UCI moves to ban Tramadol in-competition use and introduces revised rules for low cortisol

The UCI has announced that it will ban the use of the analgesic Tramadol from in-competition use from 2019.

Pain-killer Tramadol has been was shown as recently as last week in a World Anti-Doping Agency report to be widely used among professional road riders, with numerous cases of anecdotal evidence over recent years of riders using the drug during races.

Due to it's possible side-effects of "dizziness, loss of alertness, drowsiness, or physical dependency and risks of addiction to opioids" as outlined by the the UCI, Tramadol will be banned from use in races from 2019 onwards.

The UCI Management Committee announced the ruling along with a whole host of other changes in a press release on Thursday evening.

The governing body will also impose a mandatory eight-day withdrawal from work and competition for riders using local infiltrations of glucocorticoids (a class of corticosteroids). For example, if a rider needed an injection to prevent inflammation in a knee joint, their doctor would be required to declare it and impose a minimum of eight-days away from work and competition.

The UCI said in its release that "glucocorticoids can trigger undesirable side-effects which, in the case of an accident or medical emergency, can be life threatening. For cyclists, we must consider that the potential consequences of corticosteroids are a medical contraindication for practising sport in competition."

Likewise, the UCI will consult "international experts" to decide which tests need to be carried out on riders before races to detect 'adrenal insufficiency', i.e. low cortisol levels.

Previously, only voluntary members of the Movement for Credible Cycling (MPCC) have imposed a stint on the sidelines for riders with low cortisol levels - in which the adrenal glands do not produce sufficient amounts of steroid hormones like cortisol.

Use of corticosteroids for conditions like asthma can lead to low cortisol levels (as can illness or disease), which the UCI now says would be a "medical contraindication for competition" and "would therefore mean it is impossible to start the race."

In 2015, George Bennett was pulled from the LottoNL-Jumbo line-up shortly before the start of the Giro d'Italia that year for testing low in cortisol. Astana, like the Dutch team, are members of the MPCC but chose to go against the voluntary rules of the organisation after starting Lars Boom in the 2015 Tour de France, despite the rider showing low cortisol levels.

Astana said the low levels were "due to long-standing and well-known application of anti-asthma therapy by the rider" who went on to ride the Tour.

Corticosteroids have made headlines in recent years due to the Fancy Bears hacks which revealed 2012 Tour de France winner Bradley Wiggins had received a therapeutic use exemption for Triamcinolone, which was said to be used to treat allergies and asthma.

The UCI says its revised rules on Tramadol and glucocorticoids will be put in place from January 1, 2019.