A TUE is a certificate granted by an anti-doping organization (International Testing Agency 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. An application for a TUE must be based on a documented medical condition and diagnosis and the TUE will only be granted under strict criteria laid out in the International Standard of TUEs.

Athletes must absolutely avoid taking a medication with a prohibited substance without a valid TUE.

The presence of a prohibited substance or its metabolites or markers in an athlete’s sample without a valid TUE is an Anti-Doping Rule Violation (ADRV), as are the use or attempted use of a prohibited substance or a prohibited method, possession, administration or attempted administration.

Athletes must therefore consult the Prohibited List with their prescribing physician before taking a medication to ensure that no prohibited substance is contained in the medication needed.

An International-Level Athlete whose illness or condition requires treatment with a prohibited substance or method must apply to the ITF for a TUE following the ITF’s strict TUE application procedure.

The following Athletes shall be considered to be International-Level Athletes for purposes of ITF Anti-Doping Rules, and therefore the specific provisions in ITF Anti-Doping Rules applicable to International-Level Athletes (as regards Testing but also as regards TUEs, whereabouts information, results management, and appeals) shall apply to such Athletes:

• A. Athletes who hold the following licence: Global Athletes Licence (GAL) ;
• B. Athletes that compete in Events organized by the ITF or where the ITF is the ruling body;
• C. All Athletes in the ITF Registered Testing Pool and Testing Pool

TUE Application form

Each TUE application will be carefully evaluated by the ITA’s Therapeutic Use Exemption Department and will only be granted in accordance with the International Standard for TUEs and the criteria laid out in article 4 of this standard.

If the TUE 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).

Regardless of whether a TUE has been granted or not, athletes should always declare on the doping control forms filled out during sample collection any medications and supplements taken within the seven days prior to sample collection, and any blood transfusions in the three months prior for blood samples.

WADA’s role in the TUE process is two-fold. First, the Agency, through its TUEC, has the right to monitor and review any TUE granted by an ADO and, following such review, to reverse any decision. Second, an athlete who submits a TUE application to an ADO (ITA, ITF or NADO) and is denied a TUE, can ask WADA to review the decision.

If WADA determines that denial of the TUE did not comply with the ISTUE, the Agency can reverse the decision. WADA itself does not accept TUE applications from athletes.

Athletes are responsible to renew their TUEs before the expiration date

National-Level Athletes are to apply to their National Anti-Doping Organizations (NADO) for a TUE

list of NADOs
WADA’s webpage on TUEs
WADA’s Q&A on TUEs