Table 3 Most frequent asthma and rhinitis medications and the 2012 World Anti-Doping Agency (WADA) rules [24]
TreatmentWADA rulesNotes
Controller medication
 Inhaled corticosteroidsPermitted
 Nasal corticosteroidsPermitted
 Allergen immunotherapy#Permitted
Reliever medication
 Inhaled β2-agonistsProhibited except salbutamol, formoterol and salmeterolSalbutamol 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-agonistsProhibited
 Oral corticosteroidsProhibitedTherapeutic use exemption approval required
 AntihistaminesPermittedSecond-generation H1-antihistamines should be preferred to avoid somnolence
 Inhaled or nasal ipratropium bromidePermitted
 Ephedrine, methylephedrine, pseudoephedrineNasal application is permittedEphedrine 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].