Peptides in South African Sport: BPC-157, TB-500 and the 2026 WADA Rules

Why the distinction matters in South Africa

The South African Institute for Drug-Free Sport (SAIDS) publishes the WADA Prohibited List and related athlete guidance for the South African sporting system. The 2026 list took effect on 1 January 2026 and divides substances by class and by whether they are prohibited at all times or only in competition.^1,2

A second document—the Monitoring Program—serves a different purpose. Under Article 4.5 of the World Anti-Doping Code, it covers substances that are not on the Prohibited List but that WADA wants to observe for patterns of misuse in sport.^3,4 Treating “monitored” and “prohibited” as synonyms produces the wrong answer.

Where common peptide names sit in the 2026 rules

The table answers an anti-doping question, not whether any product is safe, effective, registered by SAHPRA or appropriate for a particular person. It also does not determine whether a supplement or compounded preparation contains what its label claims.

Monitoring semaglutide and tirzepatide is not a ban

The 2026 Monitoring Program specifically lists markers of semaglutide and tirzepatide for monitoring in and out of competition.³ The Code describes the Monitoring Program as covering substances that are not on the Prohibited List but that WADA wishes to observe. On the documents reviewed, that means the monitoring entry is not itself an anti-doping prohibition.

That narrow conclusion should not be stretched into a medicine-safety claim. SAHPRA, SAPC and HPCSA issued a Class I recall warning in July 2026 for specified iDEXIS semaglutide, tirzepatide and combination products. The warning did not recall every product containing those molecules, but it demonstrates why athletes must separately verify the exact finished product, prescriber, pharmacy, batch and regulatory status.¹⁰

Anti-doping status, medicine registration and evidence are separate

The S0 catch-all makes name-only searches risky

S0 is broader than a list of named examples. It covers pharmacological substances not dealt with elsewhere in the list that are not currently approved by a governmental regulatory health authority for human therapeutic use. The 2026 document names BPC-157 as one example, but the wording means an athlete cannot safely infer that a new experimental peptide is permitted merely because its name is absent from the index.²

Retatrutide illustrates the problem. Lilly continued to describe it as investigational in its May 2026 Phase 3 announcement.¹¹ This article does not issue a binding anti-doping determination for retatrutide; it flags why an athlete should obtain a current written answer from SAIDS rather than rely on search results or a supplier's interpretation of S0.

A safer pre-use workflow for athletes and support staff

1. Identify every active ingredient, salt, ester, blend component and route of administration. Do not search only the front-label product name.
2. Check the current WADA Prohibited List and Monitoring Program linked by SAIDS. Confirm whether the rule applies at all times, only in competition, to a specific sex or sport, or to a particular route.^1–3
3. Use SAIDS' medication-check resources and request a written answer when the substance is experimental, compounded, newly marketed or not clearly returned by the checker.⁷
4. If a prohibited medicine is medically necessary, review the SAIDS TUE pathway before use. The applicable athlete category affects whether an application is required in advance; a prescription is not automatically a TUE.^5,6
5. Verify the medicine separately through SAHPRA and the authorised healthcare supply chain. Anti-doping permission does not validate an unregistered or recalled product.^9,10
6. Keep the prescription, dispensing record, package, batch details and written status/TUE correspondence. Never treat a screenshot of a database search as permanent clearance.
7. Avoid assuming that a supplement is low-risk because it is sold legally. SAIDS warns that supplements can contain prohibited substances that are undeclared or appear under alternative chemical names.⁸

Responsibility does not move to the seller

The World Anti-Doping Code uses strict-liability principles for the presence of a prohibited substance or its markers in an athlete's sample. In practical terms, a seller's assurance, a coach's suggestion or a product label does not transfer the athlete's anti-doping responsibility.⁴ Questions of intent or fault can matter later in a case, but they are not required to establish every presence violation.

For peptides and novel body-composition products, the safest decision point is therefore before exposure: exact ingredient identification, current status verification, medical review, and a completed TUE process where required—not retrospective interpretation after a test.

What this analysis can and cannot establish

• It maps named substances to the 2026 WADA classes published through SAIDS.
• It distinguishes the Prohibited List from the Monitoring Program.
• It does not decide an individual athlete's eligibility, TUE, sanction, diagnosis or treatment.
• It does not imply that monitored substances are approved, safe or suitable.
• It does not convert preclinical peptide research into a human performance or recovery recommendation.