UFC IV ban: Has any fighter ever been suspended for IV infusion?

Islam Makhachev has been accused of receiving IV infusion (intravenous) treatment before his UFC 284 fight with Alexander Volkanovski. Makhachev retained the UFC lightweight title with a narrow decision victory over featherweight champion Volkanovski in Perth, Australia, at the recently concluded UFC 284 pay-per-view event.

However, the Russian has been accused by Volkanovski's teammate Dan Hooker of cheating in order to recover from his pre-fight weight cut. Several UFC fighters have been banned in the past for IV infusion treatment, which has been illegal since USADA became the UFC's anti-doping partner in 2015.

In March 2016, UFC legend B.J. Penn was handed a six-month suspension by USADA for the illegal use of an IV infusion treatment. Penn was expected to return from a two-year retirement to face Cole Miller at UFC 199, but he acknowledged the offense voluntarily in May 2016. Since this regulation did not exist when he last competed in 2014, he claimed ignorance of it.

In 2017, Brazilian middleweight contender Paulo Costa was suspended for six months for use of intravenous infusion (IV) twice. After weighing in for UFC 212 in Rio de Janeiro, Brazil, on June 2, 2017, Costa allegedly got an intravenous infusion (IV) of approved substances, including saline solution and stomach medicine, totaling more than 100 ml during a 12-hour period. The same year in November, after a weigh-in for UFC 217 in New York, the act was repeated.

While most UFC fighters are not allowed to re-hydrate through intravenous procedures after weigh-ins, Donald Cerrone has claimed in the past that he received an exemption. The Colorado native said the UFC allowed him to use an IV after weigh-in because he is "missing 50 feet of intestines and half a stomach" and cannot rehydrate as quickly as other fighters.

According to Thomas Hauser of SBNation, the United States Anti-Doping Agency (USADA) conducted a surprise drug test on Floyd Mayweather Jr. the day before his highly anticipated fight against Manny Pacquiao and found evidence of an illegal IV being used on the fighter.

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Why is IV infusion treatment illegal?

In an intravenous injection or IV infusion, a needle is used to inject a substance directly into a vein. The MMA community was divided when the ban was introduced in 2015.

USADA rules ban IV infusions if the volume of the substance administered exceeds 100 milliliters in a 12-hour period. Regardless of the substance's legality, the decision stands, and the restriction focuses on the method and quantity of use.

Nonetheless, if an athlete requires an IV, a Therapeutic Use Exemption permits them to not only use the mode of treatment but also exceed the limit. By applying two TUEs, one for the prohibited substance and one for the excess volume, the exemption can be broadened to include prohibited substances.

Intravenous fluids are not allowed since they assist athletes in improving their performance and recovering faster by raising their plasma levels. They can also alter an athlete's biological passport.