Therapeutic Use Exemptions (TUEs)

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As an athlete, you may have an illness or medical condition that requires a particular medication. If this medication contains a substance or requires an administration method that is on the List of Prohibited Substances and Methods (List), you may apply for a Therapeutic Use Exemption (TUE). A TUE allows you to use the medication or method as it will not afford you a competitive advantage, but rather ensure you can compete in a proper state of health.

A TUE ensures that athletes can be treated for medical conditions - even if the treatment involves using a prohibited substance or method – while avoiding the risk of being sanctioned.

Before taking any medication, as an athlete you must check the status on the List or with your anti-doping organization (ADO). If the substance is prohibited, you will need to follow the process to apply for a TUE. 

TUE Application Process

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    WADA outlines the rules and the process, hears appeals, and audits TUE applications. Athletes do not apply to WADA for a TUE.

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    When to apply

    Athletes should apply for a TUE as soon as possible after being prescribed the medical substance or route of administration. If the substance is prohibited in-competition only, be sure to apply at least 30 days before competition.

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    What to submit and where to send the application

    Physicians are responsible for completing the TUE form and providing the required supporting information. Applications can be completed directly in WADA’s Anti-Doping Administration Management System (ADAMS) or using an electronic or paper form that is submitted to the athlete’s ADO. TUEs can only be submitted to one ADO.

    WADA provides a series of checklists to ensure that all supporting documentation is included with the application.

    National-level athletes must apply to their National Anti-Doping Organization (NADO). International-level athletes must apply to their International Federation (IF).

    ADOs decide how they define what a national-level or international-level athlete is. Athletes should verify with their ADO before applying for a TUE.

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    What happens after the application is submitted

    TUE applications are reviewed by an ADO’s Therapeutic Use Exemption Committee (TUEC). ADOs must render a decision within 21 days of receiving a complete application.

    Athletes will receive a TUE certificate or letter from their ADO with details about their decision.

    • If the TUE is granted, details about dosage, frequency, route of administration and duration will be provided. Should any of the conditions change, for example, change to dose, change in route of administration or duration, the athlete must inform the ADO that has approved the TUE.
    • If a TUE is not granted, the ADO will explain why. The athlete can request to have the decision appealed. National-level athletes wanting to appeal the decision must apply to the relevant national appeal body in their country. International-level athletes can appeal at the Court of Arbitration for Sport (CAS) or ask WADA to review. WADA can refuse to review, except in cases where there is a disagreement between the relevant IF and NADO with regards to the status of the TUE.

Learn more on ADEL

Visit WADA's Anti-Doping Education and Learning (ADEL) platform to learn more. On ADEL, you will find eLearning courses and programs that provide in-depth information on TUEs for athletes and your support personnel as well as a guide entitled At-a-Glance: Therapeutic Use Exemptions.