2022 Prohibited List – Glucocorticoids

2022 Prohibited List Advisory Note

WADA recently released the 2022 WADA Prohibited List, which will come into effect on January 1, 2022. The 2022 List includes several changes that athletes and athlete support personnel should be aware of. The full published prohibited list can be found here.

Glucocorticoids

As of January 1, 2022, ALL glucocorticoid injections are prohibited during the in-competition period. This includes, but is not limited to, injections into joints, bursa, which are all routes of administration that were previously allowed.

Oral and rectal routes of administration also remain prohibited. For clarification, oral administration of glucocorticoids also includes oromucosal, buccal, gingival and sublingual routes.

Glucocorticoids are permitted both in and out of competition when administered by:

  • inhalation (e.g., glucocorticosteroid inhalers)
  • intranasal (e.g., nasal sprays for allergic rhinitis)
  • ophthalmic (e.g., eye drops)
  • perianal (e.g., topical haemorrhoid creams)
  • dermal (e.g., topical creams to treat rashes or allergic reactions)
  • dental intracanal application

Sport Ireland strongly recommends you check your medication and route of administration prior to consumption/use.

TUE Implications

If a GC needs to be administered to an athlete, by a prohibited route, during the washout period, a TUE may be necessary, and the athlete and physician should prepare the medical file. Athletes needing to hold a Pre-Test TUE for a GC by a prohibited route administered during the washout period should apply as soon as possible. For athletes subject to Post-Test TUE rules, if there is an Adverse Analytical Finding (AAF) then the TUE application should be submitted (SEE BELOW). To reduce the risk of a positive test, athletes should follow the minimum washout periods recommended by WADA. See Explanatory Note on GCs and TUEs.

Washout Periods for Glucocorticoids (GCs)*

Route

GC

Washout Period

Oral

(Oromucosal, buccal etc.)

All GCs

3 days

 

Execption – Triamcinolone Acetonide

10 days

Intramuscular

Betamethasone; dexamethasone; methylprednisolone

5 days

 

Prednisolone; Prednisone

10 days

 

Triamcinolone acetonide

60 days

Local Injections (periarticular, intra-articular, peri- and intratendionus)

All GCs

3 days

 

Exceptions – prednisolone; prednisone; Triamcinolone acetonide; Triamcinolone hexacetonide

10 days

* Washout period refers to the time from the last administered dose to the time of the start of the in-competition period (i.e., beginning at 11:59 p.m. on the day before a competition in which the athlete is scheduled to participate, unless a different period was approved by WADA for a given sport). This is to allow elimination of the glucocorticoid to below the reporting level.

Key Summary Points:
  • GCs are permitted out-of-competition by any route of administration.
  • Out-of-competition administration of GCs may however result in an AAF during an in-competition test (Washout Period)
  • All GCs are prohibited in-competition when administered by any injectable, oral or rectal route.
  • Retroactive application for therapeutic use of a GC is permitted in accordance with the ISTUE criteria
  • Complete clinical records will facilitate a successful TUE application and may be required for results management purposes.