection – around a joint;
• Peritendinous injection – around a tendon.
Prohibited Routes of Administration - systemic administration
You must complete a full TUE application before taking glucocorticoids by any of the following systemic routes:
• Orally – through the mouth, usually in the form of pills or tablets or syrup or drops;
• Intravenous injection – injection into a vein;
• Intramuscular injection – injection into a muscle;
• Rectally – into the rectum usually in the form of a suppository or rectal application of a cream.
Local injection of glucocorticoids - “8-days rest period”
In case of a local injection of glucocorticoids, which is subject also to the Anti-Doping Rules and the Prohibited List, the rider must rest and is prevented from competing for 8 days (article 13.3.055 of the UCI Cycling Regulations).
B. Beta-2 Agonists for Asthma
Whether or not you need to apply for a TUE before using a beta-2 agonists for the treatment of asthma depends on the medication. Please pay utmost attention to the substance which is included in your inhaler.
Salmeterol /Salbutamol/Formoterol
Inhaled salbutamol (maximum 1600 micrograms over 24 hours), inhaled formoterol (maximum 54 micrograms over 24 hours) and inhaled salmeterol in accordance with the manufacturers’ recommended therapeutic regimen are not prohibited and therefore do not require a TUE.
You must obtain a TUE only if you need to inhale more than 1600 μg per day of salbutamol.
You must obtain a TUE only if you need to inhale more than 54 μg per day of formoterol.
You must obtain a TUE if you take salmeterol, salbutamol and/or formoterol by any other routes of administration.
Terbutaline or other Beta-2 Agonist
If you take terbutaline or any other beta-2 agonist for the treatment of asthma, you must submit a TUE request for asthma and your full medical file through ADAMS to confirm the diagnosis of asthma and/or its clinical variants.
The medical file should include:
- A detailed medical history and clinical review;
- Lung function test with spirometry;
- Bronchodilator response;
- Bronchial provocation tests.
To assist your doctor in completing the correct tests, and providing the correct medical information, we suggest that he or she consults the WADA Guidelines on Asthma.
C. Injections – “No Needle” Policy
We remind you that the use of injections to administer drugs or substances without a clear and recognized medical indication is prohibited. This applies to any substance that is injected whether endogenous or exogenous, prohibited under the UCI Anti-Doping Rules (ADR) or not, and to any type of injection (article 13.3.052 of the UCI Cycling Regulations).
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