Navigating WADA Rules: Is Triamcinolone a Banned Substance?

October 9, 2025 •

4 min read

According to the World Anti-Doping Agency (WADA), the use of triamcinolone, a common corticosteroid, is strictly regulated, meaning its status as a banned substance is conditional and depends entirely on the method and timing of its administration. This conditional prohibition is a critical consideration for competitive athletes worldwide who may require the medication for legitimate medical reasons.

Quick Summary

Triamcinolone's banned status for athletes depends on its administration route and timing relative to competition. Systemic uses are prohibited, while local applications are permitted, but athletes must observe specific washout periods.

Key Points

Conditional Ban: Triamcinolone's banned status for athletes depends on the route and timing of its administration relative to competition.
Systemic Routes Prohibited: In-competition use is banned for oral, intravenous, intramuscular, rectal, and all injectable forms, including joint injections.
Local Routes Permitted: Topical creams, nasal sprays, and inhalers are permitted both in and out-of-competition.
Washout Periods are Crucial: Athletes must observe specific washout times, such as the 60-day period for triamcinolone acetonide intramuscular injections, to avoid a positive test.
Therapeutic Use Exemptions (TUEs): Legitimate medical needs can be addressed with a TUE, but the process is strict and requires official approval.
Doping Risk: Misunderstanding or misusing triamcinolone can lead to serious doping violations and lengthy bans for athletes.

Triamcinolone and WADA: The Rules of the Game

Triamcinolone is a synthetic glucocorticoid used to treat a wide array of inflammatory conditions, from skin ailments to allergic rhinitis. However, for competitive athletes, its therapeutic use is complicated by the World Anti-Doping Agency's (WADA) Prohibited List. As a glucocorticoid, triamcinolone falls under the S9 class, which prohibits its use in-competition when administered via routes that lead to significant systemic levels. The core of the issue lies not with the substance itself, but with how it enters the body and the timing relative to competition.

Prohibited Routes of Administration

As of January 1, 2022, WADA significantly tightened its regulations on glucocorticoids, including triamcinolone. Any form of systemic administration is strictly prohibited during the in-competition period. The prohibited routes include:

Oral: Swallowing tablets, syrups, or oromucosal preparations.
Intravenous (IV): Administering the drug directly into a vein.
Intramuscular (IM): Injecting the drug deep into a muscle.
Rectal: Administering the drug via the rectum.
All other injectable routes: This includes injections into joints (intra-articular), tendons (intratendinous), and other soft tissues (e.g., periarticular, epidural, intrabursal). This was a major policy shift, as some local injections were previously permitted.

Permitted Routes and Medical Necessity

For athletes, the key to compliant triamcinolone use is to choose a non-systemic route of administration. These methods are considered to have a minimal impact on overall systemic levels and are therefore permitted at all times, both in and out-of-competition. Approved routes include:

Dermal (Topical): Creams, ointments, lotions, and sprays for skin conditions like eczema or psoriasis.
Inhaled: Inhalers for respiratory conditions.
Intranasal: Nasal sprays for treating allergic rhinitis.
Ophthalmic: Eye drops for eye-related inflammation.
Dental Intracanal: Application within a tooth's canal for dental procedures.

Washout Periods: The Critical Timeline

Even with permitted out-of-competition injections, athletes must adhere to strict "washout periods" to ensure the substance is cleared from their system before competing. If an in-competition test detects a prohibited substance, it can still result in a doping violation. Washout periods are crucial for athlete safety and compliance. For instance, an intramuscular injection of triamcinolone acetonide requires a substantial 60-day washout period. Other glucocorticoids have shorter, but still significant, washout times. Athletes should use resources like the Global Drug Reference Online (Global DRO) to verify the current washout rules specific to their medication and competition.

The Role of Therapeutic Use Exemptions (TUEs)

For athletes with a legitimate medical need for a systemic glucocorticoid like triamcinolone during an in-competition period, a Therapeutic Use Exemption (TUE) is the only pathway to legal use. A TUE allows an athlete to use a prohibited substance if it's required for their health, provided it is unlikely to produce additional performance enhancement. The TUE process is robust and involves demonstrating a genuine medical need with no reasonable therapeutic alternative. Prominent cases, such as that of cyclist Sir Bradley Wiggins, have centered on TUEs for triamcinolone, illustrating the scrutiny applied to these exemptions.

Understanding the Doping Landscape: Triamcinolone vs. Other Corticosteroids


Feature	Triamcinolone (e.g., Acetonide)	Other Corticosteroids (e.g., Prednisolone)
Classification	Glucocorticoid (S9)	Glucocorticoid (S9)
In-Competition Ban	Prohibited via systemic routes	Prohibited via systemic routes
Permitted Use	Topical, nasal spray, inhaler, etc.	Topical, nasal spray, inhaler, etc.
Intramuscular Washout	60 days (for acetonide)	10 days (for Prednisolone/Prednisone)
Rectal Washout	10 days (for acetonide/diacetate)	3 days
Potency	Higher potency than many others like hydrocortisone	Varies widely; Prednisone is weaker than triamcinolone

High-Profile Doping Cases and Consequences

Several high-profile cases have highlighted the risks associated with triamcinolone use in sports, particularly regarding injectable administrations. Kenyan runners Diana Kipyokei and Betty Wilson Lempus were both banned for using triamcinolone acetonide. In Lempus's case, it was revealed that she had tampered with documentation related to her use. These examples underscore the severe consequences for athletes who fail to comply with WADA regulations, whether due to deliberate misuse or a misunderstanding of the complex rules.

Conclusion: A High-Risk Medication for Athletes

In conclusion, is triamcinolone a banned substance? The answer is not a simple yes or no. Triamcinolone is conditionally banned, specifically for in-competition use via routes of administration that produce a systemic effect, including all injections, oral, and rectal methods. Permitted uses are limited to local applications like topical creams and nasal sprays. Due to the strict nature of WADA regulations, the potential for a long washout period, and the severity of doping violations, any competitive athlete considering the use of triamcinolone must exercise extreme caution. Consulting with a sports medicine physician and reviewing the official WADA Prohibited List are essential steps to ensure full compliance and avoid unintended doping violations. WADA Prohibited List.

Frequently Asked Questions

Yes, using a triamcinolone nasal spray is permitted at all times for athletes, as it is considered a local administration route with minimal systemic effect.

An athlete can receive a triamcinolone injection for a knee injury, but only out-of-competition and with a sufficient washout period before competing. Since January 1, 2022, all injections of glucocorticoids are prohibited in-competition.

The washout period for a triamcinolone acetonide intramuscular injection is 60 days. Rectal administration requires a 10-day washout period.

A TUE is a formal authorization that allows an athlete to use a prohibited substance, such as triamcinolone via a systemic route, for a genuine medical condition without being sanctioned for a doping violation.

No, topical triamcinolone creams and ointments, as they are local applications, are not banned and are permitted for use at all times, both in and out-of-competition.

WADA changed the rules to prohibit all glucocorticoid injections in-competition due to evidence that these routes, including local injections, can result in significant systemic drug levels with the potential for performance enhancement.

Athletes should consult the official WADA Prohibited List and use resources like the Global Drug Reference Online (Global DRO) to check the status of their specific medication and administration route.