Skip to main content
SpringerLink
Log in

Adverse events of clenbuterol among athletes: a systematic review of case reports and case series

International Journal of Legal Medicine Aims and scope Submit manuscript

Cite this article

Abstract

Clenbuterol is a potent beta-2 agonist widely misused by professional athletes and bodybuilders. Information on clenbuterol associated adverse events is present in case reports and case series, though it may not be readily available. This systematic review aimed to critically evaluate the evidence of adverse events associated with clenbuterol among athletes. The search strategy was in accordance with PRISMA guidelines. Databases such as PubMed, Science Direct, Scopus, and Google Scholar were searched from 1990 to October 2021 to find out the relevant case reports and case series. There were 23 included studies. Using a suitable scale, the included studies’ methodological quality analysis was evaluated. In total, 24 athletes experienced adverse events. Oral ingestion of clenbuterol was the most preferred route among them. The daily administered dose of clenbuterol was ranging from 20 µg to 30 mg. Major adverse events experienced by athletes were supraventricular tachycardia, atrial fibrillation, hypotension, chest pain, myocardial injury, myocarditis, myocardial ischemia, myocardial infarction, cardiomyopathy, hepatomegaly, hyperglycemia, and death. The cardiac-related complications were the most commonly occurring adverse events. Clenbuterol is notorious to produce life-threatening adverse events including death. Lack of evidence regarding the performance-enhancing effects of clenbuterol combined with its serious toxicities questions the usefulness of this drug in athletes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

All the required data are available with manuscript.

References

  1. Hwang JH, Spurlock ME, Kube JC, Li XZ, Smith SB (2021) Characterization of β-adrenergic receptors in bovine intramuscular and subcutaneous adipose tissue: comparison of lubabegron fumarate with β-adrenergic receptor agonists and antagonists. J Anim Sci 99:1–12. https://doi.org/10.1093/jas/skab116

    Article  Google Scholar 

  2. Kim H-K, Della-Fera MA, Hausman DB, Baile CA (2010) Effect of clenbuterol on apoptosis, adipogenesis, and lipolysis in adipocytes. J Physiol Biochem 66:197–203. https://doi.org/10.1007/s13105-010-0024-8

    Article  CAS  PubMed  Google Scholar 

  3. Yamamoto I, Iwata K, Nakashima M (1985) Pharmacokinetics of plasma and urine clenbuterol in man, rat, and rabbit. J Pharmacobiodyn 8:385–391. https://doi.org/10.1248/bpb1978.8.385

    Article  CAS  PubMed  Google Scholar 

  4. Al-Majed AA, Khalil NY, Khbrani I, Abdel-Aziz HA (2017) Clenbuterol hydrochloride. profiles of drug substances, excipients and related methodology. Elsevier. 91–123.

  5. Grimmer NM, Gimbar RP, Bursua A, Patel M (2016) Rhabdomyolysis secondary to clenbuterol use and exercise. J Emerg Med 50:e71–e74. https://doi.org/10.1016/j.jemermed.2015.09.006

    Article  PubMed  Google Scholar 

  6. Zerobin K, Kündig H (1980) The control of myometrial functions during parturition with Aβ2-mimeticcompound, PlanipartR. Theriogenology 14:21–35. https://doi.org/10.1016/0093-691X(80)90131-4

    Article  CAS  PubMed  Google Scholar 

  7. Spiller HA, James KJ, Scholzen S, Borys DJ (2013) A descriptive study of adverse events from clenbuterol misuse and abuse for weight loss and bodybuilding. Subst Abuse 34:306–312. https://doi.org/10.1080/08897077.2013.772083

    Article  Google Scholar 

  8. Daubert GP, Mabasa VH, Leung VW, Aaron C (2007) Acute clenbuterol overdose resulting in supraventricular tachycardia and atrial fibrillation. J Med Toxicol 3:56–60. https://doi.org/10.1007/bf03160909

    Article  PubMed  PubMed Central  Google Scholar 

  9. Young J, Anwar A (2009) Strong diabetes. BMJ Case Rep 2009:bcr0820080708. https://doi.org/10.1136/bcr.08.2008.0708

    Article  Google Scholar 

  10. Waight M, McGuinness W (2016) Case of low dose clenbuterol toxicity. BMJ Case Rep 2016:bcr2016215157. https://doi.org/10.1136/2Fbcr-2016-215157

    Article  PubMed  PubMed Central  Google Scholar 

  11. WADA prohibited list January 2020. Available online: https://www.wada-ama.org/sites/default/files/wada_2020_english_prohibited_list_0.pdf (access on 30.12.2021). pp. WADA antidoping agency.

