Therapeutic Use Exemptions (TUEs)

Since 2020, the management of TUEs is handled by the International Testing Agency (ITA). You can find all the necessary information on their website.

Athletes, like all people, may have illnesses or conditions that require them to take a particular medication/substance or undergo certain procedures/methods. If the substance or method appears on WADA’s List of Prohibited Substances and Methods, athletes must obtain a Therapeutic Use Exemption (TUE) in order to have the permission to participate in their sport.

A TUE is a certificate granted by an Anti-Doping Organisation (WBSC for International-Level Athletes, NADO for national-level athletes and MEO for athletes participating in an MEO event). The certificate is for a set prohibited substance, in certain dosages, with a limited period of validity.


All of the four following criteria must be met (for more details, please refer to the art. 4.1 of the WADA International Standard for Therapeutic Use Exemptions (ISTUE):


Athletes who are subject to anti-doping rules would need a TUE to take a prohibited substance or use a prohibited method. 

First, check if the required medication or method you intend to take or use appears on the Prohibited List.
Please refer to the Global Drug Reference Online (Global DRO), the online country-specific drug reference database. It provides athletes and support personnel with information about the prohibited status of specific medications based on the current World Anti-Doping Agency (WADA) Prohibited List.

You have the responsibility to inform your doctors that you are an athlete subject to doping control, and your doctors should check the Prohibited List whenever they prescribe a medication / method to you. If the substance / method is prohibited, check with your doctors if there are any alternative treatments that are not prohibited. If not, you must apply for a TUE. You should also not assume that all medical professionals who prescribe medication have a full understanding of anti-doping-related matters in their sport.

Remember, athletes have the ultimate responsibility regarding this process. Contact your NADO or ITA to if you are having difficulties.

Second, check your competition level to determine to which organisation and when to apply for a TUE.

If you are an International-Level Athlete ‒ defined as athlete who is part of the WBSC Registered Testing Pool and WBSC Testing Pool and/or who participates in select WBSC International Events as published by WBSC on its website ‒ you must apply for a TUE to WBSC in advance, as soon as the need arises.

For substances prohibited in-competition only, you should apply for a TUE at least 30 days before your next competition, unless one of the exceptions on retroactive TUEs apply.

In particular you must apply to WBSC if:

If you already have a TUE granted for national-level competitions by your NADO (in the list below *), that TUE is automatically valid for international-level competition and it is not necessary to apply to WBSC for recognition, provided that such exemption has been granted in accordance with Article 5.4 of the International Standard for TUE.

* NADOs with agreement with WBSC for TUE mutual recognition: USA, JPN, KOR, CUB, MEX, TPE, CAN, AUS, NED, PUR, NZL, ARG, CZE, HKG, ITA, GER.

If you aren’t an International-Level-Athlete and you have been tested by WBSC, WBSC recognises a valid TUE granted by your NADO (i.e., it satisfies the ISTUE criteria for granting a TUE); unless you are required to apply for recognition of the TUE because you are competing in an international event.

If you are not a National-Level-Athlete as defined by your NADO and you have been tested by WBSC, you must apply for a retroactive TUE to WBSC. 


Athletes should submit their TUE application together with the required medical file via ADAMS.

If you don't have an ADAMS account yet, please contact to have your account set up.

If you have any challenges to send the form via ADAMS, please contact WBSC to and attach the following form filled in all its parts.

The TUE application must be submitted in English or French and in legible capital letters or typing. However, if you need any assistance, do not hesitate to contact us at the e-mail address previously indicated.

The medical file must include:

If the medical file is not in English or French, a summary explaining, in English or French, the key elements of the diagnosis, clinical examinations, medical tests and treatment plan must be provided.

Any TUE application that is not complete or legible will not be dealt with and will be returned for completion and re-submission.

To assist you and your doctor in providing the correct medical documentation, we suggest consult the WADA’s Checklists for TUE applications for guidance and support, and Medical Information to Support the Decisions of TUECs for guidance on specific common medical conditions, treatments, substances, etc.

Keep a complete copy of the TUE application form and all medical information submitted in support of your application, and proof that it has been sent.

For further information, please refer to your treating physician, consulting the Resources List that includes several documents regarding specific medical needs.

Each TUE application will be carefully evaluated by ITA and will only be granted in accordance with the International Standard for TUE criteria laid out in article 4 of the International Standard for Therapeutic Use Exemption (ISTUE). If the exemption is granted, the athlete will then be permitted to use the medication during the period of validity of the TUE without committing an Anti-Doping Rules Violation (ADRV).

WADA’s role in the TUE process is two-fold:


Athletes selected for doping control must declare in its form systematically (i.e. regardless of the presence of a TUE) the use of all prescribed and over-the-counter medications as well as supplements taken in the last 7 days and any blood transfusions in the 3 months prior to blood samples.

Important notes:

Using a prohibited substance before being granted a TUE could result in an Adverse Analytical Finding and a potential Anti-Doping Rule Violation.

In case an application for a retroactive TUE is necessary following sample collection, you are strongly advised to have a medical file prepared and ready to submit for evaluation.

WADA hosted on 22th and 23th April 2021 the TUE Virtual Symposium. Please find the report about these seminars.


Extreme caution is recommended regarding supplement use.

For more information please consult the dedicated section.

For more detailed information, please consult: