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Therapeutic Use Exemption

A Therapeutic Use Exemption (TUE) is necessary before an athlete uses a prescribed prohibited substance or method for the treatment of a legitimate medical condition.

Athletes should advise all medical personnel of their obligation to abide by the anti-doping rules of their sport and that any medical treatment received must not violate these rules.



Step 1: Check status of substance or method of treatment

Step 2: Substance or method of treatment is prohibited

  • Discuss with your doctor for permitted alternative medication or treatment.
  • If there are no alternative medication or treatment available, proceed to Step 3.

Step 3: Apply for a TUE

  • Download a TUE Application Form from ADS website or obtain it from your National Sports Association or International Federation, where applicable.

Step 4: Complete the TUE Application Form

  • Complete the form with your doctor.
  • Medical evidence to justify the use of a prohibited substance or method must be attached to the application form.

Step 5: Is the substance or method prohibited both In- and Out-of-Competition?

  • Yes, proceed to Step 6.
  • No, only prohibited In-Competition. Proceed to Step 7.

Step 6: When to submit the TUE Application Form?

  • If Substance or Method is Prohibited Both In- and Out-of-Competition, submit TUE application as soon as the medical condition is diagnosed.

Step 7: When to submit the TUE Application Form?

  • If Substance or Method is Prohibited only In-Competition, submit TUE application at least 30 days prior to participating in an event.

Step 8: Submit the TUE Application Form

  • Submit completed TUE application form with relevant justifying documents (eg. Evidence of the diagnosis, a comprehensive medical history and the results of all examinations, laboratory and investigations and imaging studies relevant to the application).
  • Submit to ADS for ADS Registered and Domestic Testing Pools and all other athletes not in any testing pool.
  • Submit to your International Federation for International-level athletes.

Step 9: Approval of TUE

  • Decisions of the TUE application will be conveyed to the athlete and/or relevant NSA within 30 days of receipt of the completed TUE application form and relevant justifying documents.




 A TUE will be granted only if the following criteria are fulfilled:

  1. The athlete would experience a significant impairment to health if the prohibited substance or method were withheld for treating an acute or chronic medical condition.
  2. The therapeutic use of the prohibited substance or method would produce no additional enhancement of performance.
  3. There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method.



A valid TUE should be obtained before the start of the use of the prohibited substance or method.

The TUE application should be made as soon as an athlete is prescribed a prohibited substance or method for a medical condition that is prohibited both In-Competition and Out-of-Competition. Where a substance or method is prohibited only In-Competition, the TUE application must be made at least 30 days before the athlete needs the valid TUE.

Retroactive consideration for the application of a TUE will be considered only in exceptional circumstances as follows:

  1. Emergency treatment or treatment of an acute medical condition was necessary, or 
  2. There was insufficient time or opportunity for an applicant to submit, or a TUE Committee/Panel to consider, an application prior to doping control.
  3. All other athletes who are not in the ADS RTP and ADS DTP, as well as those not carded under Sport Singapore's spexCarding programme, will be allowed to submit a TUE retroactively if selected for an In-Competition or Out-of-Competition test.    


All athletes who need to use inhaled beta-2 agonists (other than Salbutamol, Salmeterol and Formoterol at recommended therapeutic doses) for medical purposes must:

(a) Have a justifying medical file.

(b) Declare these substances on the Doping Control Form at the time of testing.

Alternate beta-2 agonists such as terbutaline are prohibited and need a TUE. The request for a TUE should include a complete medical file with a clear explanation of why an alternate medication is being prescribed.

However, TUEs are required for Salbutamol, Salmeterol and Formoterol if used together with Diuretics.



All athletes carded under the Singapore Sports Council's spexTEAM programme and athletes in the ADS Registered Testing Pool and ADS Domestic Testing Pool, and any other National-level athlete requiring a TUE for the use prohibited substances or methods shall submit the TUE application to ADS. A TUE application should be made on the ADS TUE Application Form that is completed with your Doctor.

Athletes who are in their respective International Federation's Registered Testing Pool shall submit the TUE application to their International Federation.

The application to ADS should include the completed ADS TUE Application Form and medical evidence (for example, comprehensive medical history, results of all relevant examinations, laboratory investigations and imaging studies) to justify the use of a prohibited substance or method. A TUE application without medical evidence will not be reviewed by the ADS TUE Committee.

For certain specific medical conditions, such as asthma, additional medical information is required to support the TUE application. Please click here for details of medical information required for specific medical conditions.

The TUE application should be submitted to:

Anti-Doping Singapore
3 Stadium Drive
Singapore 397630
Fax: +65-64409205

Note: A TUE granted by the ADS TUE Committee may not be acknowledged by the International Federation. It is the athlete's responsibility to be aware of the requirements of the International Federation or event organiser prior to competing. International Federation's may have different TUE application and information requirements and forms.

For more details, please refer to the ADS TUE Policy.