Which Russian drugs are prohibited on the Vada list? “a list of drugs not prohibited for use in sports, taking into account age indications “We will have to rewrite textbooks”

Pharmaceutical drugs for athletes that can be bought at a low price in any pharmacy
Most athletes who prefer a natural method of training (without steroids) to improve the quality of recovery and training prefer a limited list of drugs. It includes creatine, protein, various gainers and amino acids, which are freely sold in stores specializing in sports nutrition.
At the same time, there is a large selection of relatively harmless medications that are available without a prescription, are not doping and have been tested by a large number of athletes. They can be found in a regular pharmacy.

It should be immediately noted that although pharmaceutical drugs are safe, you should carefully read the instructions and consult a doctor before using them. This article offers you an overview of the main pharmaceutical drugs in bodybuilding, including a list of the main drugs, as well as information about their meaning and effect on the body of athletes. Do not forget that each drug has its own side effects and contraindications.

1. Asparkam

Asparkam contains potassium and magnesium in a form that allows them to be absorbed by the body easily and painlessly. These substances contribute to the effective regulation of metabolic processes. Basically, asparkam is used by athletes who want to quickly lose weight. In addition, asparkam helps prevent cramps and makes training easier in hot conditions. As a rule, this drug is produced in the form of tablets; the order of use and dosage can be found in the instructions. Taking pills should be planned for the morning and afternoon, since the body does not absorb magnesium and calcium well in the evening.

2. Riboxin

Riboxin is a stimulator of biochemical processes; it has a positive effect on the athlete’s heart. This drug has antiarrhythmic, anabolic and other beneficial effects. By increasing the force of heart contractions, it helps increase stroke volume. Riboxin generally improves blood supply to tissues, as well as coronary blood supply. When consuming Riboxin, you can observe an improvement in energy metabolism, the activity of many enzymes and metabolic processes in the myocardium. Another positive effect of taking this drug is improved muscle tissue regeneration. But, despite all its positive qualities, Riboxin is poor as a reducing agent, for this reason it is recommended to be taken in combination with potassium orate, which acts as a kind of amplifier.

3. Potassium orotate

This remedy belongs to the category of metabolic. Potassium orotate stimulates endogenous biochemical processes. You can buy it at a pharmacy without a prescription, most often it comes in tablet form. The dosage for a bodybuilder is in the range of 1.5-2 grams per day. In principle, potassium orotate is a common mineral salt found in the cells of any living organism. The positive effects of taking it include strengthening the athlete’s cardiovascular system and a general anabolic effect, which makes quick recovery after training possible. In addition, there is an increase in diuresis (removal of fluid from the body) and an improvement in appetite. But do not overestimate the positive effect of potassium orotate for bodybuilders; the effect is not that strong. On the other hand, an athlete taking this drug will not experience problems with poor tolerability and side effects.

4. Agapurin

The names “Pentoxifylline” and “Trental” are also possible. It is available in tablet form and is inexpensive. This drug must be taken separately, since its main task is to increase vascular tone, reduce blood viscosity and increase blood flow. This is an excellent way to train, when there is a feeling of maximum pumping of the working muscles. Agapurine is used mainly by experienced bodybuilders, and it should be taken with caution, since this drug, in addition to its positive effects, can cause various negative aspects if the instructions are not followed.

5. Leuzea(maral root)

This plant, growing in Eastern and Western Siberia, Central Asia and the Altai Mountains, contains phytoexidons - steroid compounds with pronounced anabolic properties. In the body of an athlete, Leuzea enhances the processes of protein synthesis and their accumulation in the muscles, heart, liver and kidneys. Using this drug you can significantly increase physical endurance and intellectual performance. Long-term use of Leuzea leads to expansion of the vascular bed and, in turn, improvement of general blood circulation. Heart rate decreases. Based on Leuzea, a food additive such as Leuzea-P is produced. One Levzeya-P tablet contains about 0.85 mg of Ecdisten, supplements with which cost from 700 to 1,800 rubles in sports stores.

6. Aralia Manchurian

This drug has the ability to cause a significant decrease in blood sugar (hypoglycemia), which is greater than the hypoglycemia caused by other RA adaptogens. Since the result of hypoglycemia in this case is the release of somatotropic hormone, the use of Manchurian aralia allows one to achieve a significant overall anabolic effect with weight gain and increased appetite. Aralia has stimulating properties and enhances anabolism. Aralia tincture can be purchased from any pharmacy. It should be taken 20-30 drops in the morning and an hour before the start of training.

7. Vitamin complexes

Vitamins should be used in combination or each vitamin separately. Among the complexes, the most popular is “Complevit”, which is taken 3 times a day, one tablet after meals. If you take vitamins separately, then first of all you need to pay attention to the following:

B1 (Thiamin). Regulates the body's main systems: cardiovascular, nervous and digestive, and also affects growth and energy balance. Thiamine deficiency is expressed in irritability, increased fatigue, lack of appetite and related ailments.

B12 (cyanocobalamin). Enhances the synthesis and accumulation of proteins, has a strong anabolic effect.

B6 (Pyridoxine). Very important in metabolism and normal functioning of the nervous system.

Vitamin C (ascorbic acid)
B vitamins are injectable; they are sold in 1 ml ampoules with a concentration of 5%. Vitamins cannot be administered together; on the first day the body should receive one vitamin, on the next - a second, on the third day - a third, repeating the cycle. Injections are made using 2 or 5 cc syringes intramuscularly, and B1 and B6 are quite painful, so you need to be prepared for discomfort.

8. Diabeton MV

Among the freely sold drugs, Diabeton MV is perhaps the most powerful in terms of anabolic properties. In medicine, this drug is used to stimulate the pancreas in the treatment of diabetes. In bodybuilding, Diabeton MV is used to maintain a high level of anabolism in the off-season. The strength of the effect is equal to that of insulin injections, and the overall effect can be compared to that produced by methandrostenolone. The product is also great for those who want to gain weight quickly. Diabeton MV is available in 30 mg tablets. At the beginning you should take no more than 30 grams per day, if tolerance is normal, in the next course (on average the course lasts 4-6 weeks) the permissible dosage can be 60 grams per day. Diabeton MV is incompatible with other drugs.

It is recommended to take this remedy once a day - with breakfast in the morning. The anabolic effect of Diabeton is based on stimulating the production of insulin, one of the main anabolic hormones. For everything to go well, when taking this drug you need to eat at least 6 times a day, and you need to reduce the amount of fat in favor of protein foods. Also, use should not be combined with dietary nutrition, as this increases the risk of side effects. These, first of all, include the above-mentioned hypoglycemia, which in this case carries only negative things.

9. Tamoxifen

In bodybuilding, tamoxifen is used to increase testosterone levels in the body, and is essentially an anti-estrogen. That is, the increase in testosterone levels is achieved by blocking estrogen. For maximum effect, it is better to combine this drug with others. Considering that tamoxifen takes a long time to start working, the course should be at least 6-8 weeks.

10. Calcium glycerophosphate

In medicine, calcium glycerophosphate is used in the treatment of rickets, dystrophy and fatigue. This drug accelerates protein absorption and metabolism. When taking this remedy, appetite increases significantly, so consumption of fatty foods should be limited. Instead, you should include as many protein-containing foods as possible in your diet. Glycerophosphate is well suited for formulating courses, and there are no analogues in sports nutrition stores. For this drug, the dosage is approximately 100 mg per 8 kg of weight.

11. Saltos

Great for burning fat (similar to clenbuterol). You can buy it at a pharmacy without a prescription. The action of saltos is as follows: it increases body temperature by 1 degree with a dosage of 3-5 tablets per day in 3 doses. An increase of 1 degree occurs due to the combustion of fat. In this case, a small side effect is possible in the form of trembling hands and nervousness. With its fat-burning effect, saltos is significantly superior to most sports drugs for burning fat.

12. Trimetazidine

Trimetazidine is very similar in its properties to the popular drug Mildronate, but the cost of the former is much lower. This drug promotes a better supply of oxygen to cells, preserves intracellular energy, prevents the action and formation of free radicals, and also increases resistance to physical stress. Taking Trimetazidine makes workouts more powerful and intense. This product can be replaced with drugs containing creatine, but this replacement will not be equivalent. In addition, Trimetazidine combines well with other drugs.

13. Vinpocetine

Vinpocetine is a drug that corrects various cerebral circulatory disorders. The active ingredient here is apovincamine. This drug has a direct effect on metabolism in brain tissue. The blood vessels in the brain dilate, which promotes better blood supply to its tissues. Taking vinpocetine increases resistance to hypoxia (oxygen starvation), activates glucose utilization processes, and also increases the level of metabolism of serotonin and norepinephrine in brain tissue. The use of this drug leads to a decrease in platelet aggregation (sticking together), and therefore a decrease in blood viscosity.

14. Metformin

The mechanism of action of metmorphine is based on its ability to suppress glucogenesis, the formation of free fatty acids and fat oxidation. This drug has no effect on insulin levels, but is capable of changing its dynamics by reducing the ratio of free insulin to bound insulin and increasing the ratio of proinsulin to insulin. Stimulation of glucose uptake by muscle cells plays an important role here. By taking metmorphine, you can increase blood circulation in the liver and speed up the process of converting glucose into glycogen.

15. Rhodiola rosea(Golden root)

Rhodiola rosea grows in the Sayan Mountains, Altai, the Far East and Eastern Siberia. The pharmacological effects of this drug are due to the presence of substances such as rhodioliside and rhodosin. In some countries they are produced in pure form. The main feature of Rhodiola rosea is its strong effect on muscle tissue. When taking Rhodiola, strength endurance and muscle strength increase. At the cellular level, the level of activity of contractile proteins such as myosin and actin increases. Mitochondria increase in size.

But mildronate, which is familiar to many, is, alas, not on the list. From the beginning of 2016, it will be considered a prohibited drug by WADA. You can read more.

A short guide to pharmacological drugs permitted and prohibited in sports.

Introduction

Modern sport, especially elite sport, requires adequate pharmacological support for athletes.

A feature of pharmacological support in sports is not only the search for the most effective means, but also constant and other alertness to the use of a prohibited drug or substance belonging to the category doping.

The huge variety of existing means of pharmacological support necessitates their systematization.

Pharmacological formularies used in traditional medicine do not contain information about drugs “prohibited” in sports, and the existing “prohibited list of drugs” developed by WADA is not user-friendly enough.

Due to the current shortage of “combined” reference books on sports pharmacology, for rational and safe pharmacological provision of athletes, the need arose to publish a series of reference books in this area.

The directory presents:

— a list of the main pharmacological groups and drugs used in the practice of sports training,

— international and trade names of pharmacological drugs,

— a list of substances and methods prohibited in sports (“Prohibited List”).

Notes:

In the reference book, all drugs are listed by international name, and their trade names are listed (in brackets).

Trade names of drugs highlighted in bold in the text refer to foreign production.

The drugs indicated “in quotation marks” are multicomponent (combined or complex).

Drugs classified as “prohibited” are highlighted in the text in a special way.

The use of certain drugs included in the “prohibited list” has a number of features - see appendix.