  12. Prohibited and restricted drugs in food animals. pp. Food Animal Residue Avoidance Databank.

  13. Parr MK, Koehler K, Geyer H, Guddat S, Schänzer W (2008) Clenbuterol marketed as dietary supplement. Biomed Chromatogr 22:298–300. https://doi.org/10.1002/bmc.928

    Article  CAS  PubMed  Google Scholar 

  14. Hieger MA, Emswiler MP, Maskell KF et al (2016) A case series of clenbuterol toxicity caused by adulterated heroin. J Emerg Med 51:259–261. https://doi.org/10.1016/j.jemermed.2016.05.047

    Article  PubMed  Google Scholar 

  15. Moriarty N, Attar N (2020) Clenbuterol-induced myocarditis: a case report. Eur J Case Rep Intern Med 7. 10.12890%2F2020_001662

  16. Brett J, Dawson AH, Brown JA (2014) Clenbuterol toxicity: a NSW poisons information centre experience. Med J Aust 200:219–221. https://doi.org/10.5694/mja13.10982

    Article  PubMed  Google Scholar 

  17. Gojmerac T, Pleadin J, Zuric M, Mirko L, Stipica C (2002) Effects of repeated growth-promoting doses of clenbuterol on the hepatic function of female pigs. Vet Hum Toxicol 44:269–271

    CAS  PubMed  Google Scholar 

  18. Burniston JG, Ng Y, Clark WA, Colyer J, Tan L-B, Goldspink DF (2002) Myotoxic effects of clenbuterol in the rat heart and soleus muscle. J Appl Physiol 93:1824–1832. https://doi.org/10.1152/japplphysiol.00139.2002

    Article  CAS  PubMed  Google Scholar 

  19. Chai J, Xu Q, Dai J, Liu R (2013) Investigation on potential enzyme toxicity of clenbuterol to trypsin. Spectrochim Acta A Mol Biomol Spectrosc 105:200–206. https://doi.org/10.1016/j.saa.2012.12.017

    Article  CAS  PubMed  Google Scholar 

  20. Tewari D, Samoilă O, Gocan D et al (2019) Medicinal plants and natural products used in cataract management. Front Pharmacol 10:466. https://doi.org/10.3389/fphar.2019.00466

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Howick J, Chalmers I, Glasziou P et al (2011) Background document: explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence. University of Oxford, Centre for Evidence-Based Medicine, Oxford, UK

    Google Scholar 

  22. Murad MH, Sultan S, Haffar S, Bazerbachi F (2018) Methodological quality and synthesis of case series and case reports. BMJ Evid-Based Med 23:60–63. https://doi.org/10.1136/bmjebm-2017-110853

    Article  PubMed  PubMed Central  Google Scholar 

  23. Report on medicines use during COVID-19 Pandemic, July 2020. Avalable online: https://www.aifa.gov.it/documents/20142/1202341/OsMedCovidEng.pdf (access on 04.02.22).

  24. New drug approval 2016. available online:https://newdrugapprovals.org/2016/10/03/clenbuterol/ (access on 05.02.23) pp. Clenbuterol is approved in Germany for the treatment of asthma and COPD.

