WADA Prohibited List 2025: Prescribers should be aware of introduction of 12-hourly dosing interval for formoterol from 01/01/2025

The World Anti-Doping Code, published by the World Anti-Doping Agency (WADA), harmonises anti-doping regulations across all sports and in all countries. The Prohibited List of Substances and Methods is one of the International Standards that are mandatory for all signatories of the Code.

The Prohibited List identifies the substances and methods prohibited in- and out-of-competition, and substances prohibited in particular sports. The updated 2025 Prohibited List has recently been published by WADA.

Changes of note for prescribers include:

• the introduction of a 12-hourly dosing interval for formoterol consistent with the manufacturers’ recommended use,

and

• the addition of several new examples to various sections of the WADA List including the naming of midodrine, which has always been prohibited during competition, as an example of a specified stimulant.

In addition, fentanyl and tramadol have been added to the WADA Monitoring Program to monitor patterns of out-of-competition use for these substances.

S3. Beta-2 agonists

Based on the recent publication by Jeppesen et al. regarding potential performance-enhancing doses of inhaled formoterol, WADA have updated the dosing intervals to ensure that athletes cannot achieve these ergogenic levels. The updated dosing interval from 01/01/2025 is: for inhaled formoterol the maximum delivered dose is 54 micrograms over 24 hours, in divided doses not to exceed 36 micrograms over 12 hours starting from any dose.

More information is available from Sport Ireland at (01) 8608800 or https://www.sportireland.ie/anti-doping/athlete-zone/athletezone/how-to-check-your-medication

Watch out for the combined January/February 2025 edition of MIMS Ireland which will be updated to reflect the WADA 2025 Prohibited List including Prescriber’s Guide and product monographs.