When compiling this reference book, materials from the “Register of Pharmacological Drugs”, “International anti-doping agencies" and information from other authoritative sources.

Nutrients (Nutritional Substances)

Proteins (proteins)* a group of high-molecular nitrogen-containing organic compounds whose molecules are built from amino acid residues.

Amino acids (AA)*

BCAA (branch chain amino acids) - amino acids with branched carbon chains: Valine, Isoleucine, Leucine.

Non-standard AK

GABA (gamma-aminobutyric acid) - see pages 15, 19

Carnitine - see pages 5, 7, 10, 13, 28

Creatine - see pages 20, 26, 27

Ornithine - see pages 21, 28

Taurine - see pages 5, 20

Citrulline - see pages 14, 28

* Amino acids and proteins are included in sports nutrition:

Amino acid complexes

Proteins (protein concentrates)

Gainers (carbohydrate-protein concentrates) Pre-workout and post-workout complexes

Lipids (fats)

a group of organic compounds including fatty acids and their derivatives.

Fatty acids (FA)

Saturated (marginal) FAs

Unsaturated (unsaturated) FAs

monounsaturated fatty acids

polyunsaturated fatty acids (PUFAs)* - essential fatty acids

Polyunsaturated omega-6 fatty acids (linoleic, linolenic)

Oils: mustard, corn, flaxseed, olive, soybean

Conjugated linoleic acid (CLA)

Polyunsaturated omega-3 fatty acids (eicosapentaenoic acid, docosohexaenoic acid)

"Fish oil", "Omega-3"

"Maksepa", "Omakor"

Lipotropic substances (lipid metabolism regulators) *

Phospholipids (Lecithin) - see page 21

Choline (Vit.B4) - see pages 7, 10

Inositol (Inositol, Vit.B8) - see pages 7, 10

Carnitine (L-carnitine, Vit.VP) - see pages 4, 7, 10, 13, 28

Lipoic / Thioctic acid (Bht.N) - see pages 11, 13, 21

Methionine - see pages 4, 21

Betaine - see page 21

Taurine - see pages 4, 20

* Polyunsaturated fatty acids and lipotropic substances are included in sports nutrition.

Carbohydrates (sugars)* group of organic (poly-hydroxy-carbonyl) compounds.

Monosaccharides: glucose, fructose.

Oligosaccharides: lactose, sucrose, maltose.

Polysaccharides: starch, dextrin, inulin, pectins.

Digestible carbohydrates:

glucose, fructose, lactose, sucrose, maltose;

starch, dextrin, inulin.

Indigestible carbohydrates (fiber):

cellulose.

Sugar substitutes and sweeteners

*Carbohydrates are included in sports nutrition:

Energy drinks (carbohydrate-energy mixtures/drinks)

Gainers (carbohydrate-protein concentrates)

1. Vitamins*

a group of low molecular weight metabolically active organic compounds.

Water soluble

Vit.EL (Thiamin)

Vit.B2 (Riboflavin)

Vit.VZ (Vit.RR, Nicotinic acid)

Vit.B5 (Pantothenic acid)

Vit.Vb (Pyridoxine)

Vit.B7 (Vit.N, Biotin)

Vit.B9 (Vit.Vs, Folic acid)

Vit.B12 (cyanocobalamin)

Vit.S (Ascorbic acid)

Vit.R (Rutin)

Fat soluble

Vit.A (Retinol)

Bht.D (Calciferols)

Vit.E (Tocopherols)

Vit.K (Naphthoquinones)

Vitamin-like compounds

Vit.B4 (Choline)

Vit.B8 (Inositol)

Vit.VYu / Vit.Vx (PABA - para-aminobenzoic acid)

Vit.B11 / Vit. W (Carnitine)

Vit.B13 (Orotovaya complex)

Vit.B15 (Pangamovaya kit)

Vit.B17 (Amygdalin)

Vit-F (PUFA - polyunsaturated fatty acids)

Bot.N (Lipoic / Thioctic acid)

Vit.i (Methylmethionine)

* Vitamins are included in multivitamin and vitamin-mineral complexes, as well as in sports nutrition.

Vitamin preparations and multivitamin complexes

Rosehip fruits, Rosehip oil

Primrose leaves

fruits, leaves of currant

larch needles

Actinidia fruits

Rowan fruits

Sea buckthorn fruits, sea buckthorn oil

Main sources of vitamins and minerals in the diet:

Whole vegetables, fruits, berries;

Vegetable, fruit, fruit and berry salads/drinks.

In order to adequately provide the body with vitamins and minerals, it is necessary to take multivitamin and vitamin-mineral complexes!

Example: “Complivit”, “Selmevit”, “Supradin”, “Vitrum”, etc.

Water-soluble vitamins

Vitamin B1 group (Thiamins)

Thiamine (Vit.B1)

Thiamine pyrophosphate (Cocarboxylase) - coenzyme “Compligam-B”, “Neuromultivit”, “Neurotrat”, “Trigamma”

Benfotiamine (Benfogamma) - a fat-soluble analogue of “Benfolipen”, “Kombilipen”, “Milgamma”, “Polyneurin”

Vitamin B2 group (Riboflavins)

Riboflavin (Vit.B2)

Benzaflavin - a derivative of riboflavin "Cytoflavin"

Vitamin B3 group (Nicotinates)

Nicotinic acid (Vit.VZ/RR, Niacin) - see pages 13, 25

Enduracin

Nicotinamide

"Cytoflavin", "Epargriseovit"

Vitamin B6 group (Pyridoxines)

Pyridoxine (Vit.Wb)

Pyridoxal phosphate (Codecarboxylase) - coenzyme “Angiovit”, “Benfolipen”, “Combilipen”, “Compligam-V”, “Medivitan”, “Milgamma”, “Neuromultivit”, “Neurotrat”, “Polyneurin”, “Trigamma”, “Magne” B6", "MexiV 6"

Vitamin B9 group (Folates)

Folic acid (Vit.B9/Vs) - see page 24

Folacin, "Angiovit", "Medivitan", "Folio" "Foliber"

Calcium folinate (Dalizol, Leucovorin, Prefolic)

Vitamin B12 group (Cobalamins)

Cyanocobalamin (Vit.B12) - see page 24

Hydroxocobalamin (Oxycobalamin) - active metabolite

Adenosylcobalamin (Cobamamide) - coenzyme “Angiovit”, “Vitohepat”, “Foliber”

“Benfolipen”, “Kombilipen”, “Compligam-V”, “Medivitan”, “Milgamma”, “Neuromultivit”, “Trigamma”, “Epargriseovit”

Vitamin B5 group (Pantothenates)

Pantogenic acid (Vit.B5)

Calcium pantothenate

Dskspanthenol - a derivative of pantothenic acid

Vitamin B group 7

Biotin (Vit.H, Coenzyme R)

Vitamin C group

Ascorbic acid (Vit.C) - see page 13

Galascorbin

"Ascorutin", "Profilaktin S"

Vitamin P group (Flavonoids)

Rutoside (Vit.R, Rutin) - see page 13

Quercetin (Corvitin)

Dihydroquercetin (Dikvertin)

"Ascorutin", "Profilaktin S"

Vitamin-like compounds

Vit.B4 (Choline) - see page 5

Vit.B8 (Inositol, Inositol) - see page 5

Vit.VYu / Vit.Vkh (PABA - para-aminobenzoic acid)

Vit.B11 / Vit.W (Carnitine) - see pages 4, 5, 13, 28

Vit.B13 (Orotonic acid) - see pages 20, 26

Vit.B14 (Pyrrolo-quinoline quinone, Coenzyme PQQ)

Vit.B15 (Pangamovaya), Calcium Pangamate

Vit.B17 (Amygdalin)

Vit.i (Methylmethionine)

Fat-soluble vitamins

Vitamin A group (Retinols)

Retinol (Vit.A) - see page 13

Sea buckthorn oil, Rosehip oil “Fish oil”, “Aevit”, “Tykveol”

Carotene group preparations

Betacarotene (Beta-carotene, BetaTab, Carolyn, Carotinyl) "Vetoron", "Carotolin"

Vitamin E group (Tocopherols)

Tocopherol (Vit.E) - see page 13

Tocopherol acetate (Evitol)

"Aevit", "Radevit"

Vitamin D group (Calciferols)

Ergocalciferol (Bht.D2), “Fish oil”

Cholecalciferol (Vit.EZ), (Aquadetrim, Vigantol, Videhol), "Osteokea", "Calcemin"

Oxycholecalciferol (Alfacalcidol, Alpha-DZ, Oksidevit, Etalfa)

Dihydrotachysterol (Tachistin) - analogue of bht.D2

Calcitriol (Osteotriol, Rocaltrol)

Vitamin K group (Naphthoquinones)

Phylloquinone (Vit.K1)

Menaquinone (Vit.K2)

Phytomenadione (Vit.KZ)

Vikasol is a synthetic analogue of Vit. TO

Vitamin-like compounds

Vit.B (polyunsaturated fatty acids) - see page 5 omega-3: linolenic, eicosapentaenoic, docosahexaenoic omega-6: linoleic, arachidonic

Bht.N / Lipoic acid / Thioctic acid (Berlition, Octolipen, Thiogamma, Thioctacid, Espa-lipon), Lipamide - see pages 5, 13, 21

Minerals*

a group of inorganic (macro- and microelements) substances.

Macronutrients (99%)

Essential (vital, irreplaceable) chemical elements

Microelements (1%)

* Minerals are included in mineral and vitamin-mineral complexes, as well as in sports nutrition.

Antioxidants and Antihypoxants

a group of drugs that help neutralize “free radicals” in the body and/or improve the body’s utilization of oxygen.

Vitamins, vitamin-like substances and microelements

Vitamins (A, E, C, P, PP) - see pages 7-11

“Aevit”, “Ascorutin”, “Antoxinate”, “Vitrum Antioxidant”,

“Oxitex”, “Oksilik”, “Triovit”, “Tri-vi-plus”, etc.

Carnitine (L-carnitine, Carnitene, Elcar) - see pages 4, 5, 7, 28

Lipoic / Thioctic acid (Berlition, Octolipen, Thiogamma, Thioctacid, Espa-lipon), Lipamide - see pages 5, 11, 21

Amber compound (Succinate), Cogitum - see page 16 “Limontar”, “Cytoflavin”, “Energostim”, “Reamberin”

Ubidecarenone (Coenzyme-QlO, Kudevita, Kudesan, Ubiquinone) Microelements (Zn, Se, Cu, Mn) - see page 12

Zinc (Zinkite, Zincteral), Selenium (Selenaza, Ebselen), "Selzinc"

Biopeptides and polypeptide bioregulators

Cytochrome-C (Cyto-Mac)

Ceruloplasmin (ferrooxidase)

Carnosine (Sevetin)

Glutathione (Glation, Tationil, TAD), "BioTAD"

Actovegin, Solcoseryl - see pages 16, 25, 29

Metabolics with antioxidant and antihypoxic activity

Inosine (Riboxin) - see pages 20, 21, 26, 27

Methylethylpyridinol (Cardioxipin, Emoxipin) - see page 25

Ethylmethylhydroxypyridine succinate (Mexidant, Mexidol, Mexicor, Mexiprim, Mexifin), “MexiV 6” - see. page 25

Ethylthiobenzimidazole (Bemactor, Metaprot) - see pages 14, 16

Trimetazidine (Angiozil, Antisten, Deprenorm, Predizin, Preductal, Rimecor, Triducard, Trimectal, Trimetaznd) - doping (S4.5)

Preparations of different groups with antioxidant and antihypoxic properties

Sodium polydihydroxyphenylene thiosulfonate (Hypoxene)

Hydroxyethylammonium methylphenoxyacetate (Trecrezan) - see page 14

Dimethyloxobutylphosphonide methylate (Dimephosphone) - see page 28

Adaptogens

a group of drugs with a general tonic and restorative effect.

