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FAQ on Actovegin

An Expert Explains How the Drug May Enhance Athletic Performance
By
WebMD Health News
Reviewed by Louise Chang, MD

Dec. 16, 2009 -- Actovegin, a potentially performance-enhancing drug for athletes, is suddenly in the news after media reports that a Canadian doctor who has also treated Tiger Woods is under investigation by U.S. and Canadian authorities for possibly providing it and other substances to athletes.

According to news reports, Anthony Galea, MD, was arrested in mid-October in Toronto, and the FBI has since entered the case.

Actovegin, produced by an Austrian pharmaceutical company, has legitimate medical uses, experts say, but it is not approved by the FDA. Galea had reportedly treated Woods with plasma therapy (not Actovegin) after a knee injury in 2008.

WebMD asked Gary Wadler, MD, chairman of the World Anti-Doping Agency's Prohibited List and Methods Sub-Committee and clinical associate professor of medicine at the New York University School of Medicine, to fill us in on the drug.

What Is Actovegin?

''Actovegin is a de-proteinized extract of calf blood," says Wadler. It's been produced by Nycomed Austria GmbH since 1996, according to the company's web site.

A statement on the site says "the raw material is calf blood sources from calves below 8 months of age."

But its history goes back much further than 1996, Wadler says. "It has been studied at least since the late 1970s," he tells WebMD.

What are the medical uses of Actovegin?

Among its uses, Wadler says, is the treatment of peripheral artery disease and strokes.

A search of medical literature turns up several published studies of the drug, with research ranging from treatment of cognitive disturbances after stroke to ulcers.

What are the benefits of Actovegin use in athletes?

In research studies, Actovegin has been shown to exert insulin-like activity, such as stimulating the transport of glucose in the body, as well as glucose oxidation.

That could be good news for athletes, Wadler says. "Athletes are always looking to get more oxygen to working muscles."

''The idea here was to deliver it therapeutically, to improve the transport and use of oxygen and sugar," he says.

What is the International Olympic Committee's view of Actovegin?

''In December 2000, the International Olympic Committee became sufficiently concerned that Actovegin was being abused in cycling to put it on the banned list," Wadler says. It had become the center of controversy after the 2000 Tour de France, in which Lance Armstrong's team was accused of using the drug -- a contention the team denied.

However, Wadler says, in 2001 the International Olympic Committee removed it from the banned list pending further research.

How widely used is Actovegin?

Wadler says he doesn't think the drug is widely used by athletes, noting that many other drugs work better.

The drug is sold via the Internet and is available in tablet form, injections, infusions, and topical formulas such as creams, gels, and ointments. According to the Nycomed site, the drug is marketed to hospital specialists and general practitioners in European markets, China, Russia, and elsewhere.

Online, one pharmaceutical site offers 85 tablets of 200-milligram formula Actovegin for $85.

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