Giro stage winner Ulissi tests positive for excessive amount of anti-asthma drug

Italian rider and his Lampre-Merida team say he declared inhaler use but dispute levels of substance found in his urine

by Simon_MacMichael   June 25, 2014  

Giro 2014 Diego Ulissi wins in Viggiano - picture credit LaPresse

Lampre-Merida has revealed that Diego Ulissi, winner of two stages at last month’s Giro d’Italia, has been notified by the UCI of an adverse analytical finding for an excessive amount of the anti-asthma drug salbutamol during the race. Both the rider and his team have questioned the amount of the substance found.

The 24-year-old from Tuscany, who won the fifth and eighth stages of the three-week race, was found to have 1900 ng/ml of salbutamol in his urine, nearly twice the maximum permitted level of 1000 ng/ml.

The Italian WorldTour team pointed out that prior to the samples being taken un the test at the end of Stage 11 in Savona, the rider followed correct procedures in notifying the testers of the medication he had taken that day.

In a statement, it said: “It is important to point out that Diego Ulissi, accompanied by Dr. Carlo Guardascione (head team doctor) had declared in his statement taken prior to the anti-doping control, the assumption before the race of Ventolin (2 puffs, equivalent to 100 ng of salbutamol each) and paracetamol during the race, the latter given by the race doctor due to the crash which occurred during the stage in which he had been involved with many other athletes.

“The assumption of Ventolin is permitted and was necessary because Ulissi was suffering from bronchospasm,” which is often associated with asthma. “As usual, all previous assumptions of Ventolin had been correctly declared.”

Ulissi, who has been provisionally suspended from racing by his team in line with its own code of conduct and will also miss a training camp for the national team, has requested that his B sample be opened and analysed.

Lampre-Merida added: “Ulissi strongly rejects the presence of such a large amount of salbutamol and decided to make use of the possibility provided for by the WADA and UCI regulations to undergo a controlled [urine] excretion study in relation to the substance salbutamol.”

In May 2008, the Court of Arbitration for Sport handed a ban to Italian sprinter Alessandro Petacchi and stripped him of results including five Giro d’Italia stage wins after he tested positive for an excessive amount of salbutamol.

In its ruling, CAS acknowledged that Petacchi, who was permitted to take the medication, had not intended to cheat, but it held that he had failed to exercise “utmost caution” in exceeding the permitted dosage.

Its decision overturned a previous one from the Italian Olympic Committee’s anti-doping tribunal which had ruled that the presence of the substance was due to human error and Petacchi should not therefore be sanctioned.

24 user comments

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Such a high level of salbutamol in the urine is difficult to achieve with an inhaler. It can be achieved from oral salbutamol, which, unlike an inhaler, is banned since it is a performance enhancing anabolic steroid.

two wheels good; four wheels bad

posted by cat1commuter [1379 posts]
25th June 2014 - 15:52

69 Likes

It's not an anabolic steroid. It's a selective B2 agonist.

posted by cammackmartin [8 posts]
25th June 2014 - 16:44

62 Likes

It's a funny thing; for a long, long time there have been a lot of "asthmatics" using inhalers in bike races, and I've seen it with my own eyes.

Have a nice day.

DavidC's picture

posted by DavidC [77 posts]
25th June 2014 - 19:11

49 Likes

DavidC wrote:
It's a funny thing; for a long, long time there have been a lot of "asthmatics" using inhalers in bike races, and I've seen it with my own eyes.

You'd think that Professional Cycling wouldn't be a sport for Asthma sufferers...

posted by Beaufort [184 posts]
25th June 2014 - 19:21

46 Likes

Believe it or not, exercise induced asthma is actually a real thing.

posted by Nick T [842 posts]
25th June 2014 - 19:35

69 Likes

2 puffs of Ventolin is equivalent to 100 micrograms of salbutamol, not 100 nanograms as in the report. Even if the whole of that dose made through the body into the urine in one go (it very much doesn't), the concentration still couldn't be anywhere near the UCI limit. Dodgy, dodgy, dodgy.

you can’t ride two bikes with one arse

picko's picture

posted by picko [39 posts]
25th June 2014 - 20:13

59 Likes

What's the issue here, asthma drugs are not performance enhancing! Lots of Sky fans have told me that recently. Ulissi and his team doc are telling the truth about his illness, simple mistake of too many puffs, nothing sinister, no PE intentions, and no masking of other drugs. They wouldn't lie. Granted, his performance was a bit special, but he's always shown talent!

posted by daddyELVIS [453 posts]
25th June 2014 - 20:42

51 Likes

No surprise. Lampre have never claimed to be a clean team, they're the only outfit to offer Chris Horner a job.

Crosshouses's picture

posted by Crosshouses [215 posts]
25th June 2014 - 22:05

67 Likes

Nick T wrote:
Believe it or not, exercise induced asthma is actually a real thing.

Yes it is, and I have experienced it myself in certain weather conditions, but should this be medicated when the root cause is pushing oneself too hard and the best cure is to ease off the effort?

Curing other common forms of exercise-induced physical fatigue by the use of drugs is routinely called doping and considered unethical.

Have a nice day.

DavidC's picture

posted by DavidC [77 posts]
26th June 2014 - 7:54

45 Likes

picko wrote:
2 puffs of Ventolin is equivalent to 100 micrograms of salbutamol, not 100 nanograms as in the report. Even if the whole of that dose made through the body into the urine in one go (it very much doesn't), the concentration still couldn't be anywhere near the UCI limit. Dodgy, dodgy, dodgy.

