Oral EPO – FG-4592

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Seems like I could be wasting my time trying to acclimate to high altitude when all I’d have to do is take a pill to do it.  Two cyclists so far have tested positive for FG-4592, an oral product that stimulates your body into producing more EPO “naturally”.

There are lots of disturbing aspect to this whole thing, the ease of use, etc., but what bothers me the most is that FG-4592 is only in clinical trials and supposedly can’t be out there for the “public” to use.  I wonder how many other drugs that aren’t approved are being abused by athletes?  I’d assume a lot.

David Howman, director of WADA, said in a speech that around 10% of elite athletes are taking drugs, in his opinion.  That seems low to me, at least in regard to cycling, but if he is accurate, then I wonder where those 10% finish in relation to the non-doping athletes?  I’d assume at the top.

Howman, in his speech, said that he was worried about the use of drugs in young athletes, teenagers that are trying to take a “shortcut” to get to an elite level.  I understand his concern completely.  Kids are stupid.  If they understand that they can’t compete unless they dope, then a lot of them will eventually dope.  That isn’t brain surgery.

Anyway, this oral EPO is concerning.  You don’t have to be injecting it and worrying about an overdose, I’d once again assume.  For some reason, at least to me, taking a pill seems much safer than sticking needles into one’s self, thus more attractive to someone that is thinking about taking the step of doping in sport.

I’m not sure this will ever end.  Howman said that he thinks within 5 years that doping will be a criminal offense.  I wrote about this earlier.  I think that would be a major step forward in the fight against doping in sports.

Many athletes would not risk serving jail time to be successful. The risk/reward aspect of doping does a flip-flop and I believe it would reduce doping dramatically.  Only time will tell I guess.

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26 thoughts on “Oral EPO – FG-4592

  1. Richard Durishin

    Has to be very expensive. Given that the gut does to proteins (breaks them down), you must have to take a TON of it to have a decent bioavailability. Any biochemists care to expand on that?

    1. John

      It’s not a protein. Actually a pretty small molecule compared to many oral medications.

  2. Steve Tilford Post author

    RIchard-By just doing a little internet search it looks like you can buy it from China without too much of a hassle. I have no idea how much it would cost per dosage. Crazy you can buy a drug in clinical trials already over the internet. Someone needs to address that on a planet wide basis.

    1. Richard Durishin

      Steve, anything from China is mostly talc!

      Wallboard, oral EPO, makes no difference.

      1. nancy

        Hi Steve,
        I am a fan of your blog!
        As a chemist employed by a pharma, it is quite easy to prepare and cost is quite low when reached trials generally. And most drugs are done in China because it is cheaper there than in US. But they had quite low quality standard there, so you had to be careful if you buy it online because it is probably done illegally.
        I don’t know how efficient it is in human but trials will determine since it is phase II. And I don’t know if it will boost EPO level-hemoglobin level with athletes.

    2. RGT

      Or you could buy mg quantities of the non-pharmaceutical/research grade compound from biotech companies.

      1. krakatoa

        The USA doesn’t need to criminalize “doping” per-se, when we have a perfectly robust collection of controlled substance laws.

  3. joriverdog

    I believe Germany has criminalized doping I believe and France too? In any case it would stop most that would be tempted to dope….most full on athletes probably think about it …especially if they think others they are in the fight with are doing it. I say one time bust you’re out…and if it is an offense for prescription only drugs…make it a crime. My feelings for this are due to my feeling that Pro athletes that dope are defrauding the public that in the end is the reason they get paid

    1. Mike Rodose

      Yes. It’s about Performance Enhancement against sports rules…and possibly the law now. It’s about defrauding others. Sports Fraud. Results obtained through cheating. Mechanical doping, PEDs, biomechanical, etc.

      In this case, Oral EPO is EPO and is a PED. Which constitutes sports fraud. Which perhaps should be criminal.

  4. Franz

    I am sure epo is easier to take orallyl than by injection. Overdoses are probably less common as well because you don’t people trying to figure out the difference between 10ml or 1 ml or .1ml. However I can still see people overdosing when they think how much faster 1 pill made them and wonder what 2 or 3 pills would do.

