Generic Pharmaceuticals as a Source of Diuretic Contamination in Athletes Subject to Sport Drug Testing

This paper describes nine instances of positive anti-doping tests that could be accounted for by the use of permitted generic prescription drugs contaminated with diuretics, which are prohibited in sport at all times under the WADA Prohibited List. The contamination levels found in the medications a...

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Published inFrontiers in sports and active living Vol. 3; p. 692244
Main Authors Eichner, Amy, Lewis, Laura A., Leonard, Bridget, Wagoner, Ryan M. Van, Eichner, Daniel, Fedoruk, Matthew N.
Format Journal Article
LanguageEnglish
Published Frontiers Media S.A 18.11.2021
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Abstract This paper describes nine instances of positive anti-doping tests that could be accounted for by the use of permitted generic prescription drugs contaminated with diuretics, which are prohibited in sport at all times under the WADA Prohibited List. The contamination levels found in the medications are reported and were below FDA limits for manufacturers that are based primarily on safety considerations. These cases demonstrate that great care must be taken to identify the source of low-level anti-doping positives for diuretics reported by WADA-accredited laboratories, and possibly other prohibited substances as well, in order to avoid sanctioning innocent athletes. An evaluation of the cases in this paper supports an approach which establishes a laboratory minimum reporting level (MRL) for diuretics found most commonly in medications. A global consensus after extensive review of similar anti-doping cases has resulted in implementation of a recently announced solution regarding potential diuretic contamination cases.
AbstractList This paper describes nine instances of positive anti-doping tests that could be accounted for by the use of permitted generic prescription drugs contaminated with diuretics, which are prohibited in sport at all times under the WADA Prohibited List. The contamination levels found in the medications are reported and were below FDA limits for manufacturers that are based primarily on safety considerations. These cases demonstrate that great care must be taken to identify the source of low-level anti-doping positives for diuretics reported by WADA-accredited laboratories, and possibly other prohibited substances as well, in order to avoid sanctioning innocent athletes. An evaluation of the cases in this paper supports an approach which establishes a laboratory minimum reporting level (MRL) for diuretics found most commonly in medications. A global consensus after extensive review of similar anti-doping cases has resulted in implementation of a recently announced solution regarding potential diuretic contamination cases.
This paper describes nine instances of positive anti-doping tests that could be accounted for by the use of permitted generic prescription drugs contaminated with diuretics, which are prohibited in sport at all times under the WADA Prohibited List. The contamination levels found in the medications are reported and were below FDA limits for manufacturers that are based primarily on safety considerations. These cases demonstrate that great care must be taken to identify the source of low-level anti-doping positives for diuretics reported by WADA-accredited laboratories, and possibly other prohibited substances as well, in order to avoid sanctioning innocent athletes. An evaluation of the cases in this paper supports an approach which establishes a laboratory minimum reporting level (MRL) for diuretics found most commonly in medications. A global consensus after extensive review of similar anti-doping cases has resulted in implementation of a recently announced solution regarding potential diuretic contamination cases.This paper describes nine instances of positive anti-doping tests that could be accounted for by the use of permitted generic prescription drugs contaminated with diuretics, which are prohibited in sport at all times under the WADA Prohibited List. The contamination levels found in the medications are reported and were below FDA limits for manufacturers that are based primarily on safety considerations. These cases demonstrate that great care must be taken to identify the source of low-level anti-doping positives for diuretics reported by WADA-accredited laboratories, and possibly other prohibited substances as well, in order to avoid sanctioning innocent athletes. An evaluation of the cases in this paper supports an approach which establishes a laboratory minimum reporting level (MRL) for diuretics found most commonly in medications. A global consensus after extensive review of similar anti-doping cases has resulted in implementation of a recently announced solution regarding potential diuretic contamination cases.
Author Lewis, Laura A.
Eichner, Amy
Leonard, Bridget
Wagoner, Ryan M. Van
Eichner, Daniel
Fedoruk, Matthew N.
AuthorAffiliation 2 Sports Medicine and Research Testing Laboratory , Salt Lake City, UT , United States
1 United States Anti-Doping Agency , Colorado Springs, CO , United States
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Cites_doi 10.3390/nu9101093
10.1016/j.forsciint.2016.08.029
10.1001/jamanetworkopen.2018.3337
10.1007/s40268-013-0005-9
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Copyright Copyright © 2021 Eichner, Lewis, Leonard, Wagoner, Eichner and Fedoruk.
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Edited by: Francesco Botre, University of Lausanne, Switzerland
Reviewed by: Ken Fitch, University of Western Australia, Australia; Xavier de La Torre, Federazione Medico Sportiva Italiana (FMSI), Italy
This article was submitted to Anti-doping Sciences, a section of the journal Frontiers in Sports and Active Living
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SubjectTerms adverse analytical finding
anti-doping
minimum reporting level
prescription medication
rule violation
Sports and Active Living
Title Generic Pharmaceuticals as a Source of Diuretic Contamination in Athletes Subject to Sport Drug Testing
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