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The Therapeutic Use Exemption (TUE) process is a means by which an athlete can obtain approval to use a prescribed prohibited substance or method for the treatment of a legitimate medical condition.
Athletes should advise all medical personnel of their obligation to abide by the anti-doping rules of their sport and that any medical treatment received must not violate these rules.
When prescribed a substance or method, athletes should find out whether the medication is prohibited by checking the Global Drug Reference Online system at www.globaldro.co.uk.
If the medication is not prohibited, athletes can start using the prescribed medication or treatment.
If the medication is prohibited, athletes should check with their prescribing physician or the sport’s medical personnel to see if there are any alternative medications or treatments that are permitted.
If there are no permitted alternatives, athletes should contact their National Governing Body (NGB) or follow the guidance below to find out what type of exemption is required and if a TUE should be applied for prior to use or after doping control.
Only in emergency situations (such as an allergic reaction, exacerbation of asthma, or the onset of Bell's palsy) should treatment begin without the necessary approval.
For the beta-2 agonists and terbutaline, the following documentation is required:
• A complete and legible beta-2 agonist application form
• Lung function test results
See also the information below on carrying out a lung function test.
For all other substances and methods, a standard TUE form is required.
The following medical evidence is required:
• History of medical condition
• Evidence of diagnosis (such as hospital review letters, test results)
• Evidence of using alternative permitted medications.
The requirements vary depending on the level of the athlete. For advice on determining whether, and when, a TUE is required, use the guidance form When to apply for a TUE.
An athlete not required to apply for a TUE prior to competition can make a retrospective TUE application to UK Anti-Doping. This must be no later than ten working days following sample collection.
Even if an athlete is eligible to apply for a retrospective TUE, checks should be made with the prescribing physician that the criteria and medical evidence needed by the Therapeutic Use Exemption Committee (TUEC) can be met before the athlete uses any prohibited substance or method.
Where an athlete sends their TUE application depends on their sport and level of competition.
For the majority of sports, athletes competing at an international level will be required to submit their TUE application to the International Federation (IF) of their sport. National level athletes should submit their application to either their NGB or to UK Anti-Doping.
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Note: A TUE granted by the UK TUE Committee may not be accepted by the International Federation of their sport. It is the responsibility of the athlete to understand the expectation of the IF or event organiser prior to competing.
International Federations may have different requirements surrounding TUE applications. They may have a specific form and request different information. Athletes should make contact with their NGB anti-doping office in the first instance to seek advice on this process.
Medical evidence to justify the use of a prohibited substance or method must be attached to the application form. A TUE application without medical evidence will not be reviewed by the UK TUEC.
Keep a copy of the TUE application and proof that it has been sent.
Athletes need to prove they have a clinical need to use an asthma inhaler containing terbutaline.
Further information on TUEs for asthma is available here.
Those athlete requiring a TUE for substance used to treat hayfever must submit their applications in advance of treatment and provide medical evidence to justify therapeutic use.
An overview of the guidelines is available in the Resources section
Athletes are reminded to check any medications on Global DRO at www.globaldro.co.uk.