Herbal preparations Plant raw materials containing glycosides - saponins

Ginseng root (Ginsana, Ginseng plus),

Vitamins: “Vitamax”, “Velmen”, “Gerimaks”, “Dynamizan”, “Vitrum Performance”, “Multi-tabs Active”

Aralia roots (Saparal)

herb Yakortsev (Tribulus) - see page 26 Plant raw materials containing ligands

rhizomes and roots of Eleutherococcus

rhizomes and roots of Echinopanax

Schisandra fruits and seeds

rhizomes and roots of Rhodiola

Plant raw materials containing various biologically active substances

rhizomes with roots of Leuzea (Ekdisten) - see page 26

Sterculia leaves

Preparations of animal origin

Antlers (young antlers) of deer, wapiti or sika deer (Pantocrine, Rantarin), “Cropanol”

Royal jelly (Apilak), “Apitonus” - see page 29

Drugs of synthetic origin

Citrulline manat (Stimol) - see pages 4, 28

Acetylaminosuccinic acid (Cogitum) - see page 16 “Limontar”, “Cytoflavin”

Sulbutiamine (Enerion) - see "Thiamins", page 9

Hydroxyethylammonium methylphenoxyacetate (Trecrezan) - see page 13

Ethylthiobenzimidazole (Bemactor, Metaprot) - see pages 13, 16

Meldonium (Cardionate, Mildroxin, Mildronate) - doping (S4.5)

Adamantylbromophenylamine (Bromantane, Ladasten) - doping (S6.a)

Combination drugs

"B-Royal"

"Safinor"

"Formula A"

Psychotropic drugs

(Drugs that regulate central nervous system functions)

Nootropics

(Neurometabolic stimulants)

Herbal preparations

Ginkgo Biloba extract (Bilobil, Ginos, Memoplant, Tanakan) Pyrrolidine derivatives (racetams)

Piracetam (Lucetam, Memotropil, Nootropil, Noocetam, Pirabene, Piramem, Piratropil, Cerebril),

“Combitropil”, “Omaron”, “Piracesin”, “Phesam”, “Vinpotropil”

Pramiracetam (Pramistar)

Phenylpiracetam (Phenotropil, Fonturadetam) - doping (S6.a)

Dimethylaminoethanol derivatives - see page 17

Meclofenoxate (Acefen, Cerutil) - doping (S6.6)

Acetylcholine precursors (cholinergic drugs)

Choline alfoscerate (Gliatilin, Delecit, Cerepro, Cereton)

Citicoline (Napilept, Recognan, CDP-choline, Ceraxon)

GABA derivatives and analogues

Gamma-aminobutyric acid (Aminalon, Gammalon)

Nicotinoyl-GABA (Picamilon, Picanoyl), "Gitagamp"

Aminophenylbutyric acid (Anvifen, Noofen, Phenibut) - (S6.6)

Gopanthenic acid (Gopantam, Pantogam, Pantocalcin)

Calcium gamma hydroxybutyrate (Neurobutal)

Amino acids and substances that affect the system of excitatory amino acids

Glycine, Biotredin, Eltacin - see pages 4, 19

Phenylacetylprolyl-glycine (Noopept)

Pyridoxine derivatives - see page 9

Pyritinol (Encephabol)

Vitamin-like preparations - see pages 7-11

Acetylcarnitine (Carnicetine, Nicetyl)

Idebenone (Neuromet, Noben, Celestab)

Imidazole derivatives

Ltilthiobenzimidazole (Bemactor, Metaprot) - see pages 13, 14

Iolipeptide bioregulators

Lktovegin - see pages 13, 25, 29

Lipocerebrin, Cerebramin

Cortexin, Cerebrolysate, Cerebrolysin

Neuropeptides and their analogues

Neurotropic drugs

Glutamic acid (Glutamate), Nooglutil - see page 4

Amber compound (Succinate) - see page 13 “Limontar”, “Cytoflavin”, “Energostim”, “Reamberin”

Acetylaminosuccinic acid (Cogitum) - see page 14

Ampakines

(AMPA - AminoMethylisoxazolePropionic acid)

Ampalex (СХ-516)

Farampator (СХ-691)

Drugs from other pharmaceuticals. groups with a Nootropic component

Antioxidants and antihypoxants - see page 13 Adaptogens - see page 14 Psychostimulants - see page 17

Psychostimulants

(Psychotonics / Psychoenergizers)

Phenylethylamine derivatives - doping (S6.6)

Cathine (Nor-pseudoephedrine) - Ephedrine - see page 18

Cathinone (Norephedron) - Pseudoephedrine - see page 18

Methcathinone (Ephedron) _ Methylephedrine

Methyl methcathinone (Mephedrone) _ Methyl pseudoephedrine

Phenylalkylamine derivatives (Amphetamines)* - doping (S6.a)

Amphetamine (Phenamine)

Dextroamphetamine (D-Amphetamine, Dexedrine)

Methylamphetamine (Methamphetamine, Deoxyephedrine, Deoxyn, Methedrine)

Ethylamphetamine - doping (S6.6)

Dimethylamphetamine (Dimethamphetamine) - doping (S6.6)

Methylenedioxyamphetamine (MDA) - doping (S6.6)

Methylenedioxy-methamphetamine (MDMA) - doping (S6.6)

Methylenedioxy-ethylamphetamine (MDEA) - doping (S6.6)

Amphetamine analogues - doping (S6.a)

Benzylpiperazine (BZP)

Phenethylline (Captagon)

Fenkamin

Phenylalkylpiperidine derivatives

Methylphenidate (Meridil, Metadat, Methylin, Ritalin) -

doping (S6.6)

Pyridrol (Pipradrol) - monitoring

Phenylalkyl sydnonimine derivatives (Sydnonimines)

Mesocarb (Sidnocarb), "Loxidan" - doping (S6.a)

Feprosidnine (Sidnofen)

Purine derivatives (Methylxanthines) - see pages 23, 25

Caffeine (coffee, tea, mate, cola, guarana) - monitoring

Dimethylaminoethanol derivatives - see page 15

Deanol aceglumate (Nooklerin, Demanol)

Meclofenoxate (Acefen, Cerutil) - doping (S6.6)

Adrenergic agonists (a- and p-AM)

Phenylethylamines (Catecholamines)*

Norepinephrine (Norepinephrine)

Epinephrine (Adrenaline) - doping (S6.6)

Sympathomimetics - see Amphetamines, page 17

Ephedrine - doping (S6.6)

"Solutan", "Bronholitin", "Efatin", "Teophedrine"

Pseudoephedrine (Diphedrine) - doping (S6.6)

“Grippex”, “Gripend”, “Caffetin Cold”, “Clarinase”, “Mulsinex”. "Nurofen Stopcold", "Rinasek", "Sudafed", "Fervex rhinit"

Phenylpropanolamine (Norephedrine) - monitoring Trimex, Koldakt, Kontakh, Orinol

Selective (selective) a,-AM

Phenylephrine (Mezaton) - monitoring "Adrianol", "Vibrocil", "Coldrex", "Teraflu"

Etilephrine (Fethanol), "Influbene" - doping (S6.6)

Norphenephrine (Molicor) - doping (S6.6)

Analeptics

Strychnine - doping (S6.6)

Securinin

Bemegrid

Etimizole

Sulfocamphocaine

Niketamide (Cordiamin) - doping (S6.6)

Pentetrazole (Corazol) - doping (S6.6)

Eugeroics (“wakefulness enhancers”)

Modafinil (Provigil) - doping (S6.a)

Adrafinil (Olmifon) - doping (S6.a)

Armodafinil (Nuvigil)

Drugs of other pharmacological groups

Cocaine - doping (S6.a)

Methylhexanamine (Dimethylpentylamine) - doping (S6.6)

Octopamine (Norsynephrine) - doping (S6.6)

Oxilofrine (Methylsynephrine) - doping (S6.6)

Synephrine - monitoring

Bupropion (Wellbutrin, Zyban) - monitoring

Pemoline (Volital) - doping (S6.6)

Etamivan (Instenon) - doping (S6.6)

* Topical preparations are not considered prohibited.

Sedative (calming) drugs

Herbal preparations

Plant materials containing essential oils

rhizomes with Valerian roots

Peony rhizomes and roots

hop cones

Melissa grass

passionflower grass

Plant raw materials containing glycosides-flavonoids

motherwort herb

rhizomes and roots of Skullcap

Various herbal raw materials with a sedative effect

mint leaves

Oregano herb

rhizomes with roots of Sinyuhi

Hawthorn fruits

dried grass

St. John's wort herb extract (Gelarium, Deprim, Negrustin)

Combination drugs

“BrOMeNVZL” (valerian + hawthorn + menthol + sodium bromide)

"Valemidin" (valerian + motherwort + hawthorn + mint + diphenhydramine)

“ValOCORDIN”, “CorvalOL” (EBIV + phenobarbital + mint + hops)

"Valosedan" (phenobarbital + valerian + hops + hawthorn + rhubarb)

"Valoserdin" (EBIV + phenobarbital + oregano + mint)

"Valocormid" (lily of the valley + valerian + belladonna + menthol + sodium bromide)

“Dopelherz Vitalotonic” (valerian + lemon balm + hops + hawthorn)

"Dormiplant" (valerian + lemon balm)

“HOBO-Passit” (valerian + lemon balm + hops, hawthorn + St. John’s wort + passionflower)

“Passifite” (valerian + hops + hawthorn + thyme + mint)

"Persen" (valerian + lemon balm + mint)

“Sedoflor” (hawthorn + motherwort + lemon balm + hops + sweet clover + coriander)

“Phyto Novo-Sed” (hawthorn + motherwort + lemon balm + rosehip + echinacea)

"Fitorelax" (hawthorn + valerian)

“Daytime” tranquilizers (anxiolytics/ataractics)

Aminophenylbutyric acid (Anvifen, Noofen, Phenibut) - (S6.6)

Tetra(Adaptol, Mebicar)

Fabomotizole (Afobazole)

Etifoxine (Stresam)

Organotropic drugs

(Organoprotectors)

Cardioprotectors

(from Lat. cog - heart, protectione - protection)

Preparations containing K+ and Mg2+ ions

Potassium chloride (Potassium-normine, Calyposis prolongatum)

Potassium-glucose-insulin mixture

Magnesium sulfate (Cormagnesin),

Magnesium citrate (Magnesol), "Magne-Vb"

Potassium and Magnesium aspartate (Asparkam, Panangin)

