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 in | Frontiers in sports and active living Vol. 3; p. 692244 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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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. |
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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 |
AuthorAffiliation_xml | – name: 1 United States Anti-Doping Agency , Colorado Springs, CO , United States – name: 2 Sports Medicine and Research Testing Laboratory , Salt Lake City, UT , United States |
Author_xml | – sequence: 1 givenname: Amy surname: Eichner fullname: Eichner, Amy – sequence: 2 givenname: Laura A. surname: Lewis fullname: Lewis, Laura A. – sequence: 3 givenname: Bridget surname: Leonard fullname: Leonard, Bridget – sequence: 4 givenname: Ryan M. Van surname: Wagoner fullname: Wagoner, Ryan M. Van – sequence: 5 givenname: Daniel surname: Eichner fullname: Eichner, Daniel – sequence: 6 givenname: Matthew N. surname: Fedoruk fullname: Fedoruk, Matthew N. |
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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 |
ContentType | Journal Article |
Copyright | Copyright © 2021 Eichner, Lewis, Leonard, Wagoner, Eichner and Fedoruk. Copyright © 2021 Eichner, Lewis, Leonard, Wagoner, Eichner and Fedoruk. 2021 Eichner, Lewis, Leonard, Wagoner, Eichner and Fedoruk |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 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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References_xml | – volume: 9 start-page: 1093 year: 2017 ident: B3 article-title: Intended or Unintended Doping? A Review of the Presence of Doping Substances in Dietary Supplements Used in Sports publication-title: Nutrients doi: 10.3390/nu9101093 – volume-title: 2019 Anti-Doping Testing Figures year: 2019 ident: B5 – volume: 267 start-page: 166 year: 2016 ident: B2 article-title: Detection of the diuretic hydrochlorothiazide in a doping control urine sample as the result of a non-steroidal anti-inflammatory drug (NSAID) tablet contamination publication-title: Forensic Sci. Int. doi: 10.1016/j.forsciint.2016.08.029 – volume: 1 start-page: e183337 year: 2018 ident: B4 article-title: Unapproved pharmaceutical ingredients included in dietary supplements associated with US food and drug administration warnings publication-title: JAMA Netw. Open doi: 10.1001/jamanetworkopen.2018.3337 – volume: 13 start-page: 1 year: 2013 ident: B1 article-title: Potential risks of pharmacy compounding publication-title: Drugs R&D doi: 10.1007/s40268-013-0005-9 |
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Title | Generic Pharmaceuticals as a Source of Diuretic Contamination in Athletes Subject to Sport Drug Testing |
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