Therapeutic Use Exemption (TUE) certificates demonstrate that the anti-doping authorities have permitted you to use a prohibited substance for medical purposes.
Any player who is eligible for drug testing in the UK or abroad will need to apply for a Therapeutic Use Exemption (TUE) if they are prescribed a prohibited substance or prohibited method by their doctor to treat a legitimate medical condition. The process is in place to protect the rights of players to compete on a level playing field.
Before applying for a TUE, you should check with your doctor to see if there are any alternative, permitted treatments or medications. If there are not, you will need to apply for a TUE according to the information and process outlined below.
To find out if the medication you have been prescribed is banned in sport, visit the Global Drug Reference Online website. If it is, you must apply for a TUE. You can download an application form (and guidance documents) from the UKAD website.
Club doctors can help you complete the form, but you must ensure that you are happy with the contents before you sign it. It is ultimately your responsibility, in line with the principles of strict liability, to ensure that the form is lodged correctly – and that you receive the TUE certificate stating that the TUE has been granted.
Asthma & Other Breathing Problems
Many asthma medications are Prohibited Substances, so all players need to seek advice before making any decisions.
Players need to be aware that there are upper limits for salbutamol, salmeterol formoterol and inhaled vilanterol. If these limits are exceeded players may be charged with an Anti-Doping Rule Violation.
The limits for salbutamol are a maximum of:
· 1600 microgrammes over 24 hours; and
· 600 microgrammes over 8 hours.
Salbutamol inhalers commonly dispense either 100 or 200 microgrammes per puff/inhalation, therefore this 600 microgramme allowance equates to either three or six puffs per 8-hour period.
The limit for formoterol is 54 microgrammes over 24 hours.
Salmeterol has a maximum allowable amount permitted over 24 hours as 200 microgrammes. If a player requires more than 200 microgrammes per day, UKAD should be consulted as it may be necessary to apply for a TUE.
Inhaled vilanterol has been introduced into the 2021 code. It is permitted to inhale up to 25 microgrammes over a 24-hour period. Exceeding this dosage is prohibited.
The dose administered per puff/inhalation varies between inhalers. You should check the product information leaflet that comes with the inhaler to establish the dose per puff/inhalation.
If the presence of these substances found in urine samples exceeds the respective limits, it will be presumed not to have been because of therapeutic use. It will instead be considered an ‘Adverse Analytical Finding’. This means that you will have to prove (through what is known as a controlled pharmacokinetic study) that the abnormal result was caused by you inhaling a therapeutic dose up to the maximum indicated above.
Poor administration technique or poorly controlled asthma could contribute to such abnormal urine findings. However, such a result will lead to an Anti-Doping Rule Violation hearing following which sanctions, including a suspension of up to two years, may be applied.
Players not Regularly Subjected to Testing
Players who are not regularly subject to testing (e.g. trialists) are not normally required to submit TUE applications. If you are tested at random, and you are using a prohibited substance for a legitimate medical condition, you should submit a TUE application straight away.
You should also inform the Doping Control Officer at the time of the test that you need to apply for a TUE. A fully completed TUE application needs to be received by UKAD no later than five working days after the test is completed (see mailing details above).
For further information or to download a T.U.E application form, please log on to www.ukad.org.uk