S3. Beta-2 agonists

What are beta-2 agonists?

Beta-2 agonists are dilators which cause dilation (widening) of vessels by relaxing the smooth muscle surrounding them.

Medical uses of beta-2 agonists

Inhaled forms of beta-2 agonists (including salmeterol, salbutamol, formoterol and terbutaline) are used for the treatment of asthma and exercise-induced bronchospasm (EIB). Injected forms are most commonly used in the prevention of premature labour, as they act to relax the smooth muscle of the uterus and so inhibit contractions.

Effects on performance

The sporting community has certain reserves in relation to the intake of beta-2 agonists in large quantities. As provided in the 2022 Prohibited List, “all beta-2 agonists, including all optical isomers where relevant, are prohibited except inhaled salbutamol (maximum 1600 micrograms over 24 hours), inhaled formoterol (maximum 54 micrograms over 24 hours), salmeterol  (maximum 200 micrograms over 24 hours) and inhaled vilanterol  (maximum 25 micrograms over 24 hours). When administered by injection or tablet form they are thought to have anabolic effects (increased muscle mass, reduced body fat percentage and faster recovery rates) and so their use is prohibited.

Side-effects of beta-2 agonists

The side-effects of beta-2 agonists are:

• tachycardia (rapid beating of the heart); • palpitations (abnormal/irregular beating of the heart); • headaches; • tremors; • nervousness; • sweating; • nausea; • vomiting.

S0. Non-approved substancesS1. Anabolic agentsAnabolic androgenic steroidsOther anabolic agentsS2. Peptide hormones, growth factors and related substancesErythropoietinChorionic gonadotrophinCorticotrophinHuman growth hormoneInsulin-like growth factorS4. Hormone and metabolic modulatorsS5. Diuretics and other masking agents DiureticsOther masking agentsM1. Manipulation of blood and blood componentsM2. Chemical and physical manipulationM3. Gene doping

Substances and methods prohibited at all times Substances and methods prohibited in-competitionSubstances prohibited in particular sports