Which long-acting, oral B2 agonist is commonly abused by athletes, bodybuilders, and people seeking to lose weight?
Clenbuterol.
Like albuterol, clenbuterol is a B2 agonist originally proposed for treatment of reactive airway disease but is nearly 100 times more potent. In non-clinical settings, this compound is used for its lipolytic and hypertrophic properties. Mild toxicity manifests as headache, tachycardia, agitation, palpitations, and tremors. More severe toxicity can present with myocardial ischemia, hypokalemia, lactic acidosis hyperglycemia, seizures, vomiting, anxiety or psychosis, myocardial infarction, ventricular arrhythmias, and rhabdomyolysis.
Pascal Kintz et al. Complete Post-mortem Investigations in a Death Involving Clenbuterol After Long-term Abuse. Journal of Analytical Toxicology, Volume 43, Issue 8, October 2019, Pages 660–665, https://doi.org/10.1093/jat/bkz058
Submitted by: Scott Stadler, PharmD Candidate on behalf of Clinical Toxicology in Sports