What is a Therapeutic Use Exemption (TUE)?

Athletes may have illnesses or conditions that require them to take medications or undergo medical procedures. If the medication or method an athlete is required to use to treat an illness or condition is prohibited as per the World Anti-Doping Agency’s (WADA) Prohibited List a TUE may give that athlete the authorization to use that substance or method while competing without invoking an anti-doping rule violation (ADRV) and applicable sanction.

Applications for TUEs are evaluated by ITA.

Confidentiality is maintained at all times.

Check if you are eligible to apply for a TUE at ITA. Download the TUE Form.

What are the criteria for granting a TUE?

All of the four following criteria must be met (for more details, please refer to the WADA International Standard for Therapeutic Use Exemptions (ISTUE) Article 4.2):

• The athlete has a clear diagnosed medical condition which requires treatment using a prohibited substance or method;
• The therapeutic use of the substance will not, on the balance of probabilities produce significant enhancement of performance beyond the athlete’s normal state of health;
• The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative;
• The necessity to use that substance or method is not a consequence of the prior use (without a TUE), of a substance or method which was prohibited at the time of use.

Who should apply for a TUE? Where and when to apply?

Athletes who are subject to anti-doping rules would need a TUE to take a prohibited substance or use a prohibited method. You should verify your TUE with ITA or your national MMA body or NADO to know to whom you need to apply, and if you can apply retroactively.  

First, check if the required medication or method you intend to take, or use is prohibited.  You may do this in two ways: 

– as per the WADA Prohibited List. [Prohibited List] 

You may also use a ‘check your medication’ website online tool or ask your NADO if it has one. Thoroughly research the medication you intend to take to ensure it is not prohibited. Keep records of your research.

You have a responsibility to inform your physician(s) that you are an Athlete bound to anti-doping rules. You and your physician(s) should check the Prohibited List for the substance/method you are prescribed. If the substance/method is prohibited, discuss non-prohibited alternatives, if there is none, apply for a TUE.  

Remember Athletes have the ultimate responsibility in terms of the strict liability rule. Contact your NADO or IMMAF if you are having difficulties. 

Then, check on the IMMAF website [IMMAF Rules & Testing Policy] or contact your national federation to determine your competition level and TUE application requirements. 

If it is determined that you are an International-Level Athlete 

1. Athletes included in the IMMAF Registered Testing Pool and any other Testing Pool established by IMMAF

2. Athletes who compete in an IMMAF sanctioned World or European Championships (Senior or Junior) International Event, 

3. Athletes who are sanctioned by IMMAF for an Anti-Doping Rule Violation and remain under IMMAF jurisdiction to seek reinstatement at the conclusion of their suspension.

As an International- Level Athlete you must apply to IMMAF in advance, as soon as the need arises, unless there are emergency or exceptional circumstances.

For substances prohibited in-competition only, you should apply for a TUE at least 30 days before your next competition, unless one of the exceptions on retroactive TUEs (see below) apply.

Please refer to the section “How to apply to ITA for a TUE?” below.

If you already have a TUE granted by your National Anti-Doping Organization (NADO):

IMMAF shall automatically recognise a TUE granted in accordance with the International Standard for TUEs. 

[Note: The TUE Certificate must be submitted to ITA in advance of an international event you intend to participate in to be recognized at the international level]. 

In such case, please notify IMMAF via [email protected] that you have a TUE granted by your NADO.

ª If you are NOT an International-Level Athlete and you have been tested by IMMAF, IMMAF recognizes a valid TUE granted by your NADO (i.e., it satisfies the ISTUE criteria for granting a TUE).

If you are NOT a National-Level Athlete as defined by your NADO and you have been tested by IMMAF, you must apply for a retroactive TUE to ITA.

Retroactive TUE Application Process: 

An Athlete may apply retroactively for a TUE (but must still meet the conditions in ISTUE Article 4.2) if one of any of the following exceptions applies: 

a)  Emergency or urgent treatment of a medical condition was necessary; 

b)  There was insufficient time, opportunity or other exceptional circumstances that prevented the Athlete from submitting (or the TUEC to consider) an application for the TUE prior to Sample collection; 

c)  Due to national level prioritization of certain sports, the Athlete’s National Anti-Doping Organization did not permit or require the Athlete to apply for a prospective TUE (see comment to Article 5.1); 

d)  If an Anti-Doping Organization chooses to collect a Sample from an Athlete who is not an International-Level Athlete or National-Level Athlete, and that Athlete is Using a Prohibited Substance or Prohibited Method for Therapeutic reasons, the Anti-Doping Organization must permit the Athlete to apply for a retroactive TUE; or 

e)  The Athlete Used Out-of-Competition, for Therapeutic reasons, a Prohibited Substance that is only prohibited In-Competition. 

[Comment: Athletes are strongly advised to have a medical file prepared and ready to demonstrate their satisfaction of the TUE conditions set out at Article 4.2, in case an application for a retroactive TUE is necessary following Sample collection.] 

[Comment to Article 4.1(e): This seeks to address situations where, for Therapeutic reasons, an Athlete Uses a substance Out-of-Competition that is only prohibited In-Competition, but there is a risk that the substance will remain in their system In-Competition. In such situations, the Anti-Doping Organization must permit the Athlete to apply for a retroactive TUE (where the Athlete has not applied in advance). This also seeks to prevent Anti-Doping Organizations from having to assess advance TUE applications that may not be necessary.]