Summary of Major
Modifications andExplanatory Notes
2023 Prohibited List
SUBSTANCES AND METHODS PROHIBITED AT ALL TIMES(IN- AND OUT-OF-COMPETITION)

PROHIBITED SUBSTANCES
S1. Anabolic Agents••••	 Androst-4-ene-3,11,17-trione (11-ketoandrostenedione, adrenosterone) is now listed asan example. In the body, it is converted to 11-ketotestosterone and both are androgens
already prohibited as metabolites of androstenedione and testosterone, respectively.
	 The substance 17ɑ-methylepithiostanol (commonly referred to as epistane) is the17-methylated analog to thiodrol (Shionogi, Japan) and converts in vivo to the prohibitedanabolic agent desoxymethyltestosterone. Hence, per definition, 17ɑ-methylepithiostanol
is also prohibited under S1. In order to unequivocally document the prohibited status of
17ɑ-methylepithiostanol, the substance was added as an additional example.
	 Ractopamine, a beta-adrenergic agonist approved in some countries as a growthpromoter for animals, was added to the list of examples under S1.2.
	 S-23 and YK-11 were listed as examples of SARMs in S1.2.

S4. Hormone and Metabolic Modulators••

S4.3 was updated to include antibodies of precursors of myostatin and as example,apitegromab was added.
The numbering was reformatted for clarity but there was no change in classification.

1S5. Diuretics and Masking Agents•••	 The introductory language of the section was revised to harmonize with other sectionsof the List.
	 Torasemide is added as an example of a diuretic and is already named in a WADA
Technical Document (TD MRPL) and a WADA Technical Letter (TL24).
	 It was clarified that a Therapeutic Use Exemption is not required for topical ophthalmic
administration of a carbonic anhydrase inhibitor (e.g. dorzolamide, brinzolamine) or for
local administration of felypressin in dental anesthesia in conjunction with a thresholdsubstance.

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PROHIBITED METHODS
M1. Manipulation of Blood and Blood Components•	 Voxelotor was added as an example, as it alters the ability of hemoglobin to release oxygenin the body, thereby enhancing arterial oxygen saturation. As a side effect, it increases
serum erythropoietin, which has been shown to result in higher hemoglobin concentrationin healthy individuals.

3SUBSTANCES AND METHODS PROHIBITED IN-COMPETITIONPROHIBITED SUBSTANCES
S6. Stimulants•••	1,3-dimethylamylamine and 1,3 DMAA were added as alternative common names for
4-methylhexan-2-amine, while 1,4-dimethylamylamine and 1,4-DMAA were included assynonyms of 5-methylhexan-2-amine.
	Solriamfetol was included in S6b due to its activity as a dopamine and norepinephrine
reuptake inhibitor resulting in increases in brain levels of these neurotransmitters andconsequent stimulant behavioral effects in preclinical species and in humans.
	Tetryzoline was added as an imidazoline derivative under Exceptions. In addition, it isclarified that otic administration of imidazoline derivatives is not prohibited.

S7. Narcotics•	Tramadol has been on the WADA Monitoring Program for some years. Monitoring data
has indicated significant Use in sports including cycling, rugby and football. Tramadol
abuse, with its dose-dependent risks of physical dependence, opiate addiction andoverdoses in the general population, is of concern and has led to it being a controlled
drug in many countries. Research studies funded by WADA1 have confirmed thepotential for tramadol to enhance physical performance in sports. Consequently, asproposed in the draft 2023 Prohibited List circulated for consultation to stakeholders inMay 2022, WADA’s Executive Committee approved, at its 23 September 2022 meeting,prohibiting tramadol during the In-Competition period. However, in order to thoroughly
and widely communicate the rule changes and to allow sufficient time for informationand education, the Executive Committee decided to introduce the prohibition oftramadol and the implementation of the new rule on 1 January 2024. A one-year delay
in implementation will allow Athletes and medical personnel to better prepare for thechange, Laboratories to update their procedures, and sports authorities to develop
educational tools.

S9. Glucocorticoids•1	It was clarified that otic administration of glucocorticoids is not prohibited.
a) Holgado D, Zandonai T, Zabala M, Hopker J, Perakakis P, Luque-Casado A, Ciria L, Guerra-Hernandez E, Sanabria D. Tramadol
effects on physical performance and sustained attention during a 20-min indoor cycling time-trial: A randomised controlled trial.
J Sci Med Sport. 2018 Jul;21(7):654-660.
b) Mauger L, Thomas T, Smith S, Fennell C. (2022). Is tramadol a performance enhancing drug? A randomised controlled trial.
British Association of Sport and Exercise Medicine Conference, 26-27 May 2022, Brighton, UK.
https://basem.co.uk/wp-content/uploads/2022/08/Mauger_BASEM-Abstract.pdf
https://www.wada-ama.org/en/resources/funded-scientific-research/tramadol-performance-enhancing-drug

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SUBSTANCES PROHIBITED IN PARTICULAR SPORTS

P1. Beta-Blockers••

At the request of the World Mini-Golf Federation (WMF), it was agreed to include minigolf as a sport where beta-blockers are prohibited. The skills required for mini-golf aresimilar to others found in sports disciplines where beta-blockers are prohibited.
At the request of the World Under Water Federation (CMAS) beta-blockers will be
prohibited Out-of-competition as well as In-competition in all subdisciplines offreediving, spearfishing and target shooting.

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MONITORING PROGRAM•••

 ermorphin and its analogs were added to detect patterns of use in sport InD
competition.
 nRH analogs in females under 18 years were added to detect patterns of use in sport
GIn- and Out-of-competition.
	Hypoxen (polyhydroxyphenylene thiosulfonate sodium) was added to evaluate misusein sport In- and Out-of-competition.

* 	For further information on previous modifications and clarifications, please consult
the Prohibited List Frequently Asked Questions at https://www.wada-ama.org/en/
prohibited-list#faq-anchor.

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