Drugs that stimulate metabolic processes

Inosine (Riboxin), “Cytoflavin” - see pages 13, 21, 26, 27

Creatine - see pages 4, 26, 27

"Biophosphine" - see page 27

Phosphocreatine (Creatine phosphate, Neoton) - see page 27

Orotic acid (Potassium orotate, Magnerot, Orocamage) - see pages 7, 10, 26

Taurine (Dibikor) - see pages 4, 5

Meldonium (Cardionate, Mildroxin, Mildronate) - doping (S4.5)

Trimetazidine (Antisten, Deprenorm, Predisin, Preductal, Rimekor, Triducard, Trimectal, Trimetazid) - doping (S4.5)

Drugs from other pharmaceuticals. groups with cardioprotective effects

Antioxidants and antihypoxants - see page 13 Metabolite - see pages 26-29

Hepatoprotectors

(from Latin hepar - liver, protectione - protection)

Herbal preparations

Milk thistle extract, Silymarin

(Karsil, Legalen, Leprotek, Silegon), "Gepavit", "Gepafor"

Artichoke extract (Cholebil, Chofitol, Cynarix)

Pumpkin seed oil (Vitanorm, Tykveol, Cholenol)

Kedrostat, Maksar, Ropren

Combined herbal preparations

"Hepatofalk", "Gepabene"

"Liv.52", "Sibektan"

“Essential” (irreplaceable) phospholipids and their preparations

Lecithin - see page 5

"Antraliv", "Essentiale", "Essliver"

"Phosphogliv", "Fosphonziale", "Eslidin"

"Gepagard", "Rezalyut"

Drugs of different pharmacological groups

Lipoic / Thioctic acid (Berlition, Octolipen, Thiogamma, Thioctacid, Espa-lipon) - see pages 5, 11, 13

Inosine (Riboxin), Molixan - see pages 13, 20, 26, 27

Betaine - see page 5

Arginine (Glutargin), “Hepamin” - see pages 4, 28

Methionine - see pages 4, 5

Ademethionine (Heptor, Heptral)

Ornithine (Hepa-Merz) - see pages 4, 28

Ursodeoxycholic acid (Ursodez, Ursoliv, Ursosan, Ursofalk)

Combination drugs

"Vigeratin", "Hepatamin", "Hepatosan", "Sirepar"

"Laennec", "Erbisol"

"Remaxol", "Hepasol"

Probiotics (Eubiotics)

a group of drugs of microbial origin that normalize intestinal microbiocinosis.

Preparations containing Bifidobacteria, Lactobacilli, etc.

Bifidobacterium

Bifidumbacterin, Bifinorm, Probifor "Bifiliz" (Bifidobacterium + Lysocim)

"Bifikol" (Bifidobacterium + Escherichia coli)

"Bifiform" (Bifidobacterium + Enterococcus)

“Polibacterin”, “Florin” (Bifidobacterium + Lactobacillus) “Linex” (Bifidobacterium + Lactobacillus + Enterococcus) Lactobacillus (Lactobacillus)

Lactobacterin, Acylact, Biobakton, Primadophyllus "Acipol" (Lactobacillus + Saccharomyces)

"Kipacid" (Lactobacillus + Lysocim)

Escherichia coli

Colibacterin, Bioflor

Preparations of microbial origin that competitively displace opportunistic and pathogenic microorganisms

Fungi/yeast (Saccharomyces)

Spore-forming bacilli (Bacillus)

Bactisubtil, Biosporin, Sporobacterin

Bactistatin

Prebiotics

These are drugs that stimulate the growth and metabolic activity of the intestinal microflora.

Lactulose (Duphalac, Normaze, Portalac)

"Lactofiltrum", "Hilak"

Dietary fiber (fiber):

pectin, cellulose, hemicellulose (vegetables, fruits, cereals)

Synbiotics

These are drugs that combine the properties of pro- and prebiotics.

Diuretic (diuretic) drugs*

a group of drugs that enhance the excretory function of the kidneys.

Herbal preparations

Plant raw materials containing essential oils

buds, birch leaves

Juniper fruits

Plant raw materials containing glycosides - saponins

Orthosiphon leaves (kidney tea)

Gryzhnika grass

Plant raw materials containing glycosides - flavonoids

knotweed / knotweed grass

horsetail herb

Elderberry flowers

cornflower flowers

Astragalus herb, "Flaronin"

Plant raw materials containing glycosides - phenologlycosides

Bearberry leaves (Uriflorin)

Lingonberry leaves

Lespedeza herb (Lespenefril, Lespeflan, Lespefril)

Combined drugs

"Canephron"

"Cyston"

"Pilozuril"

"Rovatinex"

Drugs of other groups Purine derivatives (Xanthines) - see page 25

* Diuretics of synthetic origin - doping (S5)

Hematotropic drugs

(Drugs affecting the blood system)

Drugs that stimulate erythropoiesis

a group of drugs that increase the level of red blood cells and hemoglobin.

Iron preparations Iron sulfate

Hematogen

"Ferroplex" (FeS04 + Vit.C)

"Actiferrin" (FeS04 + L-serine)

“Actiferrin compositum” (FeS04 + L-serine + Vit.B9) “Ferro-foil” (FeS04 + Vit.: B9 + B12)

“Fenuls” (FeS04 + Vit.: B9 + B1 + B2 + VZ + B5 + B6 + C)

Long-acting drugs

Tardiferon, Ferrogradumet, Ferrograd,

"Sorbifer-Durules" (FeS04 + Vit.C)

Ferrous fumarate

"Ferretab" (Fe-fumarate + Vit. B9)

Iron gluconate/maltosate

Iron gluconate (Ferronal),

“Totema” (Fe-gluconate + Mn-gluconate + Si-gluconate)

Iron polymaltosate (Ferrum-Lek, Maltofer),

"Maltofer Fol" (Fe-polymaltose + Vit.B9)

Other drugs that stimulate erythropoiesis

Vitamins: B9, B12, B1, B2, B6, C, E - see pages 7-11 Minerals: cobalt, copper, phosphorus - see pages 12

Erythropoietins (EPO/EPO) - doping (S2)

Epoetin-alpha (Eprex, Epogen, Epocomb, Epokrin, Eralfon)

Epoetin-beta (Recormon, Epostim, Erytrostim), Mircera

Epoetin Omega (Epomax)

Epoetin-theta (Eporatio)

Darbepoetin (Aranesp)

1. Drugs affecting rheology and blood microcirculation

a group of drugs that improve blood circulation.

Herbal preparations

Ginkgo Biloba extract (Bilobil, Ginos, Memoplant, Tanakan)

Platelet cyclooxygenase inhibitors

Acetylsalicylic acid

(Aspikor, Aspirin, Acecardol, Trombo ACC), "Cardiomagnyl"

Lysine acetylsalicylate (Aspizol, Acelizin, Laspal)

Platelet ADP receptor locators

Clopidogrel (Zylt, Plavike)

Prasugrel (Effient)

Ticagrelor (Brilinta)

Phosphodiesterase inhibitors Purine derivatives (Xanthines)

Theophylline (alkaloid of tea leaves, coffee beans) and its derivatives:

Aminophylline (Eufillin)

Xanthinol nicotinate (Complamine)

Theobromine (cocoa seed alkaloid) and its derivatives:

Pentoxifylline (Agapurin, Vazonit, Pentilin, Trental)

Pyrimidine derivatives

Dipyridamole (Curantyl)

Drugs from other pharmaceuticals. groups that improve blood microcirculation

Actovegin, Solcoseryl - see pages 13, 16, 29

Methylethylpyridinol (Cardioxipin, Emoxipin) - see page 13

Ethylmethylhydroxypyridine succinate (Mexidant, Mexidol, Mexicor, Mexiprim, Mexifin), “MexiV 6” - see page 13

Pyricarbate (Anginin, Parmidine)

Calcium dobesilate (Doxylek, Doxy-Chem)

Naftidrofuril (Duzopharm, Naftilux)

Sulodexide (Angioflux, Wessel Due)

Metabolics

(Drugs that stimulate metabolic processes)

Anabolizers

a group of drugs that stimulate anabolic processes in the body.

Anabolic steroids* - doping (S1)

Oxandrolone (Anavar, Oxandrine)

Stanozolol (Winstrol, Stanobolon)

Trenbolone (Parabolan)

Methenolone (Primobolan)

Mesterolone (Proviron)

Methandienone (Methandrostenolone, Danabol, Dianabol)

Nandrolone (Retabolil, Durabolin)

Turinabol

Oxymetholone (Anadrol, Anadrol)

Boldenone (Equipoise)

Anabolic non-steroidal substances/drugs**

Amino acids - see page 4

Creatine - see pages 4, 20, 27

Inosine (Riboxin) - see pages 13, 20, 21, 27

Orotic acid (Potassium orotate, Magnerot, Orocamage) - see pages 7, 10, 20

Protodioscin (Tribulus) - see page 14

Ecdysterone (Ecdisten) - see page 14

Eurycoma

Forskolin

* And other substances with similar chemical structure or similar biological effects.

** Anabolizers are included in sports nutrition:

Anabolic complexes

Pre-workout and post-workout complexes

Energizers

a group of drugs that increase the body's energy potential.

Macroergs (phosphagens) are high-energy substances that help preserve and restore ATP reserves.

Purine derivatives

Adenosine monophosate (AMP, Adenocor, Phosphaden)

Trifosadenine (ATP, Biosint, Phosphobion), "ATP-Long"

Inosine (Riboxin) - see pages 13, 20, 21, 26

Creatine - see pages 4, 20, 26

Fructose diphosphate (FDP, Ezaphosphine),

"Biophosphine" - see page 20

Phosphocreatine (Creatine phosphate, Neoton) - see page 20

Regulators of water-electrolyte balance and acid-base status

Rehydrants (oral rehydration salts)

"Gastrolit"

"Hydrovit"

"Regidron"

"Citraglucosolan"

Isotonic drinks (carbohydrate-vitamin-mineral mixtures/drinks)

pH regulators (nitrate and bicarbonate mixtures / drinks)

Potassium citrate (Kalinor)

“Maral” with sodium citrate, etc.

