Common meds Olympic athletes must forego for doping tests

Olympic athletes may spend years planning, training and preparing for that elusive chance at winning a gold medal, but they can risk losing it all by taking something as seemingly innocuous as a common cold medication on the day of the competition.

In fact, common drugs, including some flu medications that treat symptoms and ADHD medications, can be off-limits as well, according to the World Anti-Doping Association.

The list of prohibited substances nowadays doesn’t just include performance-enhancing drugs such as steroids or EPO — Erythropoietin, which can increase the amount of red blood cells in the body — which are banned for duration of an athlete’s training. The list also includes over-the-counter medications. Pseudoephedrine, commonly found in the cold and flu medication Sudafed, is banned on the day of competition. The drug is a stimulant and can make athlete’s more alert and awake for a competition.

Athletes also must be careful that they don’t take a medication given by a doctor to clear up a bad cold, since it’s up to them to stay free of banned substances on the day of competition. The U.S. Anti-Doping Association advises athletes to stop taking the drugs a few days before they have to compete.

“They have a banned list they [World Anti-Doping Agency] put out,” said Dr. Dennis Cardone, an orthopedic surgeon and sports medicine physician. “Athletes … it’s their responsibility to make sure [their drug’s] not on the banned list.”

Common dietary supplements that are available in many drug stores are also ill-advised, Cardone said.

“There’s a warning that most of these substances aren’t well controlled,” he said, explaining that a variety of banned ingredients may show up in supplements. “In general, they should just avoid all these potential” risks in supplements.

The USADA also advises that supplemental “water pills” may actually contain a banned diuretic and advises athletes to avoid them. Prescription diuretics are banned since they can cause rapid weight loss and mask other prohibited substances from appearing on urine tests.

In addition to these medications, some drugs to treat disorders like asthma and ADHD are also banned. Albuterol, used to treat asthma, cannot be used in conjunction with a diuretic without a medical waiver. The drug had been used by athletes in the past to build muscle mass. Additionally, amphetamines are banned, meaning if an athlete has ADHD, they may not take the stimulants usually prescribed to help people with that disorder. Cardone said a medical waiver is available, but that it’s uncommon for an ADHD medical waver to be approved.

However, anti-doping regulations are more lenient nowadays for athletes who may want to indulge in a few cups of coffee in the morning before a competition.

“Caffeine, interestingly, it used to be banned, but it isn’t anymore,” said Dr. Andrew Gregory, a sports medicine doctor and associate professor of orthopedic surgery at Vanderbilt University Medical Center.

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