Medical Opinion: How Fluimucil would have aided Wiggins, Team Sky

Posted on: December 23rd, 2016

Was the transportation to France of an €8 bottle of medicine unusual and what would it do for cyclists anyway?

 

By Dr Conor McGrane

Normally when I hear a medication being used I am familiar with it or have at least heard of it.

When David Brailsford named Fluimucil as the drug in the infamous “jiffy bag” delivered to Team Sky in France in 2011 I went straight to my MIMS; the mini bible for all Irish doctors.

Fluimucil wasn’t there.

Turns out it is authorised for use but not actively marketed in Ireland. Reports say it is not licenced in the UK but is on the continent in countries like France.

This is not unusual. Different countries have different styles of treating illness and some conditions are more common in different countries.

The French have a long tradition of using mucolytic agents in treating respiratory conditions. So it is not surprising to see it is popular there.

The only time I have used it was when working in Accident and emergency units where it was and is used as a treatment in paracetamol overdoses.

N-Acetylcystine is the proper name for it and it loosens up mucus and secretions by breaking up mycoprotiens. In short it helps break up thick mucus into looser mucus and aims to make it easier to cough up.

 

A portable nebuliser; the kind of device Fluimucil would used in.

 

It is aimed at people with chronic bronchitis and there is some evidence that prolonged use via nebulisers can reduced the rate of infections.

It is not something you would normally associate with fit cyclists or athletes.

As with many in the sport I had heard that teams were using nebulisers on a regular, if not even routine, basis to aid recovery.

I could not find much in academic journals but it would probably make it a bit easier to cough up phlegm if you had a chest infection.

It wouldn’t make it clear any quicker, though it may make you feel a bit better through it.

While I personally am very uncomfortable with this, it is not in breach of the WADA rules.

It does have a significant level of nasty side effects.

Almost 1 in 5 people using it get some form or allergic response. This ranges from a hive-like rash to a full blown asthma attack.

While it is not contra indicated in asthmatics it should be used with extreme caution.

Certainly anyone who had a reaction to it should not use it again. I did find some published research on the use of it in sports.

A number of small studies did find it seemed to improve cycling performance and recovery. This is thought to be via anti-oxidant action.

Some other articles did suggest that while it may reduce muscle soreness in the short term it may hinder muscle recovery in the medium term.

As always, research and science doesn’t give a straight answer.

I suppose to summarise it is fair to say that using it to help someone with breathing problems as result of infection or allergy is reasonable as an add on to more usual treatments.

It is certainly not the first line recommended or commonly used and did surprise me.

There is the possibility it was being used to speed up recovery and help cycling performance.

Some science does back that up and although it is not a licenced use it is not banned.

The fact that British cycling store it in Manchester suggests to me that it is a commonly used product.

It would be difficult (but not illegal) to source it there. Conversely it would be easy and cheap to source in France.

That does beg the question why fly it over to France when it would be easier and cheaper to get it there?

It is not illegal or banned but it does seem that marginal gains involves using medicines off licence to get as much benefit as possible within the letter, if not the spirit, of the law.

  • Dr Conor McGrane is a cyclist and as well as running his own medical practice has worked with Cycling Ireland as a doctor. He writes here in a personal capacity.

 

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