  25. Kierzkowska B, Stanczyk J, Kasprzak JD (2005) Myocardial infarction in a 17-year-old body builder using clenbuterol. Circ J 69:1144–1146. https://doi.org/10.1253/circj.69.1144

    Article  PubMed  Google Scholar 

  26. Barbosa J, Cruz C, Martins J et al (2005) Food poisoning by clenbuterol in Portugal. Food Addit Contam 22:563–566. https://doi.org/10.1080/02652030500135102

    Article  CAS  PubMed  Google Scholar 

  27. Brambilla G, Cenci T, Franconi F et al (2000) Clinical and pharmacological profile in a clenbuterol epidemic poisoning of contaminated beef meat in Italy. Toxicol Lett 114:47–53

    Article  CAS  PubMed  Google Scholar 

  28. Sirvent P, Douillard A, Galbes O et al (2014) Effects of chronic administration of clenbuterol on contractile properties and calcium homeostasis in rat extensor digitorum longus muscle. PLoS One 9:100281. https://doi.org/10.1371/journal.pone.0100281

    Article  CAS  Google Scholar 

  29. Thompson JA, Mirza MH, Barker SA, Morgan TW, Bauer RW, McConnico RS (2011) Clenbuterol toxicosis in three Quarter Horse racehorses after administration of a compounded product. J Am Vet Med Assoc 239:842–849. https://doi.org/10.2460/javma.239.6.842

    Article  CAS  PubMed  Google Scholar 

  30. Njoroge L, Koromia GA, Patel B (2019) Myocardial infarction associated with clenbuterol abuse in a 22-year-old college athlete. J Am Coll Cardiol 73:2859. https://doi.org/10.1016/S0735-1097(19)33465-5

    Article  Google Scholar 

  31. Bonnar CE, Brazil JF, Okiro JO et al (2021) Making weight: acute muscle weakness and hypokalaemia exacerbated by thyrotoxicosis factitia in a bodybuilder. Endocrinol Diabetes Metab Case Rep 2021. https://doi.org/10.1530/edm-21-0060

  32. Santos RP, Pereira A, Guedes H, Lourenço C, Azevedo J, Pinto P (2015) Anabolic drugs and myocardial infarction–a clinical case report. Arq Bras Cardiol 105:316–9. https://doi.org/10.5935/2Fabc.20150111

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Huckins DS, Lemons MF (2013) Myocardial ischemia associated with clenbuterol abuse: report of two cases. J Emerg Med 44:444–449. https://doi.org/10.1016/j.jemermed.2012.02.057

    Article  PubMed  Google Scholar 

  34. Burniston JG, Chester N, Clark WA, Tan LB, Goldspink DF (2005) Dose-dependent apoptotic and necrotic myocyte death induced by the β2-adrenergic receptor agonist, clenbuterol. Muscle Nerve 32:767–774. https://doi.org/10.1002/mus.20407

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Duncker DJ, Bache RJ (2008) Regulation of coronary blood flow during exercise. Physiol Rev 88:1009–1086. https://doi.org/10.1152/physrev.00045.2006

    Article  CAS  PubMed  Google Scholar 

  36. Mazzanti G, Di Sotto A, Daniele C et al (2007) A pharmacodynamic study on clenbuterol-induced toxicity: β1-and β2-adrenoceptors involvement in guinea-pig tachycardia in an in vitro model. Food Chem Toxicol 45:1694–1699. https://doi.org/10.1016/j.fct.2007.03.002

    Article  CAS  PubMed  Google Scholar 

  37. Goldstein DR, Dobbs T, Krull B, Plumb VJ (1998) DECA-it’s what’s for dinner. South Med J 91:780–784

    Article  CAS  PubMed  Google Scholar 

  38. Hoffman RJ, Hoffman RS, Freyberg CL, Poppenga RH, Nelson LS (2001) Clenbuterol ingestion causing prolonged tachycardia, hypokalemia, and hypophosphatemia with confirmation by quantitative levels. J Toxicol Clin Toxicol 39:339–344. https://doi.org/10.1081/clt-100105152

    Article  CAS  PubMed  Google Scholar 

  39. El-Sherif N, Turitto G (2011) Electrolyte disorders and arrhythmogenesis. Cardiol J 18:233–245

    PubMed  Google Scholar 

  40. Kintz P, Gheddar L, Ameline A et al (2019) Complete post-mortem investigations in a death involving clenbuterol after long-term abuse. J Anal Toxicol 43:660–665. https://doi.org/10.1093/jat/bkz058

