All you need to know about ... salbutamol

Salbutamol in questions

Salbutamol, better known to the general public as ventoline, is the preferred substance for the treatment of asthma. Its use is strictly governed by the rules decreed by WADA. However, many sports practiced at a high level, such as cycling, can be the very origin of this disease. The issues raised by salbutamol are therefore complex. Clarifications.

What is salbutamol?

Salbutamol is a member of the beta-2 agonist family which acts on bronchial smooth muscles. More prosaically, it is a short-acting bronchodilator that will free the bronchi and increase the caliber of the airways. Most generally presented in metered dose aerosol form, through a nebulizer or via an aerochamber, it is also administered orally or intravenously its main strength is its speed of action and its side effects less violent than others types of therapy, especially theophyline, although notable (headache, tremors, vomiting, muscle cramps, not to mention long-term dangers).

What do the anti-doping regulations say?

Salbutamol is on the list of prohibited products of the World Anti-Doping Agency (WADA), but its use is not prohibited and no longer requires, since 2010, an authorization for use for therapeutic purposes (TUE). At the time, all requests were almost systematically classified as therapeutic, medically covering the use of this product.

WADA now allows a maximum dose of 1 micrograms every 600 hours, with a maximum of 800 micrograms every 1 hours. The concentration of salbutamol in the urine of the athlete cannot exceed 000 nanograms per milliliters. The athlete can use this medication if he produces a declaration of use form to be presented during the control. This form must be completed by the doctor, preferably a specialist, who will attest to the necessity of taking salbutamol for the health of the athlete. The inclusion in the file of the results of any EFR (Functional Respiratory Tests) is not mandatory, but recommended, because these provide further proof of the need for treatment.

Beyond the threshold, the athlete must prove " by a controlled pharmacokinetic study that this abnormal result is indeed the consequence of the use of a therapeutic dose (by inhalation). » This level of 1 nanograms of salbutamol per milliliters of urine corresponds to 000 puffs of Ventolin. This is more than enough to treat asthma. If the patient is not stabilized with this dose, it is necessary to review the treatment as a whole. Beyond this threshold, it is indeed a question of diverted use of the product which falls within the framework of an abnormal control, involving heavy penalties.


Why do athletes use salbutamol?

Numerous large-scale studies undoubtedly show that many high-level sports, such as cycling, cross-country skiing or rowing, to name a few, promote asthma. There are thus more asthmatics in professional athletes than in the rest of the population. Salbutamol is thus commonly used in sports. Salbutamol is also used as a doping product since it has a double action. First, as a vasodilator, it increases oxygen uptake. A single puff can thus increase it by 0,3 liters. Secondly, in high doses, salbutamol has anabolic effects: thus it promotes the increase in muscle mass and the decrease in body fat. It is therefore a doping product.