Medical evidence you need to supply for the most common Therapeutic Use Exemption applications can be accessed from the list below. 

Direct your doctor to this information to complete your Therapeutic Use Exemption application.

A Therapeutic Use Exemption application cannot be processed unless all relevant medical evidence is provided. 

If your diagnosis is not listed below, select General Diagnosis.

 

On this page

    Table: WADA medical evidence for common TUE applications

    Diagnosis

    Application

    Checklist

    Physician

    Guidelines
    Adrenal Insufficiency Checklist Guidelines
    Anaphylaxis Checklist Guidelines
    Asthma Checklist Guidelines
    ADHD Checklist [PDF] Guidelines
    Cardiovascular conditions Checklist Guidelines
    Diabetes Checklist Guidelines
    Growth Hormone – Adults Checklist Guidelines
    Growth Hormone – Children and Adolescents Checklist Guidelines
    Infertility Checklist Guidelines
    Inflammatory Bowel Disease Checklist Guidelines
    Intravenous Infusions Checklist Guidelines
    Intrinsic Sleep Disorders Checklist Guidelines
    Kidney Failure and Kidney Transplantation Checklist Guidelines
    Male Hypogonadism Checklist Guidelines
    Musculoskeletal conditions: Cortisone/Corticosteroids Checklist Guidelines
    Polycystic Ovarian Syndrome Checklist Guidelines
    Sinusitis Rhinosinusitis Checklist Guidelines

    Acute Mountain Sickness

    Acetazolamide is a prohibited substance in- and out-of-competition under the World Anti-Doping Code as a S5 diuretic and masking agent.

    A number of high-altitude medical management guidelines (WEJM 2019, UIAA Medical Commission 2014, CJSM 2014, BMJ 2018) recommend the use of Acetazolamide (Diamox) for the prevention of Acute Mountain Sickness (AMS) in travellers under certain conditions such as in those with a past history of AMS, some pre-existing medical conditions or those who have a rapid ascent planned and are traveling to more than 2,500m.

    ASDMAC will consider a TUE application for the use of prophylactic (preventative) Acetazolamide for travellers to altitude where a supporting medical letter outlines any previous episodes of AMS, relevant medical conditions and includes an itinerary for flights and trekking or other activity at altitude.

    Athletes who become unwell at altitude with AMS, HAPE (high altitude pulmonary oedema) and HACE (high altitude cerebral oedema) are reminded of the importance of keeping medical records of any treatment received and if any substances prohibited under the WADA code are administered, athletes should apply for a retro-active TUE for “emergency treatment or treatment of an acute medical condition”.

     

    Cannabinoids

    Cannabidiol (CBD) is a non-psychoactive derivative of cannabis. As of 2018, WADA no longer lists CBD as a prohibited substance.

    Tetrahydrocannabinol (THC) remains a prohibited (banned) substance in-competition.
    Many cannabinoid products contain a mix of THC and CBD. There are also examples of THC contamination of products marketed as ‘pure’ CBD.

    Athletes prescribed CBD products by a Medical Practitioner for a documented medical condition, may be able to apply for a Therapeutic Use Exemption (TUE).

    Athletes who choose to take an over the counter or internet purchased (non-prescribed) CBD product, even when marketed as ‘pure’ CBD oil are cautioned about the risk of contamination and advised to consider use akin to the risk of a supplement.

     

    General Diagnosis

    This information covers the medical information required for anyone who needs a Therapeutic Use Exemption, but their diagnosis is not listed on the WADA or our website.

     

    Iron Infusions

    Iron is not prohibited by WADA but if the amount of fluid used to give the infusion is >100ml then a Therapeutic Use Exemption required. If less than 100ml is used then no Therapeutic Use Exemption is required. 

     

    Pain Management

    As of January 1st, 2024, Tramadol is prohibited In-Competition.

    Athletes may be eligible to apply for an in-advance Therapeutic Use Exemption (TUE) if they require Tramadol for a documented medical condition.

    Athletes and clinicians are reminded that if Tramadol is given within the 24 hours leading up to the In-Competition period (i.e. during the washout period), a sample collected In-Competition may result in an Adverse Analytical Finding (AAF).

    • In this scenario, the athlete may be eligible to apply for a retroactive TUE

    More information for athletes, athlete support personnel, clinicians and medical professionals can be found in the below factsheets created by the World Anti-Doping Agency (WADA):

     

    Transgender Athletes

    For gender diverse athletes it depends on the medication and level of competition if you need a Therapeutic Use Exemption

    Check your medication on Global DRO to determine if your medication is prohibited by WADA and therefore needs a TUE.

    If your medication is prohibited check your level of competition to determine whether you need a TUE in advance, or whether you can keep a medical file and apply retroactively (after the event) if needed.

    Note: A TUE does not determine whether you are 'eligible' to participate in a sport. A TUE is only about a medication exemption. Eligibility for sports participation based on criteria such as age and gender are determined by the sporting rules of the competition.

    Transgender Male to Female

    Transgender male to female athletes can apply for a TUE for prohibited substances, such as Spironolactone. Note: WADA documentation states that a TUE for Testosterone should not be approved for females.

    Transgender Female to Male

    Transgender female to male athletes can apply for a TUE for prohibited substances, such as Testosterone.