Therapeutic Use Exemptions (TUEs)

Since 2020, the management of TUEs is handled by the International Testing Agency (ITA).

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 the Prohibited List, 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):


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.

You have the responsibility to inform your doctors that you are an athlete subject to doping control and they should check the Prohibited List whenever they prescribe a medication or method to you: if it is prohibited, check with your doctors if there are any alternative treatments, otherwise you must apply for a TUE.
You should also assume that all doctors have not 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* you must apply for a TUE to WBSC in advance, as soon as the need arises. The International Level Athlete is defined as:

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

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.

To assist you and your doctor in providing the correct medical documentation, we suggest consulting 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.
For further information, please refer to your treating physician, consulting the resources list that includes several documents regarding specific medical needs.

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

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


Any change in substance, dosage, route of administration and/or frequency requires the submission of a new TUE application (ISTUE Art. 6.12).
In case of persistence of the medical condition, it is the athlete’s responsibility to apply in advance for renewal of the present TUE prior to its expiry date.

Athletes selected for doping control must always declare in its form (with or without 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: