[When treatment has anti-doping implications: therapeutic use exemptions in primary care]

Therapeutic use exemptions (TUEs) allow athletes to use prohibited substances or methods when there is a justified medical indication and the criteria established by anti-doping regulations are fulfilled. Although TUEs are commonly associated with professional sport, family physicians may care for federated athletes or individuals subject to anti-doping testing at different levels of competition. In primary care, commonly prescribed treatments such as systemic glucocorticoids, β2-agonists, beta-blockers or diuretics may have regulatory implications if the substance used, dosage, route of administration, timing in relation to competition and clinical context are not adequately considered. In addition, substances of abuse, cannabinoids, and some cold remedies and decongestants may lead to unexpected adverse analytical findings. This article provides practical recommendations aimed at identifying patients at risk, using official consultation tools, adequately justifying medical indications and safely managing common situations related to TUEs in daily clinical practice. .