    Article  CAS  PubMed  Google Scholar 

  41. Lehmann S, Thomas A, Schiwy-Bochat K-H et al (2019) Death after misuse of anabolic substances (clenbuterol, stanozolol and metandienone). Forensic Sci Int 303:109925. https://doi.org/10.1016/j.forsciint.2019.109925

    Article  CAS  PubMed  Google Scholar 

  42. Hausmann R, Hammer S, Betz P (1998) Performance enhancing drugs (doping agents) and sudden death–a case report and review of the literature. Int J Legal Med 111:261–264. https://doi.org/10.1007/s004140050165

    Article  CAS  PubMed  Google Scholar 

  43. Griswold MK, Blohm E, Cross R, Boyer EW, Carey JL (2017) Unsuspected clenbuterol toxicity in a patient using intramuscular testosterone. Clin Pract Cases Emerg Med 1:197. https://doi.org/10.5811/2Fcpcem.2017.2.33318

    Article  PubMed  PubMed Central  Google Scholar 

  44. Clore JN, Thurby-Hay L (2009) Glucocorticoid-induced hyperglycemia. Endocr Pract 15:469–474. https://doi.org/10.4158/ep08331.rar

    Article  PubMed  Google Scholar 

  45. Illera J, MartÝnez M (1998) The effect of clenbuterol on adrenal function in rats. Anlst 123:2521–2524

    CAS  Google Scholar 

  46. Liu Q, Zhang J, Guo W, Zhao Y, Hu X, Li N (2012) Identifying lipid metabolism genes in pig liver after clenbuterol administration. Front Biosci (Elite Ed) 4:2605–2616. https://doi.org/10.2741/e569

    Article  PubMed  Google Scholar 

  47. Woolum J, Mancuso N, Rutter PW, Baum RA, Akpunonu P (2020) Chomping at the bit: a descriptive report on pediatric clenbuterol ingestion. J Pharm Pract 33:386–389. https://doi.org/10.1177/0897190018823114

    Article  PubMed  Google Scholar 

  48. Bonney CF, Hatten B, Wang GS (2019) Toxicity from unintentional pediatric ingestion of a performance-enhancing drug: a case report with review of clenbuterol toxicity and treatment. J Emerg Med 57:e105–e108. https://doi.org/10.1016/j.jemermed.2019.06.016

    Article  PubMed  Google Scholar 

  49. Mascagni P, Melandro F, Larghi-Laureiro Z, Mennini G, Rossi M (2018) Spontaneous hepatic rupture in a bodybuilder: a case report and review of the literature. Rev Esp Enferm Dig 110:254–6. https://doi.org/10.17235/reed.2017.5103/2017

    Article  PubMed  Google Scholar 

  50. Abdulredha WS (2019) Effect of clenbuterol using as weight loose on liver enzymes and lipids profile. Iraq Med J 3.

  51. Hartung R, Gerth J, Fünfstück R, Gröne HJ, Stein G (2001) End-stage renal disease in a bodybuilder: a multifactorial process or simply doping? Nephrol Dial Transplant 16:163–165. https://doi.org/10.1093/ndt/16.1.163

    Article  CAS  PubMed  Google Scholar 

  52. Dufayet L, Gorgiard C, Vayssette F, Barbet J, Hoizey G, Ludes B (2020) Death of an apprentice bodybuilder following 2, 4-dinitrophenol and clenbuterol intake. Int J Legal Med 134:1003–1006. https://doi.org/10.1007/s00414-020-02268-2

    Article  CAS  PubMed  Google Scholar 

  53. Boland DM (2020) Disposition of toxic drugs and chemicals in man, 12th Edition. J Anal Toxicol 44:e13-e. https://doi.org/10.1093/jat/bkaa121

    Article  Google Scholar 

  54. Girault J, Gobin P, Fourtillan J (1990) Quantitative measurement of clenbuterol at the femtomole level in plasma and urine by combined gas chromatography/negative ion chemical ionization mass spectrometry. Biomed Environ Mass Spectrom 19:80–88

