Skip to main content

Text size:

Page Colour

Clean sport / Medications and TUEs

Medications and Therapeutic Use Exemptions

What is a Therapeutic Use Exemption (TUE)?

Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorisation to take the needed medicine.

IWAS TUE Application Criteria

IWAS has the jurisdiction on the following athletes, who must submit an application for TUE in IWAS when such a necessity arises:

  • all international level athletes in Wheelchair Fencing according to articles 4.4.3; 13.2 of World Anti-Doping Code 2021;
  • all international level athletes in Powerchair Hockey according to articles 4.4.3; 13.2 of World Anti-Doping Code 2021;
  • the athletes, who to take part in IWAS official international competitions (IWAS World Games, IWAS World Youth Games, IWAS World Women Games and etc.) according to articles 4.4.4; 13.4 of. World Anti-Doping Code 2021

When should an athlete apply for a TUE?

  • When an athlete is advised by their medical doctor or specialist that they require a Prohibited Substance to treat their medical condition or illness and has supporting medical evidence to prove this.
  • When an athlete is administered a prohibited substance in a medical emergency. In this case the athlete is required to apply retroactively for a TUE. This will only be granted in emergency or exceptional circumstances where there was insufficient time to submit to the TUE committee to consider an application prior to doping control.
  • In addition to the circumstances outlined in (a) and (b) above an athlete should submit a TUE application alongside with supporting medical documentation to his/her IF or NADO when they meet the required criteria.

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, and
  • There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method.

Who grants a TUE?

TUE applications will be reviewed by the TUE Committee (TUEC) of the relevant organization. If the TUE is approved

  • A TUE Certificate will be issued.
  • You can only begin treatment from the start date of approval mentioned on the TUE Certificate.

Where to submit a TUE?

Non-IWAS Sport – Contact your International Federation

IWAS Sports (i.e. wheelchair fencing & powerchair hockey)

  • National Athletes should contact their own National Anti-Doping Agency.
  • International Athletes should contact IWAS at: [email protected]

Applications for TUE should be made by the following ways

  • Contact your National Federation (NF), International Federation (IF) or National Anti-Doping Agency (NADO)
  • Ask the relevant organisation for the TUE Application Form to be used.
  • Consult your physician and ask him/her; to fill out the TUE Application and ask them to provide the required supporting medical documentation.
  • Forward the TUE application and medical documentation to your IF or NADO Please ensure all files are readable and complete in English.

How do I know if my application has been approved?

The athlete through their National Member Organisation will receive confirmation from the relevant TUE Committee whether a TUE application has been approved. If approved, a certificate will be issued.

IWAS endorses the principle of mutual recognition of TUEs under the following conditions.

  • The certificate is issued by a World Anti-Doping Code complaint agency
  • IWAS Sports (i.e. powerchair hockey, wheelchair fencing) athletes exclusively apply to IWAS for TUE
  • Athletes have the right to request WADA to review the decision made by the IF or NADO

Approval times are stated on the TUE certificate and athletes need to seek further approval prior to the expiry date.

Recognition of other TUEs by IWAS

If the athlete already has TUE, which is issued by his National Anti- Doping Organisation or the International Federation, and if this TUE meets the criteria of the International Standard for Therapeutic Use Exemptions (ISTUE), IWAS recognizes these TUE.

In this case, the athlete should submit his existing TUE given by IF or NADO to IWAS alongside with supporting medical documentation for consideration of recognition by TUE Committee.

If IWAS does not consider a TUE issued to an athlete satisfying the criteria of the ISTUE, IWAS refuses to recognize this TUE, informs the Athlete and his National Anti-Doping Organization on this and requires the Athlete to apply to IWAS TUE Committee for TUE.

Notification for doping control whilst using a prohibited substance under a granted TUE?

When completing the substance control form ensure declaration of the substance or medication being used if specified and declare that a TUE has been granted.

When the doping control authority receives the report from the laboratory an initial review will take place to verify that the TUE is still in effect and that the results of the analysis are consistent with the TUE granted (nature of substance, route of administration, dose, time frame of administration), the result of your test will be recorded as negative.


Athletes concerned about confidentially should note that all the information contained in their TUE application will be kept strictly confidential as medical data. All members of the TUE Committees are required to sign confidentiality agreements and if they require advice from other scientific experts on a particular case, the name of the athlete will not be used when circulating the application outside the TUE Committee.

Where can I find more information?

The WADA International Standard for TUEs can be viewed here.

This is an educational guide only. In the event of any inconsistency the IWAS Anti-Doping Code shall take precedence.

IWAS Therapeutic Use Exemptions (TUEs)
Provision of Information to Participants Download
TUE Application Form Download