A newer edition of this regulation is available: January 2027

International Standard for Therapeutic Use Exemptions (ISTUE) 2023 (in force)

The 2023 edition of the International Standard for Therapeutic Use Exemptions, in force from 1 January 2023.

In force from1 January 2023
PublicationWorld Anti-Doping Agency — 2023 edition
StructureInternational Standard for Therapeutic Use Exemptions, 2023 edition
StatusSuperseded — replaced by the January 2027 edition

What is the International Standard for Therapeutic Use Exemptions?

The International Standard for Therapeutic Use Exemptions (ISTUE) is one of the mandatory International Standards of the world anti-doping system. The Standards set out the technical detail for implementing the Code, and compliance with them is mandatory for all Code Signatories. This Standard determines the conditions and the procedure under which an athlete who must, because of a medical condition, use a prohibited substance or method obtains a Therapeutic Use Exemption, who decides on the application, and in which cases the decision is subject to review and appeal.

About the 2023 editionChanges from the 2021 edition

Key changes from the previous edition

  1. Periodic revisionThis edition took effect on 1 January 2023 and governed until the 2027 edition came into operation.

Who this document matters to

The most frequently used Standard for the team physician and the athlete. The four conditions for granting an exemption, the deadline for submitting an application, the possibility of applying with retroactive effect, and the deciding and appeal bodies are all set out in this text; and in doping cases, the existence or absence of a valid exemption is the first thing examined.

Each case is governed by the version of this Standard that was in force at the time the event occurred; for that reason, earlier versions are kept available on this page. The official text is published in English and French, and in the event of any conflict, the English text prevails.