THERAPEUTIC USE EXEMPTION (TUE)
WHAT IS A TUE?
- TUE is a permission to use medications or methods in the WADA Prohibited List for a legitimate medical condition without resulting in a doping offence.
WHAT ARE THE CRITERIA FOR GRANTING A TUE?
- The criteria are:
- The athlete would experience significant health problems without taking the prohibited substance or method
- The therapeutic use of the substance would not produce significant enhancement of performance
- There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method
- The requirement to use the substance or method is not due to the prior use of the substance or method without a TUE which was prohibited at the time of use
TO WHOM DO I APPLY FOR TUE?
- If you are an international-level athlete, apply to the TUE Committee of your International Federation
- If you are a national-level athlete, apply to the TUE Committee of the Philippine National Anti-Doping Organization (PHINADO)
WHAT DO I NEED TO APPLY FOR A TUE?
- TUE Application Form available at the PHI-NADO office – to be filled-up by the athlete and his/her doctor stating the diagnosis, the medications and the reason for the use of the prohibited medication.
- Supporting documents such the relevant laboratory tests and imaging studies should be included
WHEN DO I APPLY FOR A TUE?
- FOR SUBSTANCES PROHIBITED AT BOTH OUT-OF-COMPETITION AND IN-COMPETITION (Anabolic Steroids, Hormones, Growth Factors, Beta-2 Agonists and Diuretics)
- Apply as soon as the medical condition requiring the use of the prohibited substance or methods is diagnosed
- FOR SUBSTANCES PROHIBITED IN-COMPETITION ONLY (Stimulants, Narcotics, Cannabinoids, Glucocorticoids)
- Apply for TUE at least 30 days before the Competition unless it is an emergency or exceptional situation
I AM SICK. CAN I TAKE THE MEDICINES MY DOCTOR PRESCRIBES?
- Determine the status of your medication by checking the WADA Prohibited List at www.wada-ama.org or in apps like Global DRO at www.globaldro.com or by asking the doctors at MSAS or PHINADO
- If it is not included in the WADA Prohibited List, you can take the medicine.
- If it is included in the WADA Prohibited List, you need to apply for a TUE.
I HAVE ASTHMA. WHAT ARE THE MEDICINES THAT I CAN TAKE?
- Common medications given for Bronchial Asthma containing Salbutamol, Salmeterol, Formoterol, Budesonide and Fluticasone when given by inhalation, are not prohibited as long as they do not exceed specified limits, and do not require a TUE
- Other medications e.g. Procaterol, Vilanterol, Terbutaline, whether given orally or by inhalation, are prohibited.
I HAVE AN INJURY. CAN I TAKE PAIN RELIEVERS? MY DOCTOR WANTS TO GIVE ME AN INJECTION. IS IT OKAY?
- Pain relievers classified as NSAIDs like Mefenamic acid, Naproxen, Etoricoxib are allowed.
- Treatment with intralesional injection of steroids (e.g. Depo-Medrol) or parenteral administration of narcotic pain relievers (e.g. Nubain) for Musculoskeletal Injuries are not prohibited if given out-of-competition but would require a TUE if given in-competition.
I HAVE HYPERTENSION (HIGH BLOOD PRESSURE). AM I ALLOWED TO TAKE MEDICINES FOR HYPERTENSION?
- If your medication contains a diuretic (e.g. Hydrochlorothiazide), it is not allowed. You have to ask your doctor for an alternative drug.
- If your sports is Archery, Billiards, Golf, Shooting and other sports that require precision and accuracy, Beta-blockers e.g., Metoprolol, Atenolol and Carvidolol, are not allowed in-competition ( also out-of-competition for Archery and Shooting).
WHAT IF THERE IS AN EMERGENCY AND THERE IS NO TIME TO APPLY FOR A TUE?
- In cases of emergencies such as severe allergy or asthma attack or an accident requiring immediate blood transfusion, the doctor should proceed with the treatment as may deemed necessary and apply for a RETROACTIVE TUE immediately after.
CAN I TAKE DIETARY SUPPLEMENTS?
- Some dietary supplements can contain prohibited substances. Check the ingredients in the Supplement Facts on the label. If it has no prohibited substance and you trust the manufacturer, you use it at your own risk.
- Even if a supplement supposedly does not contain ingredients that are included in the prohibited list, an athlete may still test positive because the supplement (1) may be inadvertently cross-contaminated during the manufacturing process or (2) may have been intentionally mislabeled.
- An athlete may have inadvertently or unintentionally took a prohibited substance but under the Olympic’s rule of strict liability, he/she is responsible for whatever substance is found in his/her body
For any questions and clarifications, please contact us at the PHINADO office at the Sports Medicine Building, Philippine Sports Commission, M. Adriatico St., Manila.
TUE APPLICATION GUIDELINES
(Please read before filling up the TUE Application Form)
1. When completing the TUE Application Form, please make sure that the information written is legible, preferably typed or in block letters.
2. The supporting documents to be included in the medical file must confirm the diagnosis and justify the treatment given. It must include:
- a. Medical history and relevant physical examination
- b. Results of laboratory tests, imaging studies and other relevant diagnostic procedures
- c. If the doctor signing the TUE application is not the athlete’s attending physician, a medical abstract from the attending physician must be included.
3. WADA has made a list of TUE Physician Guidelines and Checklists for some of the medical conditions affecting athletes which can be accessed on www.wada-ama.org. If the TUE application is for any of the following medical conditions, please consult the Checklist provided in the website:
- a. Attention Deficit Hyperactivity Disorder
- b. Adrenal Insufficiency
- c. Anaphylaxis
- d. Asthma
- e. Cardiovascular Disorders requiring use of Beta-blockers
- f. Diabetes mellitus requiring use of Insulin
- g. Inflammatory Bowel Disease requiring use of Glucocorticoids
- h. Intravenous Infusions
- i. Male Hypogonadism
- j. Musculoskeletal Conditions requiring use of Glucocorticoids or Narcotics
- k. Neuropathic Pain requiring use of Narcotics or Cannabinoids
- l. Renal Transplantation
- m. Sinusitis/Rhinosinusitis requiring use of Pseudoephedrine or Glucocorticoid
- n. Intrinsic Sleep Disorders requiring use of Stimulants
- o. Transgender Athletes
4. Illegible and incomplete applications will be returned and need to be resubmitted.
5. Decisions are normally given within 21 days of receipt of all necessary documentation.
6. Always keep a copy of your TUE application form and medical file for your records.
7. If a TUE has been granted and the athlete has been chosen for a doping test, the athlete has to inform the Doping Control Officer so that the information can be included in the Doping Control Form.