International Standard for Therapeutic Use Exemptions (ISTUE)

The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is to establish:

1. the conditions that must be satisfied in order for a Therapeutic Use Exemption (or TUE) to be granted, permitting the presence of a prohibited substance in an athlete’s sample or the athlete’s use or attempted use, possession and/or administration or attempted administration of a prohibited substance or prohibited method for therapeutic reasons;
2. the responsibilities imposed on Anti-Doping Organizations in making and communicating TUE decisions;
3. the process for an athlete to apply for a TUE;
4. the process for an athlete to get a TUE granted by one Anti-Doping Organization recognized by another Anti-Doping Organization;
5. the process for WADA to review TUE decisions; and
6. the strict confidentiality provisions that apply to the TUE process

The current version of the ISTUE went into force on 1 January 2023.

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