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PSEUDOEPHEDRINE (iso-ephedrine)

Prohibited substance: PSEUDOEPHEDRINE – refer to section S6 (Stimulants) of the WADA 2022 Prohibited List.

Clarifying information from the WADA Prohibited List Q&A as published on 10 May 2019:
Pseudoephedrine is a specified stimulant prohibited In-Competition only at a urinary threshold of 150 microgram/mL. This decision was based on the results of controlled excretion studies as well as scientific literature indicating that only high doses of pseudoephedrine improved sports performance.
Given the wide availability of pseudoephedrine, particularly as a component of multi-ingredient cold and influenza treatments, athletes and their support personnel should be advised the following.

• Athletes should stop taking Pseudoephedrine-containing medicines at least 24 hours before competition. For therapeutic applications during the In-Competition period, consider
the use of alternative permitted medications in consultation with a physician, or apply for a Therapeutic Use Exemption for the use of Pseudoephedrine for therapeutic reasons.
• The established urinary threshold level of 150 microgram/mL may be reached (rarely, but possibly) in some individuals within 6-20 hours of taking some long-acting therapeutic formulations.
• The threshold level of 150 microgram/mL has been established based on the intake of therapeutic doses of pseudoephedrine, defined as a maximum daily dose of 240 mg pseudoephedrine
taken either as:
– four daily oral administrations (one every 4-6 hours) of a 60 mg (or 2 x 30 mg) immediate release preparation (i.e. tablet, capsule or liquid) or
– two daily administrations (one every 12 hours) of a 120 mg extended release preparation
– one daily administration of a 240 mg extended release preparation.
• As an example, a single daily dose of 3 x 60 mg tablets would be a supra therapeutic dose that may lead to an Adverse Analytical Finding.