What is a Therapeutic Use Exemption (TUE)?
A TUE is special permission to use a prohibited substance or method for a legitimate medical condition.
Riders, like everyone else, may have illnesses or condition which requires a particular medication. If a substance contained in your medication or the method used appears on the Prohibited List, you must apply for a TUE before starting the treatment. After the UCI Therapeutic Use Exemption Committee (TUEC) has reviewed your application, you may be given authorization to obtain treatment.
The UCI TUEC is composed of independent experts in the fields of clinical, sports and exercise medicine. It is the CADF, that provides administrative support to the TUEC.
Which riders should apply to the UCI Committee for a TUE?
If you are included in the UCI RTP, you must apply for a TUE directly to the UCI through ADAMS exclusively.
If you already had a TUE granted by your National Anti-Doping Organisation (NADO) at the time of your inclusion in the UCI RTP, you must apply for the recognition of this TUE by the TUEC through ADAMS exclusively. If that TUE meets the criteria set out in Section 4.0 of the UCI TUE Regulations, then the TUEC shall recognize it.
If you are not included in the UCI RTP, you shall apply for a TUE to your NADO in accordance with the regulations of your NADO.
However, if you are not included in the UCI RTP and wish to participate in an International Event (i.e. an event where the UCI is the ruling body), you must, prior to such participation, obtain recognition from the TUEC of the TUE already granted by your NADO. If that TUE meets the criteria set out in Section 4.0 of the UCI TUE Regulations, then the TUEC shall recognize it.
If the need for the TUE arises during the International Event Period, you may apply directly for a TUE to the TUEC.
Note: The list of International Events is published on the UCI website under each discipline.
Please note that the UCI Committee automatically recognizes TUEs decisions made by the following NADOs.
This means that if a rider’s TUE has been delivered by a NADO listed below, he/she does not need to apply to the UCI Committee for recognition of that TUE, insofar as the TUE is still valid. The TUE application is automatically recognised by the UCI Committee, without further action required by the Rider.
When shall I apply to the UCI Committee for a TUE?
A rider who needs a TUE should apply as soon as the need arises, unless exceptional circumstances or true emergencies exist.
For substances prohibited in-competition only, the rider should apply for a TUE at least 30 days before his/her next Competition, unless exceptional circumstances or true emergencies exist.
The rider should apply to the UCI Committee, using the TUE application form available on ADAMS. Please refer to section 6 below for further information on the TUE application process.
Conditions for granting TUE
Article 4.1- UCI Regulations for TUE
A rider may be granted a TUE if (and only if) he/she can show that each of the following conditions is met:
[Comment to 4.1: The WADA documents titled “Medical Information to Support the Decisions of TUECs”, posted on WADA’s website, can be used to assist in the application of these criteria in relation to particular medical conditions.]
Particular information with regard to Glucocorticoids, Beta-2 Agonists against Asthma and Injections (“No Needle Policy”)
Authorised routes of administration
The following routes of administration (i.e. how the medication is administered or taken) are authorised and hence do not require a TUE for the use of glucocorticoids:
Prohibited routes of administration – systemic administration
You must complete a full TUE application before taking glucocorticoids by any of the following systemic routes:
• Orally – through the mouth, usually in the form of pills or tablets or syrup or drops;
• Intravenous injection – injection into a vein;
• Intramuscular injection – injection into a muscle;
• Rectally – into the rectum usually in the form of a suppository or rectal application of a cream.
Local injection of glucocorticoids – “8-days rest period”
In case of a local injection of glucocorticoids, which is subject also to the Anti-Doping Rules and the Prohibited List, the rider must rest and is prevented from competing for 8 days (article 13.3.055 of the UCI Regulations).
Whether or not you need to apply for a TUE before using a beta-2 agonists for the treatment of asthma depends on the medication. Please pay utmost attention to the substance which is included in your inhaler.
Inhaled salbutamol (maximum 1600 micrograms over 24 hours in divided doses not to exceed 800 micrograms over 12 hours starting from any dose), inhaled formoterol (maximum delivered dose 54 micrograms over 24 hours) and inhaled salmeterol (maximum delivered dose of 200 micrograms over 24 hours) are not prohibited and therefore do not require a TUE.
For inhaled salbutamol, you must obtain a TUE if you need to take more than 1600 micrograms over 24 hours in divided doses not to exceed 800 micrograms over 12 hours starting from any dose.
You must obtain a TUE if you need to inhale more than 54 μg per day of formoterol.
You must obtain a TUE if you need to inhale more than 200 μg per day of salmeterol.
You must obtain a TUE if you take salmeterol, salbutamol and/or formoterol by any other routes of administration.
If you take terbutaline or any other beta-2 agonist for the treatment of asthma, you must submit a TUE request for asthma and your full medical file through ADAMS to confirm the diagnosis of asthma and/or its clinical variants.
The medical file should include:
– A detailed medical history and clinical review;
– Lung function test with spirometry;
– Bronchodilator response;
– Bronchial provocation tests.
To assist your doctor in completing the correct tests, and providing the correct medical information, we suggest that he or she consults the WADA Guidelines on Asthma.
We remind you that the use of injections to administer drugs or substances without a clear and recognised medical indication is prohibited. This applies to any substance that is injected whether endogenous or exogenous, prohibited under the UCI Anti-Doping Rules (ADR) or not, and to any type of injection (article 13.3.052 of the UCI Regulations).
Accordingly, the injection that falls under the “No Needle Policy” must be reported immediately and in writing not later than 24 hours afterwards to the UCI Doctor (via email email@example.com).
How to apply for a TUE to the UCI Committee ?
If you need to take any substance or method which is included in the Prohibited List or to have your TUE granted by your NADO recognised, you must apply for a TUE to the UCI Committee, using exclusively the TUE application form available on ADAMS. The completed TUE application form and a comprehensive medical file must be submitted to the UCI via ADAMS.
All TUE applications must be submitted in legible French or English. Written medical reports must also be submitted in legible French or English, although results of tests may be in the original language.
If you need a TUE, you should apply as soon as the need arises. For substances prohibited in-competition only, the rider should apply at least 30 days before his/her next competition, unless exceptional or true emergencies exist.
To assist your doctor in providing the correct medical documentation we suggest that you consult the WADA website to access the medical information required to support TUE application for treatments of several common medical conditions.
If you are a rider whose doctor has a medical ADAMS account, your team doctor can undertake this task on your behalf through ADAMS.
Declaration in the scope of the “No Needle Policy” (article 13.3.052 of the UCI Medical Rules) must be reported to UCI Doctor via email (firstname.lastname@example.org)