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.
Do you need a TUE?
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.
When to Apply for a 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.
What Type of Exemption to Apply for?
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:
- i. inhaled salbutamol when taken in dosages of less than 800 micrograms in any 12 hour period
- ii. inhaled formoterol when taken in dosages of less than 54 micrograms in any 24 hour period
- iii. inhaled salmeterol when taken in dosages of less than 200 micrograms in any 24 hour period
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:
- A complete and legible beta-2 agonist TUE application form
- Lung function test results
- Justification from the prescribing physician as to why permitted alternatives cannot be used
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:
- History of medical condition
- Evidence of diagnosis (such as hospital review letters, test results, examinations and investigations)
- Evidence of using alternative permitted medications
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.
Download a copy of the UK Anti-Doping TUE application form
Download a copy of UK Anti-Doping's Asthma TUE application form
Download a copy of the TUE criteria
Download a copy of the UK Anti-Doping ADHD application form
For further assistance please contact us by phone +44 (0) 207 842 3450 or send us an email
Where to Send a TUE Application
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.
2-6 Salisbury Square
London EC4Y 8AE
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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.
Hay Fever Advice
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.
Exacerbation of Asthma Advice
Guidance on applying for a TUE for the use of oral prednisolone following the exacerbation of asthma is available here.
Attention Deficit Hyperactivity Disorder (ADHD)
Athletes requiring a TUE for a prohibited substance to treat ADHD should be familiar with the following documents:
Q: My diagnosis of ADHD following the performance of a diagnostic schedule was several years ago and I’m unable to retrieve a copy of these records, what should I do?
A: Please contact the clinic where the diagnosis was made as it is likely that these records have been stored. In the event that you are still unable to retrieve these records, the UKAD TUE Committee may request that an updated diagnostic schedule is performed to support your TUE application or TUE renewal.
Q: I have already attended my annual review appointment but the review letter does not meet the new requirements for renewing my TUE, what should I do?
A: Please submit a completed ADHD TUE application form alongside a copy of your most recent specialist review letter. The UKAD TUE Committee will assess your renewal application and will be able to confirm which additional medical evidence is required to grant a long-term TUE. A short-term TUE may be able to be granted whilst you obtain any missing medical evidence.
Q: I’m no longer under the care of a specialist and my GP prescribes my ADHD medication, what should I do?
A: Please contact UKAD if you are experiencing difficulties in obtaining a specialist review as we may be able to assist by providing you with a list of psychiatrists who you could approach.
Q: What is the process for accessing a psychiatrist on the UKAD Register?
A: UKAD will be able to provide you with the contact details of a psychiatrist who is able to offer a review session within a short period of time. The costs incurred for such a review are the responsibility of the applicant.