The medication review has been made easier by the work of USADA & its partners across the globe through the development and sustainment of GlobalDRO (www.globaldro.com).
Search Global DRO to find the status of a substance/medication/method you are considering prescribing to the patient-athlete. Be sure to select the correct sport of the patient-athlete as there are some sports that prohibit certain medications (e.g. beta-blockers) that are allowed in other sports.
If the medication you are prescribing for the patient-athlete is prohibited, research if there are permitted alternatives medically-acceptable to treat the diagnosed condition.
If the substance/medication/method is prohibited in-competition only & the athlete is only taking it for a short-period of time (e.g. short-course prednisone burst), you may consider evaluating if the athlete will “washout” or clear the medication and it’s metabolites prior to an upcoming sporting event. USADA recommends that if the patient-athlete takes an in-competition prohibited substance within 30 days or less of a scheduled event that they apply for a TUE as a precaution. The TUE application process can be found at https://www.usada.org/athletes/testing/tue/apply/.
Be mindful that some medications are conditional up to a urinary threshold (e.g. some inhaled beta-2 agonists) and exceeding the WADA threshold could result in an adverse analytical finding. Additionally, while some substances/medications are permitted up to a urinary threshold, if they are taken in conjunction with a diuretic (e.g. spironolactone) a separate TUE is required for both medications.