    Article  CAS  PubMed  Google Scholar 

  55. Quinley KE, Chen H-Y, Yang HS, Lynch KL, Olson KR (2016) Clenbuterol causing non–ST-segment elevation myocardial infarction in a teenage female desiring to lose weight: case and brief literature review. Am J Emerg Med 34:1739

    Article  Google Scholar 

  56. World Anti-Doping Agency (WADA) World anti-doping code 2015 (with 2019 Amendments) (access on 01.February 2023).

  57. World Anti-Doping Ageny (WADA). Stakeholder notice regarding meat contamination. 2019. Available online: http://www.wada-ama.org/sites/default/files/resources/files/2019-05-30-meat_contamination_notice_final.pdf (Access on 01.02.23).

  58. Schlupp A, Anielski P, Thieme D, Müller R, Meyer H, Ellendorff F (2004) The β-agonist clenbuterol in mane and tail hair of horses. Equine Vet J 36:118–122

    Article  CAS  PubMed  Google Scholar 

  59. Gleixner A, Sauerwein H, Meyer H (1996) Detection of the anabolic beta 2-adrenoceptor agonist clenbuterol in human scalp hair by HPLC/EIA. Clin Chem 42:1869–1871

    Article  CAS  PubMed  Google Scholar 

  60. Vulić A, Pleadin J, Perši N, Stojković R, Ivanković S (2011) Accumulation of β-agonists clenbuterol and salbutamol in black and white mouse hair. J Anal Toxicol 35:566–570

    Article  PubMed  Google Scholar 

  61. Krumbholz A, Anielski P, Gfrerer L et al (2014) Statistical significance of hair analysis of clenbuterol to discriminate therapeutic use from contamination. Drug Test Anal 6:1108–1116

    Article  CAS  PubMed  Google Scholar 

  62. Machnik M, Geyer H, Horning S, Breidbach A, Delahaut P, Schänzer W (1999) Long-term detection of clenbuterol in human scalp hair by gas chromatography–high-resolution mass spectrometry. J Chromatogr B Biomed Sci Appl 723:147–155

    Article  CAS  PubMed  Google Scholar 

  63. WADA 2012 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2012_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  64. WADA 2013 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2013_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  65. WADA 2014 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2014_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  66. WADA 2015 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2015_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  67. WADA 2016 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2016_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  68. WADA 2017 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2017_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  69. WADA 2018 anti-doping testing figures. Available online: https://www.wada-ama.org/sites/default/files/resources/files/2018_testing_figures_report.pdf (Access on 02.02.2023).

  70. WADA 2019 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2019_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  71. WADA 2020 anti-doping testing figures. Available online:https://www.wada-ama.org/sites/default/files/resources/files/2020_anti-doping_testing_figures_en.pdf (Access on 02.02.2023).

  72. WADA 2021 anti-doping testing figures. https://www.wada-ama.org/sites/default/files/2023-01/2021_anti-doping_testing_figures_en.pdf.

  73. Mohamed RA, Elbialy ZI, Abd El Latif AS et al (2020) Dietary clenbuterol modifies the expression of genes involved in the regulation of lipid metabolism and growth in the liver, skeletal muscle, and adipose tissue of Nile tilapia (Oreochromis niloticus). Aquac Rep 17:100319. https://doi.org/10.1016/j.aqrep.2020.100319

    Article  Google Scholar 

  74. Performance and image enhancing drugs July 2019. Available online: https://www.tga.gov.au/news/news/performance-and-image-enhancing-drugs (Access on 05.02.23).

  75. Vlad RA, Hancu G, Popescu GC, Lungu IA (2018) Doping in sports, a never-ending story? Adv Pharm Bull 8:529

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Clenbuterol - DEA diversion control division. available online: https://www.deadiversion.usdoj.gov/drug_chem_info/clenbuterol.pdf (access on 29.07.22).

