Inhaled β₂agonists and performance in competitive athletes

Abstract

Objectives: To provide an overview of the current literature on the use of inhaled b 2 agonists in nonasthmatic competitive athletes, and to assess the performance enhancing effect of inhaled b 2 agonists. Methods: Review of the literature. Results: Twenty randomised, placebo controlled studies (19 double blind, one single blind) were located. Only three studies reported a performance enhancing effect of inhaled b 2 agonists. However, methodological shortcomings were most likely responsible for these findings (for example, non-elite athletes, inconsistent results in different tests, subgroups with above-average responsiveness). Conclusions: This review reveals that there is no ergogenic potential of inhaled b 2 agonists in nonasthmatic athletes. In view of the epidemiology of asthma in athletes and the considerable workload involved in provision of therapeutic use exemptions the inclusion of inhaled b 2 agonists on the list of prohibited substances should be reconsidered.

Salbutamol exhibits androgenic activity in vitro

“…Similar improvements in performance have been shown in two other studies, using a comparable daily salbutamol dose 9 23. Of note, there is no evidence that inhaled beta-2 agonists have ergogenic effects at therapeutic doses 28. Although it is too early to draw final conclusions, based on these studies we hypothesise that the agonistic activity we observed at the androgen receptor might play also a role after intravenous administration of salbutamol.…”

Diagnosis of exercise-induced bronchoconstriction: eucapnic voluntary hyperpnoea challenges identify previously undiagnosed elite athletes with exercise-induced bronchoconstriction

“…A recent review concluded that inhaled β 2 agonists have no ergogenic effect and questioned the continued inclusion of inhaled β 2 agonists on the list of prohibited substances 15. However, there has been an unforeseen benefit of this inclusion, and the associated burden of proof for the use of inhaled β 2 agonists in competition, that is, that the number of athletes who are subjected to bronchoprovocation challenges has increased.…”

An Overview of Performance Enhancing Drugs (PED’s) in Sports and WADA

“…If the urinary concentration of salbutamol is >1000 ng/ml, it is said to be a positive doping test as it is highly difficult to attain such high concentrations through inhalation alone. 17…”