Anti-doping – How to request a Therapeutic Use Exemption (TUE)

When, as part of their medical treatment, an athlete has to take medication that features on the file below: 

He or she must request a Therapeutic Use Exemption (TUE).

Requests for a TUE will only be considered in the following cases:

• The athlete would experience significant health problems if the substance was not administered or the method was not used as part of treatment for an acute or chronic disease.
• Therapeutic use of the prohibited substance or method would not lead to enhanced performance, apart from that attributable to a return to a normal state of health following treatment for the medical condition.
• There is no reasonable authorised therapeutic alternative to the use of the substance or method that is usually prohibited.

For example, insulin for the treatment of Type 1 Diabetes (insulin dependent).

TUEs apply for the duration of the treatment as prescribed by a doctor, usually for a maximum of two years. It is the athlete's responsibility to note the expiry date of the TUE and request renewal before the expiry date, if necessary.

The special case of Asthma

All Beta-2 agonists (including their two optical isomers) are prohibited, except for Salbutamol (a maximum of 1600 microgrammes per 24 hours), Formoterol (a maximum of 36 microgrammes per 24 hours) and Salmeterol, when these are inhaled in accordance with the manufacturer's treatment guidelines.

A declaration of use for Salbutamol, Formoterol, Salmeterol and inhaled glucocorticoids, when these are inhaled, is no longer required, in accordance with the International Standard for TUEs.

However, glucocorticoids, Salbutamol, Formoterol or Salmeterol administered orally, intramuscularly, intravenously or rectally are prohibited, and therefore a TUE is required.

Traces of Salbutamol in urine in a concentration above 1000ng/ml or Formoterol in a concentration above 30ng/ml will be presumed not to be for intentional therapeutic use. Therefore, the results of the analysis will be deemed an adverse analytical finding, unless the sportsperson can prove by a controlled pharmacokinetic study that this abnormal result is in fact due to a therapeutic dose.

To get this form, you can either:

• Download it here below:
  Therapeutic Use Exemptions (327-0031_01-2015)

  PDF501.8 kB
• Or collect it from the Secretariat of the Centre Médico Sportif :

7, avenue des Castelans
Stade Louis II - Entrée G
98000 MONACO

• You must attach proof of the diagnosis to your request.
• The medical evidence must include your family history and the results of any medical examinations, laboratory analyses and medical imaging. Copies of the original reports or letters should be included if possible.
• The reasoning for the clinical circumstances should be as objective as possible. In the case of non-demonstrable conditions, the request must be supported by an independent medical statement.

The documents should be sent in a sealed envelope, marked as confidential, to the Medical Inspector for Sport, Monaco Anti-Doping Committee. You should keep a copy.