β2-agonists

β2-agonists, which are primarily used therapeutically to treat asthma, were first classified as doping substances and banned in 1993 after their misuse in sports came to light. Similar to clenbuterol, it was assumed that higher doses of β2-agonists enhance protein synthesis. The effect is said to be similar to, but weaker than, that of anabolic-androgenic steroids (AAS). However, there are hardly any studies to support this. Whether the effect of β2-agonists on the bronchi can lead to improved breathing and endurance performance in healthy individuals is also controversial.

Special provisions for salbutamol, formoterol, salmeterol, and vilanterol

The exact text from the World Anti-Doping Agency (WADA) in the regulations effective January 1, 2026:

  • Inhaled salbutamol: maximum 1,600 micrograms over 24 hours in divided doses not to exceed 600 micrograms over 8 hours starting from any dose
  • Inhaled formoterol: maximum delivered dose of 54 micrograms over 24 hours in divided doses not to exceed 36 micrograms over 12 hours starting from any dose
  • Inhaled salmeterol: maximum 200 micrograms over 24 hours in divided doses not to exceed 100 micrograms over 8 hours starting from any dose
  • Inhaled vilanterol: maximum 25 micrograms over 24 hours

Note: The presence in urine of salbutamol in excess of 1000 ng/mL or formoterol in excess of 40 ng/mL is not consistent with therapeutic use of the substance and will be considered an Adverse Analytical Finding (AAF) unless the Athlete proves, through a controlled pharmacokinetic study, that the abnormal result was the consequence of a therapeutic dose (by inhalation) up to the maximum dose indicated above.

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The following β2-agonists are specifically listed as examples:

arformoterol, fenoterol, formoterol, higenamine, indacaterol, levosalbutamol, olodaterol, procaterol, reproterol, salbutamol, salmeterol, terbutaline, tretoquinol (trimetoquinol), tulobuterol, vilantero

However, the ban generally applies to all β2-agonists, even if they are not listed by name.

For therapeutic use exemptions involving ß2-agonists, WADA has proposed corresponding procedures, which are applied in consultation with the respective responsible anti-doping agencies or with the international sports federations. This procedure is referred to as a "Therapeutic Use Exemption" or "Medical Exemption."
See also information from the National Anti-Doping Agency (NADA)

For the 2002 Winter Olympics in Salt Lake City, the IOC mandated for the first time a comprehensive reporting requirement for inhaled β2-agonists approved for therapeutic use.

As of: February 5, 2026