  5. Chad

    Clinical trials are 2mg/kg, three times per week. Mean maximal hemoglobin increase of ≥ 1 g/dL from baseline

    ~$250 for 50mg through a few sites, so do the math based on your weight

  6. Bolas Azules

    “David Howman, director of WADA, said in a speech that around 10% of elite athletes are taking drugs, in his opinion.”

    I can assure you, beyond a doubt that number is ridiculous. When 25 years ago more than 10% of domestic riders – some not necessarily ‘elite’ – were juiced…it is a ridiculous claim today. Whether it was the Euro-go-go-juice & pills, the brown vials the boys shipped back to the states and shot in their rear-ends or Eddy B’s famous ‘vitamin B-12′ injections at the OTC or boys experimenting with speed pills like their heroes… the 10% claim is a laugh. Yeah science, technology, pharma, shipping or rogue third-world nations’ interest in cashing in has not grown in those 25 years….please.

  7. James

    Huh. This is interesting. Impressive that such a substance was found. I suppose we will always have cheats in any thing… Just not too many! We should make them work at it… I am satisfied with it as it is currently.

  8. Pepsi Frank

    And best thing is you don’t need a thermos and the constant search for ice. The doping doctors are a decade ahead of the testers and always will be. Trying to race clean is like taking a knife to a gunfight.

    1. Mike Rodose

      I hadn’t thought of those benefits…wow, So very true! Super easy to transport, store and use.

      In addition to eliminating the Needle requirement. I worry more about this at the younger and amateur levels of sport. Pros will dope and get tested. But I wonder if a pill-form would reduce some major barriers, stigma and fear at the development levels?

      I totally support criminal and financial penalties for sports fraud, including the proven use of PEDs. But…not for all banned substances on the current wada list. I’m conflicted on this issue. Marijuana vs. Diet pills vs. EPO for example. Same crime of sports fraud? Same criminal charges? Same sanctions in racing? Interesting stuff and somewhat scary.

  9. Collin

    Making doping a criminal offense versus the cycle of doping then getting caught annnnd then…..starting your own gran fondo, getting signed to a new contract on a world tour team, starting your own clothing company, becoming a ds or team owner, or being a TV broadcaster for the Tour de France. Honestly, from everything I have seen, it pays to dope$$$. The only dopers that get caught and don’t get immediately reinserted back into the system are the Michael rasmussen’s and Ricardo Ricco’s of the world.

  10. krakatoa

    I don’t see how its any easier to OD with a syringe than a pill. If you dose too high, you dose too high. Simple.

  11. frank b

    I’m still trying to process that the dude that finished 3 places in front of you this weekend got busted by USADA in 2009 for taking a 19th century performance enhancer, strychnine. If you are willing to self administer a toxin like strychnine, you have a risk profile most cannot understand. Taking oral EPO seems tame.

  12. Ken

    The product the cyclist got caught with is made by AstraZeneca in conjunction with another company I can’t remember while writing. Bayer Pharmaceuticals has a similar compound. These compounds inhibit an enzyme called prolyl hydroxylase, which normally breaks down hypoxia-inducible factor. Basically, it tricks your body into making more EPO because the hypoxia-inducible factor levels stay high and stimulate EPO production/release. I commented to a friend of mine that you just need an average chemist and they could make that stuff for you in a lab. I heard about it several months ago as a treatment for chronic kidney failure and my first reaction was that some cyclist was probably already taking it. Kudos to AstraZeneca for making a test for it. All pharmaceutical companies need to do that. But I’m sure someone will find a way to change the structure just enough so it still works but can’t be detected.

  13. chuck martel

    While there’s much concern over performance enhancing drugs in athletics, no one seems to care about the other medical procedures, surgery, for instance, that can improve ability. These procedures are usually an effort to treat injuries but can actually make an athlete more effective than he was before the injury. The famous “Tommy John” surgery used in baseball where ligaments from other parts of the body replace the damaged ones in the throwing arm are good example. Many major league players undergo eye surgery to improve their vision and, hopefully, their hitting ability. Should these procedures be legal? Why should a quasi-government official be the one that determines what medication is or is not suitable for use by an athlete? Should ibuprofen be legal to use? How about cortisone? An Amish cycling association would probably frown on cortisone.


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