Helmlin, Hans-Jorg, Murner, Andre, Steiner, Samuel, Kamber, Matthias, Weber, Christina, Geyer, Hans, Guddat, Sven, Schaenzer, Wilhelm and Thevis, Mario (2016). Detection of the diuretic hydrochlorothiazide in a doping control urine sample as the result of a non-steroidal anti-inflammatory drug (NSAID) tablet contamination. Forensic Sci.Int., 267. S. 166 - 173. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-6283

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Abstract

Hydrochlorothiazide (HCTZ, 6-chloro-3,4-dihydro-2H-1,2,4-benzothiadiazine-7-sulfonamide-1,1-dioxide) belongs to the class of diuretic agents that represent one of today's cornerstones of the treatment of hypertensive patients. In addition to its clinical relevance, HCTZ is prohibited in sports according to the regulations of the World Anti-Doping Agency (WADA) at all times and has frequently been detected in sports drug testing urine samples worldwide since its ban was introduced in 1988. Despite these facts, the adverse analytical finding concerning HCTZ in an in-competition routine doping control sample collected in December 2014 was further investigated, particularly motivated by the comparably low urinary concentration of the drug accounting for approximately 5 ng/mL. The athlete in question did not declare the use of any nutritional supplement or medication other than the ingestion of a non-steroidal anti-inflammatory drug (NSAID) prior to competition. Hence, the drug (formulated as coated tablet) provided by the athlete as well as the corresponding retention sample of the manufacturer were analyzed. Noteworthy, both samples confirmed the presence of about 2 mu g of HCTZ per tablet. In order to further probe for the plausibility of the observed urinary HCTZ concentrations with the scenario of drug ingestion and subsequent doping control sample collection, administration studies with produced HCTZ-spiked placebo-tablets (2.5 mu g of HCTZ/tablet) were conducted. Urine specimens were collected prior to and after ingestion of the drug and subjected to routine doping control analytical procedures employing liquid chromatography/tandem mass spectrometry. While blank urine samples returned negative test results, post-administration specimens were found to contain HCTZ at concentrations of approximately 1-16 ng/mL, which supported the athlete's inadvertent intake of HCTZ via contaminated NSAID tablets. Due to the substantial sensitivity of test methods employed today by doping control laboratories, even drug contaminations ranging within the good manufacturing practice (GMP) limit of 10 ppm overall carry-over can evidently lead to adverse analytical findings. This calls into question whether selected (classes of) substances such as diuretics should be reported only when exceeding a defined reporting level and/or whether adverse analytical findings of non-threshold substances should be reported with an estimated semi-quantitative concentration of the identified substance to facilitate the result management by anti-doping organizations. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Helmlin, Hans-JorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Murner, AndreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steiner, SamuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kamber, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Geyer, HansUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guddat, SvenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaenzer, WilhelmUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thevis, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-260064
DOI: 10.1016/j.forsciint.2016.08.029
Journal or Publication Title: Forensic Sci.Int.
Volume: 267
Page Range: S. 166 - 173
Date: 2016
Publisher: ELSEVIER IRELAND LTD
Place of Publication: CLARE
ISSN: 1872-6283
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MASS-SPECTROMETRY; SUPPLEMENTS; AGENTSMultiple languages
Medicine, LegalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/26006

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