Preparations from various pharmaceuticals. groups with antiacidotic action

Arginine aspartate (Sargenor),

Arginine glutamate (Glutargin) - see pages 4, 21

Citrulline malate (Stimol) - see pages 4, 14

Cotiamine (Cocarboxylase) - see page 9

Carnitine (L-carnitine) - see pages 4, 5, 7, 13

Dimephosphone - see page 13

Trometamol (Trisamine)

Electrolyte solutions for infusion*

“Disol”, “Acesol”, “Chlosol”, “Trisol”

"Quintasol"

"Mathusol"

"Reosorbilakt", "Sorbilakt"

"Ringer acetate", "Ringer lactate", "Hartmann solution"

Correctors of urea formation and excretion Hepatoprotectors (Arginine, Ornithine, Citrulline, etc.) - see page 21 Diuretics (Lespenefril, Pilozuril, etc.) - see page 23

* Intravenous injections and/or infusions in a volume of more than 50 ml over a 6-hour period, except in cases of providing necessary medical care, are regarded as a prohibited method - doping (M2)

Various metabolic stimulants

Correctors of cartilage tissue metabolism (Chondroprotectors)

Glucosamine (Aminoartrin, Dona, Elbona, Yunium)

Chondroitin (Artradol, Structum, Chondrogard, Chondroxide, Chondrolone)

Glycosaminoglycan-peptide complex (Biartrin, Rumalon)

Combined chondroprotectors

"Arthra", "Teraflex", "Chondroflex", "Inoltra"

Other chondroprotectors

Hyaluronate (Synovial, Hyalgan)

Alflutop

Piascledine

Various biogenic stimulants of metabolic processes

Kalanchoe juice

liquid extract from Chaga (Befungin) - cobalt (S2.2)

Mumiyo (“mountain resin”)

"Api" drugs: - see page 14

Propolis (“bee glue”)

Royal jelly (Apilak)

Flower pollen, (pollen, pollen)

Drugs from other pharmaceuticals. groups that stimulate metabolic processes

Actovegin, Solcoseryl - see pages 13, 16, 25 Vitamins - see pages 7-11

Adaptogens - see page 14

Immunotropic drugs

(Drugs that stimulate immune processes)

Preparations for immunoprophylaxis

Drugs that create active artificial immunity

Anatoxins

Drugs that create passive artificial immunity

Blood serum

Immunoglobulins (IG)

Drugs intended for emergency prevention and delaying the development of the pathogen in the infected body

Some vaccines (rabies) and toxoids (tetanus)

Bacteriophages (BF)

Interferons (IF)

Immunomodulators

endogenous (immunocytokines)

exogenous (adjuvants)

Immunostimulants

(Immunomodulators / Immunocorrectors)

Herbal preparations

Echinacea herb (juice, tincture, extract)

(Imunal, Immunorm, Echinabene)

"Sinupret", "Tonsilgon"

Preparations of hormones of the thymus gland (thymus)

Polypeptides

Taktivin, Timalin, Timoptin

Timactid

Interferons

(a-leukocyte, (3-fibroblast and y-lymphocyte)

Interferons are a group of endogenous low molecular weight proteins that have antiviral and immunomodulatory activity.

a-Interferon

Human leukocyte interferon Recombinant a-interferon

Interferon alpha (Alfaferon, Viferon, Genferon, Grippferon, Interal, Lokferon, Reaferon, etc.), "Kipferon"

Interferonogens (Inducers of endogenous IF)

Umifenovir (Arbidol)

Methylglucamine acridone acetate (Cycloferon)

Tiloron (Amiksin, Lavomax)

Kridanimod (Neovir)

Polyadenyl-uridyl acid (Poludan)

Inosine pranobex (Groprinosin, Isoprinosine)

Pentanedium imidazolylethanamide (Dicarbamine, Ingavirin)

Preparations of microbial and yeast origin

Bacterial lipopolysaccharide (Prodigiosan, Pyrogenal)

Glucosaminylmuramyl dipeptide (Lykopid)

Bacterial lysates:

"Imudon"

"IPC-19" (immunomodulatory respiratory spray)

"Broncho-munal", "Broncho-Vaxom"

"Ribomunil"

Various immunostimulants

Peptide immunostimulants

Thymogen, "Tsitovir-3"

Imunofan

Immunomax

Other immunostimulants

Oscillococcinum ‘

Pentoxyl

Oxymethyluracil (Immureg)

Sodium ribonucleate (Ridostin)

Sodium deoxyribonucleate (Deoxynate, Derinat), "Ferrovir"

Aminodihydrophthalazindione (Galavit, Tamerit)

Azoximer bromide (Polyoxidonium)

Glutoxim

Drugs from other pharmaceuticals. groups with immunostimulating effects

Vitamins and minerals - see pages 7-12

Adaptogens - see page 14

Probiotics - see page 22

Various metabolic stimulants - see page 29

Application

Doping (from the English dope - to give drugs) - pharmacological drugs and methods that artificially increase physical, emotional performance and athletic performance.

World anti-doping Code (WADA) Prohibited List

Substances and methods prohibited at all times

(during out-of-competition and competitive periods)

Prohibited Substances (S)

Androgens; Anabolic steroids and their analogues

Hormones of peptide structure; Growth factors and their analogues

Beta-2 agonists ((32-Adrenergic agonists)

Hormones; Hormone antagonists; Metabolism modulators

Diuretics; Masking agents

Prohibited methods (M)

M1 - Manipulations with blood and its components M2 - Chemical and Physical manipulations M3 - Gene doping

Substances and methods prohibited during competition

— Stimulants (Adrenergic agonists; Psychostimulants, etc.)

Drugs

Cannabinoids; Cannabimimetics

Glucocorticosteroids (GCS) - IM, IV, per os, per rectum

Substances prohibited in certain sports (P)

P1 - Alcohol (ethanol)

P2 - Beta blockers

Special substances*

S3; S4.1-S4.3; S5; S6.6; S7; S8; S9; PI; P2

* The Prohibited List specifically identifies “specified substances” whose use may be considered unintentional due to their general availability or because their ability to influence athletic performance is questionable.

Violation anti-doping rules resulting from the use of these substances may be subject to less severe sanctions if it is determined that the athlete did not use the substance for the purpose of improving his athletic performance.

PROHIBITED LIST 2017

(Used materials from RUSADA: http://www.rusada.ru/documents)

WORLD ANTI-DOPING CODE

In accordance with Article 4.2.2 of the World anti-doping Code, all Prohibited Substances shall be considered as “Specified Substances” with the exception of substances classified as Classes SI, S2, S4.4, S4.5, S6.a, as well as Prohibited Methods Ml, M2 and M3.

SUBSTANCES AND METHODS PROHIBITED AT ALL TIMES

(both in-competition and out-of-competition)

PROHIBITED SUBSTANCES

1. SUBSTANCES NOT AUTHORIZED FOR USE

Any pharmacological substances that are not included in any section of the List and are not currently approved by any government regulatory body in the field of health care for use as a therapeutic agent (for example, drugs that are in preclinical or clinical trials or the clinical trials of which have been stopped , “designer” drugs, medications approved only for veterinary use) are prohibited for use at all times.

S1. ANABOLIC AGENTS

The use of anabolic agents is prohibited.

Anabolic androgenic steroids (AAS)

A. Exogenous* AAS, including: Androstenediol, Androstenedione,

Bolandiol,

Bolasterone,

Gestrinone,

Hydroxytestosterone,

Dehydrochlormethyltestosterone,

Deoxymethyltestosterone,

Drostanolone,

Calusterone,

Quinbolon,

Clostebol,

Mestanolone,

Mesterolone,

Methandienone,

Methandriol,

Methasterone,

Methenolone,

Methyl dienolone,

Methylnortestosterone,

Methyltestosterone,

Metribolon,

Mibolerone,

Norboleton,

Norclostebol,

Norethandrolone,

Oxabolone,

Oxandrolone,

Oxymesterone,

Oxymetholone,

Prostanozol,

Stanozolol,

Stenbolone,

*The term “exogenous” refers to substances that are not typically produced naturally by the body.

Tetrahydrogestrinone,

Trenbolone,

Fluoxymesterone,

Formebolone,

Furazabol,

Ethylestrenol.

and other substances with a similar chemical structure or similar biological effect.

b. Endogenous* AAS with exogenous administration:

Androstenediol, Androstenedione,

Boldenone,

Dehydroepiandrosterone (Dehydroandrosterone), Dihydrotestosterone,

Nandrolone,

Norandrostenediol, Norandrostenedione,

Testosterone,

as well as their metabolites and isomers, but not limited to: Androstanediol,

Androstenone,

Androsterone,

Hydroxyandrostanon,

Hydroxy-dehydroepiandrosterone,

Keto-dehydroepiandrosterone,

Noradrosterone,

Norethiocholanolone,

Epi-dihydrotestosterone,

Epitestosterone,

Etiocholanolone.

Other anabolic agents, but not limited to:

Zilpaterol,

Clenbuterol,

Selective androgen receptor modulators (SARMs), eg Andarine, Ostarine, Ligandrol.

*The term “endogenous” refers to substances that are typically produced naturally by the body.

S2. PEPTIDE HORMONES, GROWTH FACTORS.

SIMILAR SUBSTANCES AND MIMEtics.

The following substances and other substances with similar chemical structure or similar biological effect are prohibited:

Erythropoietin receptor agonists:

Agents that stimulate the production of erythropoietin (ESAs), for example, Erythropoietin (EPO), Darbepoetin (dEPO), EPO-Fc; Peptide EPO mimetics (EMP),

eg CNTO 530, Peginesatide (Hematid), Methoxypolyethylene glycol-epoetin beta (CERA);

GATA inhibitors, for example (K-11706);

TGF-p inhibitors, for example, Sotatercept, Luspatercept.

Erythropoietin receptor agonists that do not affect erythropoiesis, for example, ARA-290, Asialo EPO, Carbamylated EPO.

Hypoxia-inducible factor (HIF) stabilizers, for example, Cobalt, Roxadustat (FG-4592), Molidustat; HIF activators, for example. Argon, Xenon.

Chorionic gonadotropin (CG), Luteinizing hormone (LH) and their releasing factors (stimulants of synthesis and secretion), for example, Buserelin, Gonadorelin, Leuprorelin, are prohibited only for men.

Corticotropins and their releasing factors, for example Corticorelin.

Growth hormone (GH) and its releasing factors,

including Growth hormone releasing hormone (GHRH) and its analogues, for example, (CJC-1295), Sermorelin (GRF 1-29), Tesamorelin; Growth hormone secretagogues (GHS), for example, Ghrelin and Ghrelin-mimetics, for example, Anamorelin, Ipamorelin, Ibutamoren (MK-677); Growth hormone releasing peptides (GHRPs),

for example, Alexamorelin, Hexarelin (GHRP-6), Pralmorelin (GHRP-2).

In addition, the following growth factors are prohibited:

Hepatocyte growth factor (HGF),

Insulin-like growth factor 1 (IGF-1),

Mechanical growth factors (MGFs),

Vascular endothelial growth factor (VEGF), Platelet-derived growth factor (PDGF),

Fibroblast growth factor (FGFs),

S3. BETA-2 AGONISTS

All beta-2 agonists are prohibited, including all optical isomers.

Beta-2 agonists include, but are not limited to:

Vilanterol,

indacaterol,

Olodaterol,

Procaterol,

Reproterol,

Salbutamol,

Salmeterol,

Terbutaline,

Fenoterol,

Formoterol,

Higenamine.

With the exception of:

Salbutamol (in a daily dose not exceeding 1600 mcg), Formoterol (in a daily dose not exceeding 54 mcg) and Salmeterol (in a daily dose not exceeding 200 mcg)

The presence of Salbutamol in the urine at a concentration greater than 1000 ng/mL or Formoterol at a concentration greater than 40 ng/mL will not be considered therapeutic use and will constitute an Adverse Analytical Finding unless the athlete demonstrates through a controlled pharmacokinetic study that it is not appropriate. Normally, the result was a consequence of inhalation of therapeutic doses in a volume not exceeding the above.

