Exemptions & Asthma

What is a T.U.E?

A T.U.E is a Theraputic Use Exemption. The T.U.E application process gives players a means of attaining approval to use a Prohibited Substance or Method for the treatment of a legitimate medical condition.

This process is in place to protect the rights of players to compete on a level playing field.

Applying for a T.U.E

Each T.U.E application is assessed according to the same criteria as laid out in the International Standard for Therapeutic Use Exemptions. This provides fair and consistent standards for the approval of any medical use of a Prohibited Substance or Method.

Any player that is eligible for testing will need to apply for a TUE if they are prescribed a Prohibited Substance or Method by their Doctor to treat a medical condition. For the avoidance of doubt, all players in the Academy competitions, Reserve competition, the Championships and the Super League are eligible for testing and should therefore complete T.U.Es when appropriate.

A T.U.E can be applied for by a player or a member of the medical team, however, it is ultimately the player’s responsibility. All persons involved in the process will be required to sign the form (including the prescribing physician. Both the player and clinician are required to read and sign the player and clinician declarations forms. Before applying for a T.U.E, check to see if there are any permitted alternative treatments or medications.

Process for Asthma medications

Players have a responsibility to ensure that they take appropriate action when prescribed any inhaled medication. The table below details the action to take:

Medication Action Required
Salbutamol None*
Salmeterol None
Formoterol None*
Terbutaline TUE
Corticosteriods None

*Although you do not need to obtain a TUE to use a Salbutamol, Salmeterol or Formoterol inhaler you still need to be careful about how much you take. Players need to be aware that there are upper limits for Salbutamol, Salmeterol and Formoterol and if these limits are exceeded players may be charged with an Anti-Doping Rule Violation.

The limit for Salbutamol is a maximum of:

  • 1600 micrograms over 24 hours; and
  • 800 micrograms over 12 hours.

Salbutamol inhalers commonly dispense either 100 or 200 micrograms per puff/inhalation, therefore this 800 microgram allowance equates to either 4 or 8 puffs per 12-hour period. 

The limit for Formoterol is 54 micrograms over 24 hours.

Previously there has not been an explicit limit for Salmeterol, however the 2017 Prohibited List confirmed that maximum allowable amount permitted over 24 hours as 200 micrograms. If a player requires more than 200 micrograms per day, UKAD should be consulted as it may be necessary to apply for a TUE.

The dose administered per puff/inhalation does vary between inhalers therefore it is vital that players are advised to check the information leaflet which accompanies the inhaler to establish the dose per puff/inhalation.

The presence in urine of these substances in excess of the respective limits is presumed not to be a therapeutic use of the substance and will be considered as an Adverse Analytical Finding unless the Athlete proves, through a controlled pharmacokinetic study, that the abnormal result was the consequence of the use of the therapeutic inhaled dose up to the maximum indicated above.

Poor administration technique or poorly controlled asthma are recognized as possible contributory factors to such abnormal urine findings. However, such a result will lead to an Anti-Doping Rule Violation hearing following which sanctions, including a suspension of up to two years, may be applied.

Players not regularly subjected to testing

New signings or players on trial from amateur clubs that are not usually subjected to the testing procedure but are tested at random during a period with your club are required to submit a T.U.E application following the match if they are using a prohibited substance for a legitimate medical condition.

It is the responsibility of the Player to ensure that the application is received by UKAD no later than 5 working days after the test is completed.

For further information or to download a T.U.E application form, please log on to www.ukad.org.uk