  77. Wiegand TJ (2010) Adulterated cocaine and lessons learned from the Jake walk blues. Springer

    Book  Google Scholar 

  78. Estrada-Montoya M, González-Córdova A, Torrescano G, Camou J, Vallejo-Cordoba B (2008) Screening and confirmatory determination of clenbuterol residues in bovine meat marketed in the Northwest of Mexico. Cienc Tecnol Aliment 6:130–136. https://doi.org/10.1080/11358120809487637

    Article  CAS  Google Scholar 

  79. Pino Scotto D (2015) Polypharmacy tra gli utenti di steroidi androgeni anabolizzanti: un metasynthesis descrittivo. Subst Abuse Treat Prev Policy 10:12. https://doi.org/10.1186/s13011-015-0006-5

    Article  Google Scholar 

  80. Hemery D, Ogden G, Evans A (1990) Winning without drugs: the natural approach to competitive sport. Willow.

  81. Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 10:1–11

    Article  Google Scholar 

  82. Perera NJ, Steinbeck KS, Shackel N (2013) The adverse health consequences of the use of multiple performance-enhancing substances—a deadly cocktail. J Clin Endocrinol Metab 98:4613–4618. https://doi.org/10.1210/jc.2013-2310

    Article  CAS  PubMed  Google Scholar 

  83. Mayer KN, Wyder D, Spasic D, Herren T (2016) Severe rhinovirus pneumonia in a young woman taking performance-enhancing drugs. BMJ Case Rep 2016:bcr2015213836. https://doi.org/10.1136/bcr-2015-213836

    Article  PubMed  PubMed Central  Google Scholar 

  84. Žlak N, Košuta D, Potisek M, Stevanović Ž (2018) Clenbuterol toxicity in a young male athlete. Toxin reviews 37:182–186

    Article  Google Scholar 

  85. Li C, Adhikari BK, Gao L et al (2018) Performance-enhancing drugs abuse caused cardiomyopathy and acute hepatic injury in a young bodybuilder. Am J Men’s Health 12:1700–1704. https://doi.org/10.1177/1557988318783504

    Article  Google Scholar 

  86. Shafrir A, Leibowitz DW, Alcalai R, Elitzur Y, Muszkat M (2019) Myocardial injury induced by the long acting beta2 adrenergic agonist clenbuterol. Cardiol Cardiovasc Med 3:186–92. https://doi.org/10.26502/fccm.92920066

    Article  Google Scholar 

  87. CDSCO, Clenbuterol hydrochloride solution for injection 30mcg/ml. https://cdscoonline.gov.in/CDSCO/Drugs. (access on 03.02.23).

  88. List of most commonly encountered drugs currently controlled under the misuse of drugs legislation 8 August 2022. Available online: https://www.gov.uk/government/publications/controlled-drugs-list--2. (access on 23.09.22).

  89. (2022) Health Canada. Policy for the importation or sale of active pharmaceutical ingredients for veterinary use POL-0018. Available online: https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/dhp-mps/alt_formats/hpfb-dgpsa/pdf/compli-conform/pol_0018-eng.pdf (access on September 20122).

  90. China bans clenbuterol tablets. Available Online: https://www.thepigsite.com/news/2011/10/china-bans-clenbuterol-tablets-1#:~:text=CHINA%20%2D%20China%20has%20banned%20the,on%20Friday%20(30%20September) (access on 29.07.22).

Download references

Author information

Authors and Affiliations

  1. School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India

    Sweta Kumari, Biplab Pal & Sanjeev Kumar Sahu

  2. School of Allied Medical Sciences, Lovely Professional University, Phagwara, Punjab, 144411, India

    Pranav Kumar Prabhakar

  3. Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, 110017, India

    Devesh Tewari

Authors
  1. Sweta Kumari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Biplab Pal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sanjeev Kumar Sahu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pranav Kumar Prabhakar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Devesh Tewari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Devesh Tewari.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kumari, S., Pal, B., Sahu, S.K. et al. Adverse events of clenbuterol among athletes: a systematic review of case reports and case series. Int J Legal Med 137, 1023–1037 (2023). https://doi.org/10.1007/s00414-023-02996-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-023-02996-1

Keywords

search

Navigation