S4. HORMONES AND METABOLISM MODULATORS

‘Prohibited:

Aromatase inhibitors, but not limited to: Aminoglutethimide,

Anastrozole,

Androstadiendione (Arimistan), Androstatriendione, Androstentrione,

Letrozole,

Testolactone,

Formestan,

Exemestane.

Selective estrogen receptor modulators (SERMs),

but not limited to: Raloxifene, Tamoxifen, Toremifene.

Other antiestrogenic substances

but not limited to: Clomiphene, Fulvestrant, Cyclophenyl.

Agents that alter myostatin function

but not limited to: Myostatin inhibitors.

Metabolism modulators:

Adenosine monophosphate-activated protein kinase (AMPK) agonists, eg Amino-imidazole carboxamide riboside (AICAR); Peroxisome proliferator-activated receptor delta (PPAR8) agonists, for example, GW 1516;

Insulins,

Insulin mimetics, for example, Incretin mimetics (GLP analogues): Liraglutide, Exenatide, Lixisenatide;

Meldonium;

Trimetazidine.

S5. DIURETICS AND MASKING AGENTS

Diuretics and masking agents are prohibited.

Masking agents include:

Diuretics,

Desmopressin,

Probenecid,

Plasma volume expanders (eg, Glycerol, intravenous Albumin, Dextran, Hydroxyethyl starch and Mannitol).

Diuretics include:

Amiloride,

Acetazolamide,

Bumetanide,

Vaptans (for example, Tolvaptan),

Indapamide,

Canrenon,

Metolazone,

Spironolactone,

Thiazides (eg, Chlorothiazide, Hydrochlorothiazide), Triamterene,

Furosemide,

Chlorthalidone,

Ethacrynic acid

and other substances with a similar chemical structure or similar biological effect, with the exception of: Drospirenone, Pamabrom; locally applied Dorzolamide and Brinzolamide, as well as local administration of Felipressin during anesthesia.

When using, either in-competition or out-of-competition, any number of substances approved for use at threshold concentration levels (e.g., Salbutamol, Formoterol, Cathina, Ephedrine, Methylephedrine and Pseudoephedrine), in combination with a diuretic or other masking agent, require a therapeutic use authorization for the substance in addition to a therapeutic use authorization for a diuretic or other masking agent.

PROHIBITED METHODS

Ml. MANIPULATIONS WITH BLOOD AND ITS COMPONENTS

The following methods are prohibited:

1 Primary or repeated introduction of blood of autologous, allogeneic (homologous) or heterologous origin, or red blood cell preparations of any origin into the cardiovascular system.

2 Artificial enhancement of oxygen consumption, transport, or delivery, including, but not limited to, fluorinated derivatives, efaproxiral (RSR13), and modified hemoglobin products (e.g., hemoglobin blood substitutes, microencapsulated hemoglobin), excluding the administration of supplemental oxygen by inhalations.

3 Any form of intravascular manipulation of blood or its components by physical or chemical methods.

M2. CHEMICAL AND PHYSICAL MANIPULATIONS

The following methods are prohibited:

Falsification, as well as attempts to falsify samples taken as part of the doping control procedure in order to violate their integrity and authenticity.

These manipulations include, but are not limited to: Actions to replace urine and/or change its properties in order to complicate analysis (for example, the introduction of protease enzymes).

Intravenous infusions and/or injections of more than 50 ml over a 6-hour period, except in cases of essential medical care in hospital, surgical procedures or clinical research.

M3. GENE DOPING

The following are prohibited as they can improve athletic performance:

Transfer of nucleic acid polymers or nucleic acid analogues;

Use of normal or genetically modified cells.

SUBSTANCES AND METHODS,

PROHIBITED DURING THE COMPETITION PERIOD

In addition to substances and methods classified in categories S0-S5 and Ml-M3, the following are also prohibited in-competition:

PROHIBITED SUBSTANCES

S6. STIMULANTS

All stimulants are prohibited, including all optical isomers.

Stimulants include:

a: Stimulants not classified as Specified Substances: Adrafinil,

Amiphenazole,

Amfepramone,

Amphetamine, Amphetaminyl,

Benzylpiperazine,

Benfluorex,

Bromantane,

Clobenzorex,

Cropropamide,

Crotetamide,

Lisdexamfetamine,

Mesocarb,

Methamphetamine, Methylamphetamine,

Mefenorex,

Mephentermine,

Modafinil,

Norfenfluramine,

Prenylamine,

Prolintan,

Phendimetrazine,

Fenetylline,

Phenylpiracetam (Phenylpiracetam),

Fenkamin,

Fenproporex,

Phentermine,

Fenfluramine,

Furfenorex.

b: Stimulants classified as Special Substances: Benzphetamine,

Heptaminol,

Hydroxyamphetamine (Parahydroxyamphetamine), Dimethylamphetamine,

Isometheptene,

Cathin*, Cathinone and its analogues (for example, Mephedrone, Metedron), L evmethamphetamine,

Meclofenoxate,

Methylhexanamine (Aminomethylhexane, Geranamine, Dimethyl-Pentylamine),

Methyl enediox iamphegamin (Tenamphetamine), Methylenedioxymethamphetamine,

Methyl phenidate,

Methylephedrine**,

Niketamide,

Norfenephrine,

Oxilofrine (Methylsynephrine),

Octopamine,

Pentetrazole,

Propylhexedrine,

Pseudoephedrine* * *,

Seledzhilin,

Sibutramine,

Strychnine,

Tuaminoheptane,

Famprofazone,

Fenbutrazate,

Phenylethylamine and its derivatives, (including Phenibut), Phencampamine,

Phenmetrazine,

Phenpromethamine,

**Methylephedrine and Ephedrine are classified as Prohibited Substances when the urine content of either substance exceeds 10 mcg/ml.

*** Pseudoephedrine is classified as a prohibited substance when its concentration in urine exceeds 150 mcg/ml.

Epinephrine* (Adrenaline),

Etamivan,

Ethylamphetamine,

Etilephrine,

and other substances with a similar chemical structure or similar biological effect.

With the exception of locally used imidazole derivatives, as well as stimulants included in the Monitoring Program - see page 46.

S7. DRUGS

Prohibited:

Buprenorphine,

Hydromorphone,

Dextromoramide,

Diamorphine (Heroin),

Nicomorphine,

Oxycodone,

Oxymorphone,

Pentazocine,

Fentanyl and its derivatives.

S8. CANNABINOIDS

Natural (for example, Cannabis, Hashish, Marijuana) and synthetic Delta-9-tetrahydrocannabinol (THC) cannabinoids, as well as cannabimimetics (for example, “Spice” (JWH), (HU-210) are prohibited.

S9. GLUCOCORTICOIDS

Any glucocorticosteroids fall into the category of prohibited substances if used orally, intravenously, intramuscularly or rectally.

* Local use (eg, nasal, ophthalmic) of Epinephrine (Adrenaline) or its use in combination with local anesthetics is not prohibited.

SUBSTANCES,

PROHIBITED IN CERTAIN SPORTS

P1. ALCOHOL

Alcohol (ethanol) is prohibited only during the competitive period in the sports listed below.

The presence of alcohol in the body is determined by analyzing exhaled air and/or blood.

Violation anti-doping rules is considered to be exceeding the threshold blood alcohol concentration of more than 0.10 g/l.

Motorsport (FIA)

Aeronautics (FAI)

Powerboating (UIM)

Archery (WA)

P2. BETA BLOCKERS

Unless otherwise noted, beta blockers are prohibited in-competition only in the following sports:

Motorsport (FIA)

Billiard sport (all disciplines) (WCBS)

Golf (IGF)

Darts (WDF)

Skiing/snowboarding (FIS)

Scuba diving (CMAS)

Shooting (ISSF, IPC) (also prohibited out-of-competition)

Archery (WA) (also prohibited out-of-competition)

Beta blockers include, but are not limited to: Alprenolol, Atenolol, Acebutolol,

Betaxolol, Bisoprolol, Bunolol,

Carvediol, Carteolol,

Labetalol, Levobunolol,

Metypranolol, Metoprolol,

Oxprenolol,

Pindolol, Propranolol,

Celiprolol,

MONITORING PROGRAM 2017*

The following substances are included in the Monitoring Program for 2017:

Stimulants - during the competitive period:

Bupropion,

Pipradrol,

Synephrine,

Phenylpropanolamine,

Phenylephrine.

Drugs - during the competitive period:

Mitragynin,

Tramadol.

Glucocorticoids - during the out-of-competition period.

Telmisartan -

during the competitive and out-of-competition periods.

* Worldwide anti-doping The code (Article 4.5) states that: “WADA, in consultation with Signatories and governments, shall establish a monitoring program for substances not on the Prohibited List but which WADA determines need to be monitored to identify abuse of those substances in sport.”

List of used literature

Large reference book of medicines. Ed. Ziganshina J.I.E., Lepakhina V.K., Petrova V.M., Khabrieva R.U. "GEOTAR-Media", 2011

World anti-doping code. International standard. Prohibited list. "WADA", "RUSADA", 2017

State register of medicines, 2016

Clinical pharmacology. National leadership. Ed. Belousova Yu.B., Kukesa V.G., Lepakhina V.K., Petrova V.I. "GEOTAR-Media", 2014

Clinical pharmacology. Textbook 4th edition. Ed. Kukes V.G. "GEOTAR-Media", 2013

Clinical pharmacology and pharmacotherapy. Manual 3rd edition. Belousov Yu.B. "Medical Information Agency (MIA)", 2010

Clinical pharmacology and pharmacotherapy. Textbook. Petrov V.I. "GEOTAR-Media", 2015

Clinical pharmacology and pharmacotherapy. Textbook 3rd edition. Ed. Kukesa V.G., Starodubtseva A.K. "GEOTAR-Media", 2013

Methods of research and pharmacological correction of human physical performance. Ed. Ushakova I.B. "Medicine", 2007

Register of permitted and prohibited pharmacological drugs in sports. Dyoshin R. G. et al. "Department of Health of Khanty-Mansi Autonomous Okrug-Yugra", 2015

Directory of medicines. Manual for doctors 16th edition. Mashkovsky M.D. "New Wave", 2014

Directory of medicines "RLS" 24th edition. Register of Medicines of Russia. Encyclopedia of drugs. "RLS-Media", 2016

Directory of medicines "VIDAL" 22nd edition. Directory VIDAL. Medicines in Russia. "Astra-PharmService", 2016

Pharmacology of sports. Gorchakova N.A., Gudivok Ya.S., Gunina L.M. and others. Under the general editorship of Oleynik S.A., Seifulla R.D. "Olympic Literature", 2010

Pharmacological support of sports activities. Makarova G.A. "Soviet Sport", 2013

When considering the problem of doping in modern sports, one cannot ignore one extremely important issue, both medically, legally and morally. This is the problem of using drugs classified as doping by WADA for therapeutic purposes.

First of all, it should be borne in mind that all substances included in the WADA list of prohibited substances can be divided into two groups:

• substances that are medicines or components of medicines in different countries - this is the majority of prohibited substances;
• substances that do not have the legal status of medicines.

