Substances subject to restricted authorization and reporting requirements
Therapeutic Use Exemptions (TUE)
The therapeutic use of medications containing substances listed on the Prohibited List is clearly regulated by the anti-doping regulations of the World Anti-Doping Agency (WADA) and the international sports federations. Certain substances on the Prohibited List are specifically permitted for the treatment of asthma and allergies.
At this point, reference should be made only to the WADA regulations. As a general rule, international sports federations adapt their rules to comply with WADA guidelines, although minor deviations are certainly possible.
The following substances may be used for therapeutic purposes:
- β2-agonists: For the treatment of asthma and exercise-induced asthma, the β2-agonists salbutamol, formoterol, and salmeterol are permitted as inhaled preparations. Their use does not need to be reported. However, the administered amount of salbutamol must not exceed a maximum dosage of 1,600 micrograms over 24 hours, and for formoterol, 54 micrograms over 24 hours. Use of all other β2-agonists requires a TUE.
- Corticosteroids: are not prohibited when administered locally (e.g., by inhalation). They are prohibited when administered orally, intravenously, intramuscularly, or rectally.
In principle, a TUE may be requested for all other substances as well as for the prohibited uses of corticosteroids. However, these are generally only approved when medically necessary and when no alternative medications are available. For example, in the case of diabetes, a TUE is typically issued following certification by a physician.
Medical exemptions must be applied for at the relevant anti-doping agencies; in Germany, for example, at the National Anti-Doping Agency (NADA).
TUE is the abbreviation for Therapeutic Use Exemptions.
Institute of Biochemistry at DSHS Cologne, October 2013