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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Performance-Enhancing Effects of Inhaled Medications: Implications for Heart, Muscle Function, and Doping Detection in Athletes

by
Riccardo Cricco
1,2,
Andrea Segreti
1,2,*,
Emanuele Stirpe
3,
Aurora Ferro
1,2,
Martina Ciancio
1,2,
Flavia Cipriani
1,2,
Chiara Fossati
4,
Gian Paolo Ussia
1,2,
Fabio Pigozzi
4 and
Francesco Grigioni
1,2
1
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
2
Unit of Cardiovascular Sciences, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
3
Department of Respiratory Disease, Hospital of Bolzano (SABES-ASDAA), Via Lorenz Böhler 5, 39100 Bolzano, Italy
4
Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Funct. Morphol. Kinesiol. 2025, 10(4), 462; https://doi.org/10.3390/jfmk10040462
Submission received: 29 September 2025 / Revised: 3 November 2025 / Accepted: 25 November 2025 / Published: 26 November 2025
(This article belongs to the Section Sports Medicine and Nutrition)
Versions Notes

Abstract

Inhaled medications, commonly prescribed for respiratory conditions such as asthma and exercise-induced bronchoconstriction, are increasingly scrutinized in sports medicine due to their potential performance-enhancing effects. Bronchodilators, in particular, may improve lung function, increase oxygen delivery, and influence muscle contractility, potentially enhancing athletic performance. However, supratherapeutic use raises concerns about cardiovascular risks, including tachyarrhythmias and altered autonomic balance, as well as muscle hypertrophy and sprint capacity gains. These effects blur the line between therapeutic use and doping, creating challenges for fair competition. This review explores the mechanisms by which inhaled drugs affect the cardiovascular and muscular systems, summarizes notable doping cases, and evaluates current detection methods. Despite regulatory thresholds established by the World Anti-Doping Agency, assay interpretation remains complicated by inter-individual variability, short drug half-lives, and enantiomeric differences. Addressing these gaps requires refined pharmacokinetic modeling, enantioselective assays, and metabolomic fingerprinting to safeguard both athlete health and the integrity of sport.
Keywords: inhaled medications; sport medicine; doping; athletes; muscle; cardiovascular system inhaled medications; sport medicine; doping; athletes; muscle; cardiovascular system

Share and Cite

MDPI and ACS Style

Cricco, R.; Segreti, A.; Stirpe, E.; Ferro, A.; Ciancio, M.; Cipriani, F.; Fossati, C.; Ussia, G.P.; Pigozzi, F.; Grigioni, F. Performance-Enhancing Effects of Inhaled Medications: Implications for Heart, Muscle Function, and Doping Detection in Athletes. J. Funct. Morphol. Kinesiol. 2025, 10, 462. https://doi.org/10.3390/jfmk10040462

AMA Style

Cricco R, Segreti A, Stirpe E, Ferro A, Ciancio M, Cipriani F, Fossati C, Ussia GP, Pigozzi F, Grigioni F. Performance-Enhancing Effects of Inhaled Medications: Implications for Heart, Muscle Function, and Doping Detection in Athletes. Journal of Functional Morphology and Kinesiology. 2025; 10(4):462. https://doi.org/10.3390/jfmk10040462

Chicago/Turabian Style

Cricco, Riccardo, Andrea Segreti, Emanuele Stirpe, Aurora Ferro, Martina Ciancio, Flavia Cipriani, Chiara Fossati, Gian Paolo Ussia, Fabio Pigozzi, and Francesco Grigioni. 2025. "Performance-Enhancing Effects of Inhaled Medications: Implications for Heart, Muscle Function, and Doping Detection in Athletes" Journal of Functional Morphology and Kinesiology 10, no. 4: 462. https://doi.org/10.3390/jfmk10040462

APA Style

Cricco, R., Segreti, A., Stirpe, E., Ferro, A., Ciancio, M., Cipriani, F., Fossati, C., Ussia, G. P., Pigozzi, F., & Grigioni, F. (2025). Performance-Enhancing Effects of Inhaled Medications: Implications for Heart, Muscle Function, and Doping Detection in Athletes. Journal of Functional Morphology and Kinesiology, 10(4), 462. https://doi.org/10.3390/jfmk10040462

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