QWhy is spironolactone on a list of banned medications for certain types of athletic competitions?

Spironolactone is included on the World Anti-Doping Agency’s (WADA) List of Prohibited Substances and Methods. The primary reason for this inclusion is its potential to act as a masking agent for other prohibited substances.

Spironolactone is classified as a diuretic and masking agent by WADA. Diuretics can promote the excretion of fluids, which can be used to excrete other banned substances in the body, such as performance-enhancing drugs or illegal drugs. By using spironolactone, athletes may attempt to hide or obscure the presence of these substances during drug testing.

Additionally, another concern for WADA is that spironolactone’s antiandrogenic effects can interfere with the endocrine system and potentially affect hormone levels. This is viewed as potentially having performance-enhancing implications, even though reducing the effects of androgens may theoretically have a negative impact on muscle building potential.

It’s important to note that the inclusion of spironolactone on the prohibited substances list does not imply that it directly enhances athletic performance. Rather, its ban is primarily due to its potential for misuse as a masking agent and its potential impact on hormone levels.

Dermatologists need to be aware of this potential career changing consequence for their athlete patients. It’s also important to encourage patient athletes to educate themselves on the specific regulations and consult with their respective sports federations or anti-doping agencies to ensure compliance and prevent potential ban from competitions.

References:

1.  https://www.wada-ama.org/en/prohibited-list#search-anchor