Athletes 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 authorization to take the needed medicine.

The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is to ensure that the process of granting TUEs is harmonized across sports and countries.


Medical Information to Support the Decisions of Therapeutic Use Exemption Committees (TUECs) have been developed as part of the World Anti-Doping Program. It is based on the World Anti-Doping Code (Code) and on the International Standard for TUE (ISTUE).

This information should be read in conjunction with the principles set out in the ISTUE regarding the granting criteria for TUEs (Article 4.1 to 4.3). The objective is to guide and assist TUECs in the decision making process for TUE applications and are not mandatory documents.

These documents are “living documents” and will be updated as necessary based on the evolution of medical best practice. Pathologies covered at this stage are the most current ones encountered in the TUE field. This is not an exclusive list and TUEs for any other medical condition may be considered based on the principles of the ISTUE.

The following Medical information documents (also called TUE Physician Guidelines) are grouped under the Medical information documents Collection .


International level athletes must apply directly with WAKO IF, using the application template attached below.
All the required documents can be sent by fax at +39 039 2328901 or by e-mail at

National level athletes must apply for a TUE to the NADO of their homecountry. WAKO will automatically recognize any TUE granted by any NADO declared compliant by WADA, in accordance with Article 7.1 (a) of World Antidoping Code.
TUE granted by a Non-compliant NADO will have to be submitted to WAKO for recognition, in accordance with Article 7.1(b).

Definition of National and International Athlete (WAKO Antidoping Rules, page 3):

“Within the overall pool of Athletes set out above who are bound by and required to comply with these Anti-Doping Rules, the following Athletes shall be considered to be International-Level Athletes for purposes of these Anti-Doping Rules, and therefore the specific provisions in these 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:

1. International Level Athlete is:

a. An Athlete who is National Champion in that given year and subsequent years where he/she is the official national Champion as recognized by the WAKO National Governing Body.

b. An Athlete who has competed in a WAKO World Cup, or A/B class event in the last two years as defined in the WAKO Calendar.

2. National Level Athlete is:

A registered competitor who participates or has participated in local and regional events within their country in the last two years.”