Therapeutic Use Exemption: What It Is and How Athletes Use It

When an athlete needs a medication that’s banned in sports, they don’t just quit taking it—they apply for a Therapeutic Use Exemption, a formal permission that lets athletes use otherwise prohibited drugs for legitimate medical reasons. Also known as TUE, it’s not a loophole—it’s a regulated safety net for people with real health conditions.

A TUE isn’t something you can get just because you want an edge. It’s for conditions like asthma, diabetes, ADHD, or hormone deficiencies that require medication listed on the World Anti-Doping Agency’s banned list. For example, an athlete with asthma might need salbutamol inhalers, which are restricted in high doses. Or someone with hypothyroidism might need levothyroxine. Without a TUE, taking these meds could mean a suspension. With one, they can compete fairly while managing their health.

Getting a TUE isn’t easy. You need official diagnosis records, lab results, and proof that no allowed alternative works as well. The process varies by sport and country, but all follow the same rule: the drug must be necessary, not enhance performance beyond normal, and not create a health risk if used properly. Sports federations, national anti-doping agencies, and international bodies like WADA all review applications. A TUE isn’t a green light to abuse drugs—it’s a way to level the playing field for athletes who need medical care.

What you’ll find in the posts below are real-world examples of how TUEs connect to common medications athletes use. You’ll see how drugs like domperidone, dapoxetine, or even insulin are treated under anti-doping rules. Some posts dig into how these meds work in the body, what side effects they carry, and how doctors decide if a TUE is justified. Others compare alternatives—like which asthma inhalers are allowed without approval, or how to manage ADHD without stimulants. This isn’t about cheating. It’s about understanding the line between treatment and advantage—and how athletes stay clean while staying healthy.