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Study #12 Inhaled Salbutamol - Caution with Nebulizers

2025年9月28日 13:46

*This is a study record as of September 2025. Always check the official JADA (Japan Anti-Doping Agency) website for the latest information.

Prohibited Dosage of Salbutamol

Salbutamol (a β₂-agonist) falls under Prohibited List S3: Beta-2 Agonists, but
it is exceptionally permitted only when inhaled.
However, there is a strict upper limit on the dosage.

Up to 1600µg in 24 hours
Do not exceed 600µg every 8 hours

Exceeding this range constitutes a doping violation and may result in a positive test result.

How to Use Inhalers

Inhaler (Saltanol®) as a treatment for bronchial asthma

1 puff: 100µg
Standard: 2 puffs at a time = 200µg
Up to 4 times a day with at least 3 hours between doses (= maximum 800µg)
👉 Easily stays within the 1600µg limit.

Pediatric: 1 puff at a time, up to 4 times a day.

Nebulizer (Venetolin® Inhalation Solution)

Adult: 0.3–0.5mL per dose (1.5–2.5mg = 1500–2500µg)
Pediatric: 0.1–0.3mL (0.5–1.5mg = 500–1500µg)

👉 A single dose can exceed 1600µg, posing a risk of immediately exceeding the prohibited dosage.

Clinical Reality

Nebulizers are frequently used for colds and asthma attacks.
However, for athletes, exceeding the limit in a single dose → risk of doping violation.

Points to Note Regarding TUE (Therapeutic Use Exemption)

In principle, a TUE is not required if the inhaler is used within the prescribed limits.
Caution is required as nebulizers may be used when visiting a doctor for a cold, etc.
Even within the prescribed limits, urine tests may exceed the threshold → it is important to keep medical certificates and prescription records.
TUE approval may require objective test data (spirometry, etc.) for "asthma/exercise-induced asthma".
If used in an emergency, a retroactive TUE application is possible, but a doctor's record is essential. Furthermore, the reason why it could not be substituted with other drugs is also required.

Summary

Salbutamol is "permitted for use if inhaled," but there are dosage limits (within 1600µg per 24h and 600µg per 8h).
Inhalers are safe and easy to use, but nebulizers require caution.
It is important for athletes to consult with a sports pharmacist or doctor in advance and prepare a TUE application if necessary.

Suggested Hashtags

#SportsPharmacist #AntiDoping #AsthmaTreatment #Salbutamol #Inhaler