Permitted Alternatives

One of the conditions for the approval of a TUE is that no reasonable, permitted therapeutic alternative can be used. For athletes, therefore, therapies permitted according to the Prohibited List should be prescribed first and foremost. Athletes can check with their physician whether a permitted therapy can be used. No TUE is required for permitted therapies.

If, from a medical point of view, a prohibited therapy is necessary, please refer to the section on medical documentation below.

Medical Documentation


Cold medicines, asthma medication and iron infusions are examples of therapies that may be prohibited according to the Prohibited List. At the same time, there are permitted alternatives for these medications. Therefore, the prescription of prohibited medication can often be avoided.

Special topic Asthma Medication

Special topic Iron Infusion

On the other hand, there are diseases for which the therapy of choice is prohibited according to the Prohibited List and no permitted alternatives can be used. This applies, for example, to the use of insulin in patients with type 1 diabetes. The prescription of stimulants prohibited by the Prohibited List, such as methylphenidate, is also recognized as the first-choice therapy for the diagnosis of attention deficit hyperactivity disorder (ADHD). However, this does not mean that every TUE application can be approved for the above-mentioned therapies. For these diagnoses and therapies too, the conditions for obtaining a TUE must be met and a medical file must be submitted in accordance with the application criteria.

Medical Documentation

If for medical and health reasons there is a necessity to prescribe prohibited medication, it is essential for the athlete concerned that the diagnosis and choice of therapy are fully documented. This is necessary either in order to submit a TUE application before the start of therapy or to keep the relevant medical file available for a retroactive TUE application. In addition, each TUE application requires a comprehensive medical justification why no permitted therapy alternative can be used. If such a justification is missing, inadequate according to the applicable regulations or not comprehensible to the TUE committee, no TUE will be granted.

The TUE Wizard will show you at what time and to which anti-doping organization the TUE application must be submitted.

TUE Wizard

Self-purchased Medication in Pharmacy or Drugstore

Generally, for medications that are sold over-the counter in pharmacies and drugstores and which are prohibited according to the Prohibited List, there is a permitted alternative. When choosing over-the-counter medications in pharmacies or drugstores, it is therefore recommended to seek a permitted alternative directly with the health professionals. No TUE application can be submitted for medication used by athletes without a doctor's prescription, as the necessary diagnosis for the application is missing.