Treatment | WADA rules | Notes |
Controller medication | ||
Inhaled corticosteroids | Permitted | |
Anti-leukotrienes | Permitted | |
Nasal corticosteroids | Permitted | |
Allergen immunotherapy# | Permitted | |
Reliever medication | ||
Inhaled β2-agonists | Prohibited except salbutamol, formoterol and salmeterol | Salbutamol maximum 1,600 μg over 24 h and formoterol maximum 36 μg over 24 h; the presence in urine of salbutamol >1,000 ng·mL−1 or formoterol >30 ng·mL−1 is presumed not to be an intended therapeutic use of the substance and will be considered as an adverse analytical finding |
Oral β2-agonists | Prohibited | |
Oral corticosteroids | Prohibited | Therapeutic use exemption approval required |
Antihistamines | Permitted | Second-generation H1-antihistamines should be preferred to avoid somnolence |
Inhaled or nasal ipratropium bromide | Permitted | |
Ephedrine, methylephedrine, pseudoephedrine | Nasal application is permitted | Ephedrine and methylephedrine are prohibited when its concentration in urine is >10 μg·mL−1 Pseudo-ephedrine is prohibited when its concentration in urine is >150 μg·mL−1 |
#: depends on appropriate patient selection (evidence of specific immunoglobulin E to clinical relevant allergens), choice of allergen and correct dosage, pending a risk/benefit evaluation. It should be performed by, or under the close supervision of, trained physicians. There is no contraindication to perform allergen immunotherapy in athletes, with the precaution to avoid physical exercise just after receiving the injection [25].