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According to International Standard for Therapeutic Use Exemptions an athlete may use a prohibited substance or prohibited method if he or she was granted a Therapeutic Use Exemption (TUE).

An athlete who is not an international-level athlete should apply to RUSADA for a TUE. An Athlete who is an International-Level Athlete should apply to his or her International Federation.

A TUE request to RUSADA must be submitted by those athletes who question the prohibited substance or prohibited method due to medical conditions and who are national-level athletes according to All-Russian antidoping rules (athletes who compete at national level championships and any other national sport competitions organized by all-Russian sport federation unless mentioned athletes belong to international-level athletes according to criteria set by his or her international sport federation).

International-level athletes as they are defined by each international sport federation must submit a TUE application to his or her international federation.

Those athletes who are not an international-level or national-level athletes are not obliged to submit a TUE application form prior to competition and may apply for a retroactive TUE in 5 working days after notification of an adverse analytical finding.

TUE application form should comply with the International Standard for Therapeutic Use Exemptions and all-Russian antidoping rules, which are in force at the moment of application.

TUE application form should be accompanied by a comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible) and the results of all examinations, laboratory investigations and imaging studies relevant to the application.

Criteria to be granted a TUE:

- The Prohibited Substance or Prohibited Method in question is needed to treat an acute or chronic medical condition, such that the Athlete would experience a significant impairment to health if the Prohibited Substance or Prohibited Method were to be withheld.

- The Therapeutic Use of the Prohibited Substance or Prohibited Method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the Athlete’s normal state of health following the treatment of the acute or chronic medical condition.

- There is no reasonable Therapeutic alternative to the Use of the Prohibited Substance or Prohibited Method.

- The necessity for the Use of the Prohibited Substance or Prohibited Method is not a consequence, wholly or in part, of the prior Use (without a TUE) of a substance or method which was prohibited at the time of such Use.

An athlete who needs to use a prohibited substance or prohibited method for therapeutic reasons must obtain a TUE prior to using or possessing the substance or method in question. An athlete who needs a TUE should apply as soon as possible. For substances prohibited in-competition only, the athlete should apply for a TUE at least 30 days before his/her next competition.

An Athlete may only be granted retroactive approval for his/her Therapeutic Use of a Prohibited Substance or Prohibited Method (i.e., a retroactive TUE) if:

a. Emergency treatment or treatment of an acute medical condition was necessary; or

b. Due to other exceptional circumstances, there was insufficient time or opportunity for the athlete to submit, or for the TUEC to consider, an application for the TUE prior to sample collection; or

c. An athlete is neither international-level nor national-level athlete; or

d. It is agreed, by WADA and by RUSADA, that fairness requires the grant of a retroactive TUE.

An athlete applying for the grant of a TUE or for recognition of a TUE shall provide written consent:

a. for the transmission of all information pertaining to the application to members of all TUECs with authority under this International Standard to review the file and, as required, other independent medical or scientific experts, and to all necessary staff (including WADA staff) involved in the management, review or appeal of TUE applications;

b. for the athlete’s physician(s) to release to the TUEC upon request any health information that the TUEC deems necessary in order to consider and determine the athlete’s application; and

c. for the decision on the application to be made available to all Anti-Doping Organizations with testing authority and/or results management authority over the athlete.

According to the TUEC decision the Committee may request from the Athlete or his/her physician any additional information, examinations or imaging studies, or other information that it deems necessary in order to consider the athlete’s application; and/or it may seek the assistance of such other medical or scientific experts as it deems appropriate.

The TUEC shall decide whether or not to grant the application as soon as possible, and usually (i.e., unless exceptional circumstances apply) within no more than 21 days of receipt of a complete application.

The TUEC’s decision must be communicated in writing to the athlete and must be made available via ADAMS. A decision to grant a TUE must specify the dosage(s), frequency, route and duration of administration of the prohibited substance or prohibited method in question that the TUEC is permitting, reflecting the clinical circumstances, as well as any conditions imposed in connection with the TUE. A decision to deny a TUE application must include an explanation of the reason(s) for the denial.

In the event that, after his/her TUE is granted, the athlete requires a materially different dosage, frequency, route or duration of administration of the prohibited substance or prohibited method to that specified in the TUE, he/she must apply for a new TUE.

Each TUE will have a specified duration, as decided by the TUEC, at the end of which the TUE will expire automatically. If the athlete needs to continue to use the prohibited substance or prohibited method after the expiry date, he/she must submit an application for a new TUE well in advance of that expiry date, so that there is sufficient time for a decision to be made on the application before the expiry date.

A TUE will be withdrawn prior to expiry if the athlete does not promptly comply with any requirements or conditions imposed by the Anti-Doping Organization granting the TUE.

If an athlete who was granted a TUE by RUSADA becomes subject to the TUE requirements of an International Federation or International Event Organization, such TUE will not have power until recognized by International sport federation. An athlete should inform RUSADA that his or her competing level has changed. In this case RUSADA assists an athlete to get recognition for his or her TUE granted by RUSADA.

TUE application form is uploaded at www.rusada.ru. Athletes may apply for TUE via following ways:

- Via e-mail rusada@rusada.ru, or (rusada@rusada.ru),

- Fax.: (+7 (495) 788-40-60), or

- Post 125284, Moscow, Begovaya str., 6A

International Standard on Therapeutic use Exemptions, January 2016
TUE physician guidelines: Male Hypogonadism
TUE physician guidelines: Sinusitis/Rhinosinusitis
TUE physician guidelines: Renal Transplantation
TUE physician guidelines: Inflammatory Bowel Disease
TUE physician guidelines: Attention Deficit Hyperactivity Disorder (ADHD) In Children and Adults
TUE physician guidelines: Infertility/Polycystic Ovarian Syndrome
TUE physician guidelines: Transgender Athletes
TUE physician guidelines: Adrenal Insufficiency
TUE physician guidelines: Musculoskeletal Conditions
TUE physician guidelines: Diabetes Mellitus
TUE physician guidelines: Neuropathic Pain
TUE physician guidelines: Intravenous Infusions and/or Injections