So to hit the UCI limit you'd need 1% of the entire dose to end up in the urine - even though it's a small percentage, it still seems to me like a large amount of a dose to survive (and his reading was nearly twice that). Any pharmacologists or other medical bods on here know what a reasonable pass-through percentage might be for this ?

fukawitribe's picture

posted by fukawitribe [538 posts]
26th June 2014 - 8:23

38 Likes

Read a report this morning from Lampre which said that the Doctor had explained that it was almost impossible for that amount to be present in urine.

posted by Joelsim [1446 posts]
26th June 2014 - 8:55

42 Likes

cammackmartin wrote:
It's not an anabolic steroid. It's a selective B2 agonist.

Sorry, you're right that it isn't a steroid. It is thought to be anabolic though. References to this in its Wikipedia article. Which is why it might be tempting to dopers.

There is no evidence that it is performance enhancing to healthy athletes when administered by an inhaler.

two wheels good; four wheels bad

posted by cat1commuter [1379 posts]
26th June 2014 - 10:46

37 Likes

Joelsim wrote:
Read a report this morning from Lampre which said that the Doctor had explained that it was almost impossible for that amount to be present in urine.

He's right that it is almost impossible to get that high a dose via an inhaler. Not if he was taking tablets.

two wheels good; four wheels bad

posted by cat1commuter [1379 posts]
26th June 2014 - 10:49

37 Likes

Unless Ulissi has the urine volume of a small robin we're talking about a huge quantity in the urine, not just 1900 ng total. If we assume 100 microgram dose (2 shots), which at 1% pass-through is 1mg/1000 ng to be absorbed in a total volume of urine of 50 ml (I'm guessing compeletly here). So to get 1900 ng/1.9 micrograms PER ml of urine you would need to take up 95 micrograms into your urine, or originally (again assumining, with no knowledge, a 1% pass rate) about 9500 micrograms or 190 shots.
*all assumptions and likely to contain multiple mathematical errors*

posted by MattT53 [129 posts]
26th June 2014 - 13:05

27 Likes

So while everyone is looking under the team Sky bed for evidence, who's paying any attention to the other teams? It's the usual "I don't know how that could have happened" response and carry on as normal... Yawn

posted by JeevesBath [131 posts]
26th June 2014 - 14:02

28 Likes

daddyElvis - the difference between this and Froome is that Froome's test results did not show and adverse amount and was within the UCI limits, and as such he has no case to answer whereas Ulissi has shown an adverse result which is outside the UCI limits.

If your going to comment try sticking to the truth.

There are no stupid questions, just stupid people.

stumps's picture

posted by stumps [2840 posts]
26th June 2014 - 15:12

25 Likes

...and of course we could wait until the B sample results are in before actually stringing him up. Controversial suggestion out here in the 'tubes I realise....

fukawitribe's picture

posted by fukawitribe [538 posts]
26th June 2014 - 15:39

35 Likes

Food is analbolic. My point is your comment misrepresents the facts which can happen when using Wikipedia as a reference source. In addition, the issue with excessive levels of salbutamol would be that at higher doses it ceases to be a selective B2 agonist resulting in B1 receptor activation. This means it acts as a stimulant which has the potential to help increase exercise tolerance and improve performance by increasing oxygen delivery. The concern therefor does not relate in any way shape or form to anabolic action even if it does exist.

posted by cammackmartin [8 posts]
26th June 2014 - 16:19

30 Likes

cammackmartin wrote:
Food is analbolic.

That just sounds so wrong...

fukawitribe's picture

posted by fukawitribe [538 posts]
26th June 2014 - 16:28

28 Likes

fukawitribe wrote:
cammackmartin wrote:
Food is analbolic.

That just sounds so wrong...

Couldn't have done it better if I'd tried!! Probably an appropriate comment on the whole thing!! Cheers fukawitribe.

posted by cammackmartin [8 posts]
26th June 2014 - 17:01

24 Likes

stumps wrote:
daddyElvis - the difference between this and Froome is that Froome's test results did not show and adverse amount and was within the UCI limits, and as such he has no case to answer whereas Ulissi has shown an adverse result which is outside the UCI limits.

If your going to comment try sticking to the truth.

I didn't mention Froome - you did!

Read my comment properly - tell me what truth I have broken please.

posted by daddyELVIS [453 posts]
26th June 2014 - 20:21

24 Likes

Not sure where your 1% comes from? If 100% of the total claimed dose of 100 micrograms (100,000 nanograms) were passed unchanged in one go into a urine volume of 500mL (volume of a small bladder), that would give a concentration of 200 nanograms/mL. Not even within spitting distance of the 1000 nanograms/mL found in the sample.

you can’t ride two bikes with one arse

picko's picture

posted by picko [39 posts]
26th June 2014 - 21:07

22 Likes

picko wrote:
Not sure where your 1% comes from? If 100% of the total claimed dose of 100 micrograms (100,000 nanograms) were passed unchanged in one go into a urine volume of 500mL (volume of a small bladder), that would give a concentration of 200 nanograms/mL. Not even within spitting distance of the 1000 nanograms/mL found in the sample.

It was because I was being an idiot and completely neglecting the sample volume, that's why Smile (1% of 100mg being the 1000ng in question). Had a feeling I was missing something so that's why it was phrased more as a question. Tah for the correction.

fukawitribe's picture

posted by fukawitribe [538 posts]
26th June 2014 - 21:29

14 Likes

We know that salbutamol is subject to control, and it seems fair to say that in this case questions must be answered.

But the the most important point, to my mind has been touched upon; that of whether or not the treatment of asthma (or other chronic condition) should be allowable in elite sport.

Quite apart from any intention by an individual to dose beyond mere treatment and to gain advantage, is that condition no simply a part of their physical capacity and so is entirely comparable to any other measure of that and so should be improved only through training?

posted by LJM [16 posts]
30th June 2014 - 10:41

2 Likes