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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 DRO. If the medication is not prohibited, athletes can start using the prescribed medication or treatment.
1) Check to see if any medications you are using are prohibited on Global DRO. If the medication is not prohibited, you can start using the prescribed medication or treatment.
2) If the medication is prohibited you should check with your prescribing physician to see if there are any alternative medications of treatments that are prohibited.
3) If it is prohibited and there are no permitted alternatives, you now need to work out if you need a TUE in advance or a retroactive TUE.
To find out whether you are required to hold a TUE in advance or not see the When to Apply for TUE section.
An athlete not required to apply for a TUE prior to competition can make a retroactive TUE application to UK Anti-Doping. Any athlete requiring a retroactive TUE has five days post the receipt of an adverse analytical finding (AAF) to submit a retroactive application. Typically an athlete will receive a letter by courier to confirm an AAF and inform them of the requirements to apply for a retroactive TUE for the prohibited substance detected in their sample. The NGB or UKAD may also contact the athlete to make them aware that this correspondence is on its way, in relevant circumstances.
We encourage any athlete who has been tested, without a TUE in place who may require one, to contact UKAD to discuss the process to better understand their rights and responsibilities. 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.
TUEs related to beta-2 agonist medication to treat asthma
Inhaled beta-2 agonists are prohibited at all times and require a Therapeutic Use Exemption (TUE), except for:
Inhaled terbutaline and inhaled indacterol are prohibited when taken in any dose and therefore require a TUE.
The following documentation is required to support a TUE application related to the use of prohibited beta-2 agonist medication to treat asthma:
Athletes should check Global DRO for confirmation about the prohibited or permitted status of their asthma medication.Standard TUE
For all other substances and methods, a standard TUE form is required.
The following medical evidence is required:
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 UKAD TUEC.
Keep a copy of the TUE application and proof that it has been sent.
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 UKAD TUE Committee may not be mutually recognised by International Federations (IF) and other Major Event Organisers (MEO). It is the responsibility of the athlete to check if their IF will recognise an existing TUE granted by UKAD.
Those athletes requiring a TUE for a prohibited substance used to treat hay fever must submit their applications in advance of treatment and provide medical evidence to justify their therapeutic need.
For further details on TUE applications for the treatment of hay fever, please see our Hay Fever Guidelines. Athletes are reminded to check any medications on Global DRO.
Guidance on applying for a TUE for the use of oral prednisolone following the exacerbation of asthma is available here.