Athletes must check all their medications and their conditions of use against the World Anti-Doping Agency’s (WADA) Prohibited List before use. The Prohibited List is updated at least annually on the 1st January, with substances and methods being added or removed. The new Prohibited List is published on the WADA website usually three months prior to it coming into force. In exceptional circumstances, a substance or method can be added to the Prohibited List at any time.
To check medications, an athlete and their support personnel can:
For more information on medication use in sport, athletes and support personnel are encouraged to explore this Medications section further. For additional support, please contact us.
Athletes must check all medications, both those purchased over-the-counter (e.g. from a pharmacy), or those prescribed, before use as some can contain ingredients which are included on the Prohibited List.
Not knowing a medication is prohibited is not an excuse if there is a positive test. This is because anti-doping is based on the principle of strict liability which means an athlete is solely responsible for everything they use and is found in their body, regardless of whether there was an intention to cheat or not or if the athlete is at fault.
Athletes must check in medications and any conditions of use against the Prohibited List before use. To do so, athletes can:
GlobalDRO is an online drug reference tool that provides information about the status of substances and methods on the Prohibited List and any conditions of use. Conditions of use can include, for example, specific daily doses of medications that should not be exceeded without a TUE in place, or specific routes of administration that may be prohibited. See this video for more information.
Not necessarily. Both over-the-counter and prescription medications can contain prohibited substances or use a prohibited route of administration. Athletes must check all ingredients and any conditions of use against the Prohibited List before use.
In-Competition is the period from 11:59pm the night before a competition until the end of that competition or associated doping control, whichever occurs last.
WADA may approve an alternative definition if an International Federation (IF) can justify this is necessary in their sport.
If the response to a medication check is prohibited In-Competition the medication must have left an athlete’s system by the start of this period.
If an athlete does not have a Therapeutic Use Exemption for the specific medication prohibited In-Competition, it must have left their system by the start of the In-Competition period.
WADA provides information on the wash out periods (the time it takes for a substance to leave an athlete’s system) for glucocorticoids and tramadol but not other substances.
Athletes should be cautious about the Out-of-Competition use of any substance that is prohibited In-Competition and ask their medical professional for advice before use.
A route of administration is the way a substance is administered to an athlete, in other words, how the substance gets into the body.
Examples of routes of administration include intravenous injections or infusions (IV), inhalation (using an inhaler), oral (tablet, capsule, liquid), rectal (suppository), topical (cream), nasal (nose spray or drops), and ophthalmic (eye drops).
Some routes of administration for specific substances are prohibited in sport – these are indicated on the Prohibited List.
When checking a medication, an athlete must also check the route of administration as, for example, a cream may be permitted while an injection of the same substance may be prohibited.
Yes. Topical medications and sprays can be prohibited therefore athletes must check all substances and their route of administration against the Prohibited List before use.
Intravenous injections or infusions (IV) are prohibited when administered in volumes over 100 ml in a 12-hour period (both In- and Out-of-Competition), even if the substance itself is not prohibited. Intravenous administration of volumes less than 100ml in a 12-hour period are not prohibited (if the substance itself is not prohibited).
For example, a 500ml saline solution containing a medication for intravenous administration administered over 30 minutes would be prohibited since the volume is more than 100ml given within a 12-hour period. The only exception to this is when an intravenous injection or infusion (IV) is legitimately received in the course of hospital treatments, surgical procedures or clinical diagnostic investigations.
Yes. Medications with the same name can include different ingredients in different countries and some may be prohibited. This means, that if an athlete has checked a medication purchased at home and it is permitted, the same cannot be guaranteed for what appears to be the same product abroad.
Athletes must check all ingredients in medications (including any conditions of use such as the route of administration and threshold limit) against the Prohibited List before use. To do this when abroad:
Athletes must check the status of all vaccinations (substances and routes of administration) against the Prohibited List before use. To do so, athletes should:
Ask a doctor or pharmacist who is familiar with the Prohibited List and understands athletes’ anti-doping responsibilities (and if they are not aware, show them the Prohibited List).
Traditional medicines, including Traditional Chinese Medicine (TCM), can contain various substances including herbal products, plant extracts, mineral products, and animal parts or products.
Due to the wide range of ingredients and the lack of standardised production methods, there is no guarantee that traditional medicines are free from prohibited substances, as they cannot be checked like medications.
Athletes should be aware that the same risks associated with supplement use apply to traditional medicines. For more information, visit the ITA Athlete Hub Supplements section.
Due to the wide range of ingredients and the lack of standardised production methods in homoeopathic medicines, there is no guarantee that they are free from prohibited substances.
Athletes should be aware that the same risks associated with supplement use apply to homoeopathic medicines. For more information, visit the ITA Athlete Hub Supplements section.
Athletes have a right to medical treatment as laid out in the Athletes’ Anti-Doping Rights Act.
This means that if an athlete has a medical condition, illness or injury that requires a particular substance or method on the Prohibited List, they can apply for a Therapeutic Use Exemption (TUE), which would be granted if strict conditions are met. This gives the athlete permission to use that prohibited substance or method in the context of anti-doping rules.
For more information on TUEs, visit the ITA Athlete Hub Therapeutic Use Exemption section.
In an emergency medical situation, athlete health comes first, and necessary medical treatment can be received. If a prohibited substance or method must be used in this situation, a retroactive Therapeutic Use Exemption can be submitted after the emergency treatment is given.
It should not be assumed that medical professionals know about the Prohibited List or athlete’s anti-doping responsibilities. Athletes must therefore tell all medical professionals that they are an athlete, who can be tested anytime, and they cannot use substances or methods on the Prohibited List without a Therapeutic Use Exemption (TUE). Medical professionals who are most likely to be able to advise on medications include doctors and pharmacists.
Under the principle of Strict Liability, the athlete is solely responsible for everything they use and is found in their body, regardless of whether there was an intention to cheat or not or if the athlete is at fault. In this case, it is likely that the athlete would receive a sanction after testing positive for a prohibited substance (ADRV 2.1).
ADRV 2.8 (administration or attempted administration) applies to Athlete Support Personnel as well as athletes so sanctions could apply medical professionals too.
Regardless of the reason for use, all natural and synthetic cannabinoids are prohibited (In-Competition). This includes cannabis, hashish, marijuana and products containing cannabinoids (including foods and drinks). All synthetic cannabinoids that mimic the effects of THC are also prohibited.
CBD itself is not prohibited; however, athletes should be aware that some CBD oils and tinctures extracted from cannabis plants may also contain THC and other cannabinoids, which are prohibited, and may result in a positive test for a prohibited cannabinoid.
Unless it is an emergency when athlete health must be prioritised. Otherwise, athletes should always refuse the use of prohibited substances and methods unless they have a current and valid TUE or seek alternative permitted treatments.
Anti-Doping Rule Violation 2.6 Possession applies to both athletes and ASP. If an ASP requires a prohibited substance (or use of a prohibited method) for medical purposes, it is recommended they can provide sufficient evidence to explain the need to have this in their possession, such as a doctor’s prescription.