Of course, substances belonging to the second group cannot under any circumstances be used as medicines, not only in sports medicine, but in general in medical practice in any civilized country. Examples include, for example, a number of anabolic steroids that are legally drugs of veterinary medicine (Finaject, Finaplix, Check Drops) or designer steroids (the notorious tetrahydrogestrinone), testosterone metabolite epitestosterone, synthetic anabolic zeranol (banned even in animal husbandry and therefore used illegal in this area), a number of substances very different in chemical structure and biological activity classified as “stimulants” (amphepramone, amifenazole, amphetaminil, benzphetamine, dimethylamphetamine, ethylamphetamine, heptaminol, isometheptene, levmethamphetamine, D-methamphetamine, methylenedioxyamphetamine, methylenedioxymethamphetamine, p-methylamphetamine, parahydroxyamphetamine, pemoline, tuaminoheptane, etc.), a number of narcotic analgesics excluded from all Pharmacopoeias (heroin, beta-hydroxy-3-methylfentanyl, desomorphine, etorphine, thiofentanyl, etc.) and some other substances.

However, the majority of prohibited substances should be classified in the first group - that is, completely legal pharmacological drugs officially used in medicine for the treatment, prevention and diagnosis of diseases in humans. Indications for the clinical use of a particular drug are clearly specified in the Instructions approved by the authorized body of the state that has authorized its use on its territory. At the same time, some of the drugs classified as prohibited by WADA are used, in accordance with the approved Instructions, in urgent, i.e., emergency situations, for life-saving reasons. Examples include the use of narcotic analgesics for persistent pain associated with injuries or myocardial infarction, for indomitable (life-threatening) cough, for severe shortness of breath (heart failure), for pulmonary edema, i.e. in cases where non-narcotic analgesics are ineffective. Glucocorticoid drugs are widely used for acute hormonal insufficiency of the adrenal cortex, hemolytic anemia, glomerulonephritis, acute pancreatitis, hepatitis; In connection with the anti-shock effect, glucocorticoids are prescribed for the prevention and treatment of shock (post-traumatic, surgical, toxic, anaphylactic, burn, cardiogenic, etc.). Among the indications for the use of adrenergic drugs in clinical practice, there are also emergency conditions, in particular, acute hypotension of various origins (collapse, shock, overdose of ganglion blockers, poisoning with inhibition of the vasomotor center, intoxication), cardiac arrest, hypoglycemic coma, bronchial asthma, anaphylactic shock , allergic swelling and other allergic reactions. As for β-blockers, they were created (and are now used) as a means of treating coronary heart disease (angina pectoris, myocardial infarction), tachyarrhythmia, and complex treatment of hypertension.

Athletes, like all people, may need treatment that requires medications. If substances needed for treatment are doping and are prohibited under anti-doping rules, the athlete may still be allowed to use them. This procedure is called therapeutic use case (TUE). For TUE, a separate permit must be obtained in each specific case.

A TUE may be granted if:

• the athlete is at risk of serious deterioration in health without taking any prohibited drug;
• the therapeutic use of a prohibited drug will not significantly improve performance in competition;
• There is no alternative to the use of this drug or method (among those approved).

WADA has developed an International Standard for Therapeutic Uses of Prohibited Substances. Under this standard, all International Federations and National Anti-Doping Agencies are required to accept a TUE request from an athlete in need of treatment. In Ukraine, the request is considered by the relevant sports federation or the Therapeutic Use Exemption Committee (TUC), which consists of independent medical experts.

The procedure for submitting a TUE request is as follows.

An international athlete or international competitor must submit a TUE request to the international federation for his or her sport. This can be done through the Ukrainian federation. Other athletes (not competing in international competitions) must submit a request to the TEC. Athletes should not submit a TUE request to more than one organization. Athletes cannot submit a request directly to WADA.

During major international competitions, special therapeutic use protocols may come into force. Therefore, participants in such competitions should check with their sports federation or TUEC to determine if there are any changes to the standard protocol for therapeutic use during upcoming competitions.

At the same time, during the validity of the TUE permit, the TUE may at any time initiate a review of the decision to issue the permit.

WADA, through the Therapeutic Use Exemption Committee, has the right to review any TUE issued by a federation or TUE and accordingly revoke any decision. In addition, athletes who have submitted a TUE request to a federation and have been denied it may refer the decision to the WADA Therapeutic Use Exemption Committee. If WADA determines that the denial of a TUE was not in accordance with the international standard, the Agency may overrule the decision of the federation or anti-doping organization.

If WADA rejects the decision to grant a TUE, the athlete or his representatives may appeal to the International Arbitration for Sport in Lausanne for a final decision.

In practice, the procedure for applying for a TUE is as follows. The athlete must:

• Contact your sports federation (or the TUE directly) and obtain a TUE application form.
• send the form filled out by the doctor, with your signature and with the necessary documents attached, to the international federation and the TEC.

It is important to remember that a TUE request must be submitted at least 21 days before the start of the competition. It is important to attach medical examination data, an extract from a medical card or medical history to the application. The request must be completed in block letters. Previously, there were two forms of requests: shortened (for beta-2 adrenergic agonists and glucocorticosteroids) and full. In accordance with the 2009 International Standard for Therapeutic Use Exemptions, the abbreviated form has been removed and a declaration of use must be submitted through ADAMS when using corticosteroids by intra-articular, periarticular, intraligamentous, epidural, intradermal, or inhaled injections. If glucocorticosteroids are administered orally, rectally, intravenously, or intramuscularly, a request must be submitted along with all relevant documentation as noted above. Topically applied glucocorticosteroid preparations (applied to the skin, including iontophoresis and phonophoresis, as well as drops in the ears, nose and eyes) are not prohibited, and their use does not require a declaration of use. The use of beta-2-agonists requires TUE approval.

The athlete may begin treatment only after receiving written permission from the relevant organization (except in cases where urgent medical intervention is required for an acute condition, in which case retrospective consideration of the application is allowed). Examples of this kind of urgent and, moreover, fairly typical conditions for athletes include traumatic shock or sunstroke.

As is known, injuries of varying localization and severity are typical for various sports. Severe injuries are naturally accompanied by the development of traumatic shock - a severe pathological process that develops in response to injury and affects almost all body systems, primarily the circulatory system. The pathogenesis of shock is based on: hemodynamic factor (reduction in the volume of circulating blood as a result of its leakage from the vascular bed and deposition), anemic factor, pain and violation of the integrity of bone formations. Prevention and treatment of traumatic shock is a very complex set of therapeutic measures, depending largely on the degree of shock, but in any case providing for the emergency use of local anesthetics, narcotic analgesics and glucocorticoids (all together or selectively depending on the specific clinical situation). Another example of an urgent condition typical for sports practice, requiring the use of prohibited drugs (diuretics, most often furosemide), can be sunstroke, accompanied by pulmonary edema; Moreover, refusal to use diuretics often poses a threat to the patient’s life.

If a prohibited substance was used during the provision of emergency medical care, the situation is considered as follows. The International Standard for Therapeutic Use Exemptions allows prohibited substances to be used for treatment before they have been approved for use. Also, in addition to this situation, the use of prohibited substances is allowed until permission is received in the event that the athlete, due to exceptional circumstances, does not have sufficient time or opportunity to submit a request, and the TUEC considers the request, as well as in cases where the athlete does not use international level (or not competing at an international sporting event, if specified by the international federation) of formoterol, salbutamol, salmeterol and terbutaline inhaled for the purpose of treatment.

The therapeutic use permit specifies the dosage, frequency and method of use of a specific drug, which the athlete must strictly follow. If it is necessary to change the method, frequency of use or dosage, a new request must be submitted. The athlete must strictly comply with the requirements specified in the TUE permit. Information regarding a TUE issued by an international federation or TUE is sent to WADA, which may review the decision if it does not comply with the international TUE standard.

The request and documents are reviewed within 30 days, so the athlete must send these materials to the anti-doping organization 30 days before the moment when he requires permission.

To summarize, it should be noted that in general the entire procedure is cumbersome and has a pronounced element of subjectivity. Firstly, this element is present in the definition of the diagnosis - you can always, if desired, refer to the fact that the results of any laboratory or instrumental method are missing, which allows us to consider the diagnosis to be finally established and confirmed. Secondly, the question of the effectiveness and appropriateness of using certain drugs for the treatment of a specific pathology and in a specific patient is debatable; however, common sense suggests that a doctor standing at the bedside of a particular patient can more correctly determine these issues than some “members of the Clinical Institute”: even if they are qualified specialists in the field of sports medicine, they have not observed the patient with this clinical condition case are known only in absentia, and, in addition, it is possible that they may have no experience at all in treating this particular pathology. In other words, obtaining a TUE permit largely depends on the subjective factor. This equally applies to applying for a TUE retroactively for emergency reasons - saving a person’s life can be qualified as doping, with all the ensuing consequences for both the doctor and the athlete.

All this contradicts both common sense and moral principles, as well as legal norms regulating the activities of medical workers. The approach according to which a doctor who saved a person’s life can be accused of any unacceptable actions looks completely absurd and immoral! Moreover, a doctor who did not do everything possible to save the life of his patient is an oathbreaker, because before starting his medical career he took the Hippocratic oath! As for the legal aspects, failure to provide medical care by a medical professional is an illegal act in any civilized country. For example, legislative acts of Ukraine recognize the life and health of a person as the object of a crime, and also determine the procedure for medical and pharmaceutical workers to perform their professional duties.

According to the current legislation of Ukraine, in his professional activities, a medical practitioner bears administrative and criminal liability for violating the provisions of the “Fundamentals of Ukrainian Legislation on Health Protection”. The types of doctor's responsibility and the subjects around which the doctor's liability relationship arises can be presented as follows:

The above “Fundamentals...” provide, in particular, for liability for failure to provide medical care (Article 39) and violation of the conditions of medical intervention (Articles 42-43). These articles are duplicated in the Criminal Code of Ukraine: Art. 136 - failure to provide assistance to a person who is in a life-threatening condition; Art. 137 - improper performance of duties regarding the protection of the life and health of children; Art. 139 - failure to provide assistance to a patient by a medical worker; Art. 140 - improper performance of professional duties by a medical or pharmaceutical worker. Liability under these articles actually occurs as determined by the court in accordance with the articles of the Criminal Code of Ukraine. Of course, similar articles are present in the criminal legislation of any other civilized country.

However, even in cases where the therapeutic use of a doping drug is not urgent, the officially determined period for consideration of the application (30 days) is not always acceptable from the point of view of the treatment process and common sense.

RUSADA provided an explanation of the main changes to the prohibited list of substances and methods, which was approved by the Executive Committee of the World Anti-Doping Agency (WADA). The list will come into force on January 1, 2016.

The All-Russian Swimming Federation draws the attention of athletes, coaches and doctors to the danger of using substances and methods that have joined the list of prohibited substances, and to the need to stop their use in advance, since from January 1, 2016, their detection in an athlete’s sample will be regarded as a violation of anti-doping rules!

Overview of the main changes with explanations

Substances and methods prohibited at all times (in-competition and out-of-competition)

Prohibited Substances

S2: Peptide hormones, growth factors, similar substances and mimetics

· Triptorelin was replaced by leuprorelin as a more universal example of human chorionic gonadotropin and luteinizing hormone-releasing factor.

