Step 1

Determine Medication Status

Research the medication to determine its prohibited status. The best way to do this is by using USADA’s Global DRO service. Substances will fall into one of three categories.


  1. Not Prohibited in- or out-of-competition (Stop Here – No TUE Required and No Further Action Needed)

  2. Prohibited in-competition and Not Prohibited out-of-competition (Continue to Step 2)

  3. Prohibited in- and out-of-competition. (Continue to Step 2)

USADA also makes available an athlete express email address and a drug reference phone line719.785.2000, staffed with an expert during business hours to help athletes understand prohibited substances.

Step 2

Determine your Competition Level

After determining that a substance is prohibited, an athlete should determine their competition level, as this status further effects whether or not a TUE is required. An athlete will be in one of two categories.

  1. International / National Level – An athlete is treated as an International/National Level athlete if he or she:

    – Is in an International Federation Registered Testing Pool, or has been in the past;
    – Is planning to compete in any event sanctioned by an International Federation, the IOC, the IPC, the USOC, or PASO;
    – Is planning to compete in a competition which immediately results in National Team selection for an Olympic, Paralympic, Pan or Para-Pan American Games, including Youth Olympic Games;
    – Is in the USADA Registered Testing Pool, or has been in the past;
    – Receives USOC funding;
    – Has ever tested positive in an anti-doping test;
    – Is planning to compete in an Elite-Level National Championship (Open category only. Youth, juniors, masters, or age-groupers- are non-nationals).

  2. Non-National – All Other Athletes

Step 3

Select Competition Level & Follow Directions For Corresponding Substance

International / National Level

For International/National Level athletes, as described in Step 2, a therapeutic use exemption is needed prior to using any prohibited substance or method. This applies to any prohibited substance, regardless of whether the substance is prohibited in-competition only or at all times.

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1) If the substance is prohibited only during competition, and not out-of-competition as well, then a TUE is not needed prior to competition.

2) If the substance is prohibited both in-competition and out-of-competition, then a TUE is needed prior to competition, except for the following substances.

  • Diuretics and masking agents

  • Inhaled Beta-2 agonists

  • Insulin (If diagnosed with insulin-dependent diabetes.)

  • Tamoxifen where the female Athlete can demonstrate use due to a diagnosis and treatment of breast or other cancers

  • An IV or injection of a non-prohibited substance greater than 50mL per 6 hours for rehydration

For these listed substances a TUE is not needed prior to competition.

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