06 August 2019

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Explained what is Terbutaline Why Terbutaline is banned by WADA

Explained what is Terbutaline Why Terbutaline is banned by WADA

Thursday, 6 August, 2019

What is Terbutaline? How does Terbutaline Work?

Terbutaline is a member of a class of drugs called beta adrenergic receptor agonists (stimulators) that is used for treating asthma and other diseases of the airways

It was patented in 1966 and came into medical use in 1970. The FDA approved terbutaline in 1974.

Terbutaline is used to prevent and treat wheezing, shortness of breath, and chest tightness caused by asthma, chronic bronchitis, and emphysema. Terbutaline is in a class of medications called beta agonists. It works by relaxing and opening the airways, making it easier to breathe.

Terbutaline is a bronchodilator, a medication that dilates (expands) air passages in the lungs. It attaches to beta adrenergic receptors on muscles surrounding the air passages, causing the muscles to relax and dilate the air passages. Wider air passages allow more air to flow in and out of the lungs. Increased airflow reduces shortness of breath, wheezing, and cough. Terbutaline also is used for delaying premature labor by relaxing the muscles of the uterus that are responsible for expelling the fetus at the time of delivery.

Brethine is a brand name of terbutaline, approved by the FDA Brand names include Bronclyn, Brethine, Bricanyl, Brethaire, or Terbulin.

Prithvi Shaw had provided a urine sample, as part of the BCCI’s anti-doping testing programme, during the Syed Mushtaq Ali Trophy match on February 22 last in Indore. The sample was subsequently tested and found to contain Terbutaline, which is commonly found in cough syrups. A specified substance, Terbutaline is prohibited both in and out of competition in the WADA prohibited list of substances.

Shaw was formally charged with the commission of an Anti-Doping Rule Violation (ADRV) under the BCCI Anti-Doping Rules (ADR) Article 2.1 and provisionally suspended - pending determination of the charge.

In a statement BCCI said Prithvi Shaw registered with Mumbai Cricket Association, has been suspended for doping violation. Mr. Shaw had inadvertently ingested a prohibited substance, which can be commonly found in cough syrups

The release also added that “Shaw responded to the charge by admitting the ADRV but asserting that it was inadvertent, being caused by his ingestion of the over the counter cough syrup he had taken for his cough.”

Shaw's period of suspension is eight months, starting from March 16 to November 15, effectively ruling him out of India's home series against Bangladesh and South Africa

Why Terbutaline is banned by WADA?

Terbutaline which is commonly found in cough syrups and is banned on match days as well as on non-match days. It is prohibited for all athletes at all time.

The terbutaline has been kept in the category of banned drugs by WADA because it increases muscle strength. In its report, the European Respiratory Journal has made it clear that consuming terbutaline medication increases anaerobic performance, i.e. the person can live without oxygen for a long time, compared to normal conditions.

In February 2011, the Food and Drug Administration has ordered to put a boxed warning on the drug's label. Pregnant women should not be given injections of the drug terbutaline for the prevention of preterm labor or for long-term (beyond 48–72 hours) management of preterm labor, and should not be given oral terbutaline for any type of prevention or treatment of preterm labor "due to the potential for serious internal heart problems and death

Terbutaline may improve performance by altering muscle function so that power production per muscle contraction is enhanced. Long-term use may also improve the energy producing pathways that do not require the presence of oxygen, hence a boost to anaerobic bursts of power

So an athlete using terbutaline as prescribed therapeutically is not likely to benefit from a performance enhancement in their sprinting. However, once an athlete has a TUE for terbutaline they have license to use as much as they like. So an unscrupulous athlete could seek to gain an advantage once they had the exemption.

As per medicine net article Brethine, Bricanyl, Brethaire are no longer available in the U.S.

The recommended adult oral dose for treating bronchospasm due to asthma, emphysema, or bronchitis is 2.5-5 mg 3 to 4 times daily approximately 6 hours apart while awake.
The maximum dosage is 15 mg/day.

WADA - World Anti-Doping Agency

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