S4. Hormones and metabolic modulators

· Insulin mimetics have been added to the List to include all insulin receptor agonists.

· Meldonium (Mildronate) was added because there is evidence of its use by athletes to improve performance.

S5.Diuretics and masking agents

· It was clarified that the ophthalmic use of carbonic anhydrase inhibitors is permitted.

Substances and methods prohibited during competition

S6. Stimulants:

· It was clarified that clonidine is permitted.

Substances prohibited in certain sports

P1: Alcohol:

· After considering a request from the International Motorsports Federation (FIM), this federation was removed from the list of sports in which alcohol is prohibited.

WADA understands that the federation will independently regulate the use of alcohol in this sport through internal documents.

Monitoring program 2016

· Meldonium has been removed from the monitoring program and added to the Prohibited List.

· Hydrocodone, morphine/codeine ratio and tapentadol have been removed from the monitoring program.

WADA has the right to review issued permits. TUEs can also be issued retroactively: if an athlete needs emergency care due to a sharp deterioration in health, doctors can use a drug prohibited by the Anti-Doping Code, after which the athlete will be required to obtain permission for it.

Who exactly gets a TUE?

Lists of athletes who have received TUE are not officially published - this is a medical secret that is not subject to disclosure; WADA provides information only on the number of therapeutic exceptions issued (see infographics for this material). Information is also available on drugs that have been approved for use by athletes with therapeutic exceptions.

Since September 2016, the hacker group Fancy Bears began posting documents stolen from the WADA server, which contain the names of athletes who received TUE at different times. Among them are world sports superstars, the Williams sisters, Rafael Nadal (tennis), Ryan Lochte, Mireya Belmonte Garcia (swimming), Fabian Cancellara (cycling), Simone Biles (gymnastics) and others. Letters from WADA officials published in October 2016 by Fancy Bears name more than 200 top US athletes (about half of them in cycling). In February 2017, the doctor of the Norwegian ski team, Petter Ohlberg, mentioned in an interview with the Norwegian newspaper VG Sporten that “50-70% of team members are diagnosed with asthma and take drugs from the prohibited list.” Fancy Bears has published correspondence from WADA, which mentions the names of Norwegian skiers with TUE.

The question of the need to publish information about which athletes received a TUE has been raised more than once. Belarusian biathlete Daria Domracheva believes that the disclosure of this information is a violation of the human right to protect information about private life, but it will not help in the fight against doping. Russian skier Nikita Kryukov said in an interview with the Soviet Sport newspaper that he asked IOC President Thomas Bach when therapeutic exemptions would be lifted, but he replied that it would be difficult to do so. In his open letter in December 2017, Kryukov equated TUE with doping. “If you are sick, then get treatment! If you took a drug that is prohibited, then wait a month, six months, a year until it wears off so that it doesn’t leave a mark on the chart, and then come back. You don’t run competitions in a cast or take off the cast in a week if the doctor told you to walk for six months,” he wrote in an official statement on his website.

How often do Russian athletes get TUE?

In 2017, the Russian Anti-Doping Agency (RUSADA) issued 22 TUEs, and in 2016, the year of the Summer Olympics in Rio de Janeiro, 15. National agencies of other leading sports countries took advantage of this opportunity much more actively. Athletes from the USA, France and Italy received the largest number of therapeutic exemptions (see infographic).

In 2016, 2,175 TUEs were issued worldwide, WADA told RBC. More than a quarter of them (28%) occur in just two countries - the USA and France. The agency associates a significant increase in the number of permits issued in 2015-2016 with the tightening since 2016 of the requirements for entering such information into the ADAMS database (contains information about all movements of athletes and the results of their doping tests, as well as TUEs issued to them).

“Athletes are not receiving more therapeutic exemptions from year to year, but we are seeing more exemptions being issued worldwide due to better compliance,” WADA spokesperson Maggie Durand told RBC.

Why Russian athletes rarely receive TUE

Russian athletes are less likely than their colleagues to apply for a TUE. According to sports doctors, this is due to the weakness of administrators who provide services to clubs and teams, and poor awareness of the athletes themselves about this possibility. The former head of RUSADA, Ramil Khabriev, in an interview with the Sport Express newspaper, suggested that the reason for the small number of applications from Russian athletes may be difficulties in preparing documents. In her book “The Magic of Victory,” Olympic gymnastics champion Svetlana Khorkina said that she learned about the existence of the practice of therapeutic exclusion only from materials published by the hacker group Fancy Bears in 2016.

RUSADA General Director Yuri Ganus, in response to a request from RBC, noted that the reason for significant differences between the number of TUEs issued in Russia and in other countries may be the approaches used in different healthcare systems. For example, athletes with diagnosed asthma (the most common disease for the treatment of which representatives of ski disciplines receive TUE) in Russia are most often eliminated at the stage of children's sections, noted sports doctor, Professor Nikolai Durmanov.

There is evidence that Russian athletes, even when sick, often did without medications included in the prohibited list. For example, at the World Championships in 2010, swimmer Ksenia Popova had an asthma attack during a 25 km swim, and after finishing she lost consciousness. Popova did not use potent drugs and did not obtain permission for them. The diagnosis of asthma was also confirmed for biathlete Alexei Volkov, who won gold in the 4x7.5 km relay at the Sochi Olympics . At two years old, he was diagnosed accordingly, and Volkov was given permission to take medications only two years after the start of his international sports career. Volkov noted that before receiving TUE he did without drug therapy, since exacerbations of the disease occurred in late spring, when the ski season was already ending .

What medications are most often requested by athletes?

American athletes most often issue TUEs for the use of drugs of the group of central nervous system stimulants (138 permits were issued by USADA and sports federations in 2016), Russians and Italians, as a rule, request permission to use glucocorticosteroids - (39 requests to RUSADA and 238 requests to NADO Italia in 2016, the agencies of these countries do not disclose information on the number of approvals issued by type of drug). In France, athletes requested the most TUEs for diseases of the endocrine and cardiovascular systems (a total of 118 approvals for the two specified reasons). In 2016, French athletes received 42 permits to use various glucocorticosteroids.

“This is a group of drugs that are used as widely as antibiotics: for rheumatism, rheumatoid arthritis, bronchial asthma, autoimmune diseases, thyroid diseases. Glucocorticosteroids are also used for all connective tissue diseases,” sports doctor Ilya Melekhin told RBC. In his opinion, if steroids are allowed as a therapeutic exception, they do not greatly affect athletic performance. Doctor Yuri Vasilkov points out that steroids, in addition to respiratory diseases, are used for minor injuries, bruises and sprains. “When they were not prohibited, we were fluent in this technique, administered the drugs where needed, and the recovery period was literally cut in half. Glucocorticosteroids have been widely used in contact sports, particularly football. When we were banned, we began to use medicinal ointments and physical rehabilitation. The time frame [for recovery] is shifting a little, but why should we get caught,” the former chief doctor of the Russian national football team explained to RBC.

The diagnosis often cited by foreign athletes for TUE is attention deficit hyperactivity disorder (ADHD). To treat it, athletes are seeking permission to take stimulants, specifically methylphenidate (commonly known under the brand name Ritalin).

In the United States, in 2016, 138 permits were issued for the use of various stimulants (the American Anti-Doping Agency does not disclose exactly which permits and how many permits were requested). It was methylphenidate that American gymnast Simone Biles, who won four gold and one bronze medal at the 2016 Olympic Games, took; information about the therapeutic exemption given to her was in documents leaked by the hacker group Fancy Bears. After the publication of the data, Biles stated that she was taking the drug with the permission of the Anti-Doping Agency, since she was diagnosed with ADHD as a child.

In Russia, methylphenidate and its derivatives are withdrawn from the circulation of medicines and are considered a narcotic. The diagnosis of ADHD raises doubts among doctors; it cannot be checked instrumentally. According to Alexander Fedorovich, a researcher at the Center for Preventive Psychiatry, the diagnosis of attention deficit hyperactivity disorder is not used in adult psychiatric practice in Russia. “This is a childhood diagnosis, at least in Russia. If such syndromes are observed in an adult, we diagnose “organic damage to the central nervous system” or something else,” he told RBC. However, the criteria for diagnosing “disorder of activity and attention” are present in both the International Classification of Diseases and the American statistical classification of mental disorders DSM-V.

In 2016, RUSADA received only two requests for stimulants and antidepressants; it is unknown whether they were satisfied.

Are there “occupational diseases” of athletes?

The most common disease among professional athletes is asthma, which is typical for representatives of cyclic sports. Research by the American Olympic Committee has shown that it is very common among cyclists (45% of the elite athletes in the study) and skiers (60% of all skiers in the study).

A member of the WADA Medical Research Committee, Professor Ken Fitch, found that athletes with asthma were more likely to win medals at the Olympics in 2000-2010 than athletes who were not diagnosed with this disease: the percentage of asthmatics among all Olympic participants traditionally ranges from 4-7%, and the percentage of winners diagnosed with asthma reached 15.6% of all gold medalists at the 2002 Olympics in Salt Lake City.

Is it possible to fake a sickness certificate to obtain a TUE?

Former doctor of the Russian national football team and Spartak Moscow, Yuri Vasilkov, in a conversation with RBC, expressed the opinion that it is impossible to obtain a fictitious certificate to obtain a TUE. “Everything is checked there [at WADA], such jokes don’t work there,” he said. National Anti-Doping Agencies and International Sports Federations may submit a request to WADA to review decisions regarding therapeutic exemptions issued to athletes of a competing team. In this case, a WADA specialist will need to confirm that all criteria for issuing an exception are met.

A 2013 study of Danish athletes (studying 645 people in 40 sports, of whom 19% had ever received a TUE) found that 51% believed that their competitors may have been inappropriately given therapeutic exemptions for non-medical reasons. diseases, but to improve the result. 4% of respondents called this “normal practice.” Moreover, athletes who had already received a TUE were more likely than their colleagues without such experience to say that unscrupulous competitors could bypass the system of control over the issuance of therapeutic exemptions.

Does the TUE dose of the drug help improve athletic performance?

The standard to guide physicians when deciding whether to issue a therapeutic exemption emphasizes that the drug should not have a significant effect on the outcome. However, in practice, determining the degree of influence is not always possible, experts say.

Sports traumatologist, Candidate of Sciences Artem Katulin believes that medical indications for the use of substances prohibited by WADA put athletes in a “more advantageous position.” In his opinion, there is a clear line between when a prescribed drug only treats and when it begins to have a significant impact on athletic performance, and this line is determined individually for each person.

Of the drugs for which athletes most often request a TUE, stimulants (dispensed to athletes diagnosed with ADHD or narcolepsy) may have the most obvious effect on performance. Corticosteroids, when used systematically, can also have a stimulating effect, points out Professor Ken Fitch from the University of Western Australia. Martine Duclos, a professor at the Center for Sports Medicine and Functional Research at the University Hospital in Clermont-Ferrand, also noted the stimulating effect of glucocorticosteroids on the body of athletes.

The dosage of drugs prohibited by WADA is determined by the doctor prescribing the treatment. There are no clear restrictions on dosage in the rules for obtaining TUE, except for the principle that the prescribed dose is “lowly likely to lead to improved athletic performance.”