Medications
and Flying
Do Not Issue
Do Not Fly
Do Not Issue
Do Not Fly
Do Not Fly list
In addition to the medications on the Do Not
Issue list, pilots should not fly while using any of the
medications or classes/groups of medications listed below
without an acceptable wait time after the last dose. These
medications may cause sedation (drowsiness) or impair
cognitive function, seriously degrading pilot performance.
This impairment can occur even when the individual
feels alert and is apparently functioning normally - in
other words, the pilot can be “unaware of impair.”
• Allergy medications
• Muscle relaxants
• OTC dietary supplements
• Pain medications
• Pre-medication or Pre-procedure drugs
• Sleep aids
• Any medication, prescription or Over the Counter
(OTC) that carries a label precaution or warning
that it may cause drowsiness or advises the user
“be careful when driving a motor vehicle or
operating machinery.”
For aviation safety, airmen should not fly following the
last dose of any of the medications above until a period of
time has elapsed equal to:
5-times the maximal
pharmacologic half-life of the
medication; or 5-times the
maximal hour dose interval
if pharmacologic half-life
information is not available.
For example, there is a 30-hour
wait time for a medication that
is taken every 4 to 6 hours
(5 times 6).
This is an example of the most common meds or mediation
types that could cause problems in flight. This is not meant to
be an inclusive list. If you have any questions you should see
your AME.
Side effect concerns of frequently
used OTC medications
If you must take over-the-counter medications,
• Read and follow the label directions.
• If the label warns of significant side effects, do not
fly after taking the medication until at least five
maximal dosing intervals have passed.
• Remember that you should not fly if the
underlying condition that you are treating would
make you unsafe if the medication fails to work.
• Never fly after taking a new medication for the
first time until at least 48 hours have passed and
no side effects are noted.
• As with alcohol, medications may impair your
ability to fly—even though you feel fine.
• If you have questions about a medication, ask a
healthcare provider.
• When in doubt, safety first—don’t fly.
MEDICAL FACTS FOR PILOTS
Provided by
Aerospace Medical Education Division, AAM-400
T o obtain copies of this brochure online:
http://www.faa.gov/pilots/safety/pilotsafetybrochures/
or contact:
Federal Aviation Administration
Civil Aerospace Medical Institute
AAM-400
P .O. Box 25082
Oklahoma City, OK 73125
(405) 954-4831
OK-17-2022 (10)
Does this story sound familiar?
It’s Sunday morning, the last day of a three-day trip. You
have four hours of flying ahead of you to get back home,
but something about the air conditioner last night has
left you with a stuffy nose and sinuses this morning. You
know from your training and experience that flying with
congested upper airways is not a good thing. As it turns out,
one of the others on the trip has some new over-the-counter
sinus pills that
are “guaranteed”
to unstop your
breathing passages
and let you fly
without any
worries about
the congestion.
Should you take the
medication?
Another scenario
You and your spouse are on the second leg of a five-leg,
cross-country flight. While visiting relatives, you stayed up
late at the party they threw in your honor, ate too much,
and the next morning
your stomach feels sort
of queasy. Your spouse,
a non-pilot, offers you
a common motion-
sickness pill prescribed
by her doctor.
Should you take the
medication?
Get the facts
Just like any other decision (equipment, weather, etc.)
that you must make when you fly, you should know the
facts before you can answer this question. There are several
things that you need to know and take into account before
you make the go/no-go decision. Add these to your check
list:
First, consider the underlying condition that you are
treating. What will be the consequences if the medication
doesn’t work or if it wears off before the flight is over? A
good general rule to follow is not to fly if you must depend
on the medication to keep the flight safe. In other words,
if the untreated condition is one that would prevent safe
flying, then you shouldn’t fly until the condition improves
– whether you take the medication or not.
Second, you must consider your reaction to the
medication. There are two broad categories of medication
reactions. One is a unique reaction based on an individual’s
biological make-up. Most people don’t have such reactions
but anyone can, given the right medication. Because of
this, you should NEVER fly after taking any medication
that you have not taken before. It is not until after you
have taken the medication that you will find out whether
you have this uncommon and unexpected reaction to the
medication.
Third, consider the potential for adverse reactions, or
side effects – unwanted reactions to medications. This type
of reaction is quite common, and the manufacturer of the
medication lists these on the label. You MUST carefully
read all labeling. If you don’t have access to the label, then
don’t fly while using the medication.
Look for such key words as lightheadedness, dizziness,
drowsiness, or visual disturbance. If these side effects are
listed or if the label contains any warning about operating
motor vehicles or machinery, then you should not fly while
using the medication.
Side effects can occur at any time, so even if you’ve taken
the same medication in the past without experiencing side
effects, they could still occur the next time. For this reason,
you must never fly after taking a medication with any of the
above-noted side effects.
LIGHT-HEADEDNESS
DIZZINESS
DROWSINESS
VISUAL DISTURBANCE
Do Not Issue list
AMEs should not issue medical certificates to
applicants who are using these medication classes:
• Angina medications
• Anticholinergics (oral)
• Cancer treatments
• Controlled Substances (Schedules I – V This includes
medical marijuana, even if legally allowed or prescribed
under state law)
• Selected Diabetic medications
• Dopamine agonists
• Hypertensive (centrally acting such as clonidine)
• Selected Psychiatric or Psychotropic medications
• Malaria medication
• Over-Active-Bladder (OAB) medications
• Other: Selected medications with less than 12 month
FDA approvals
• Seizure medications
• Smoking cessation aids
• Steroids (high does)
• Weight loss medications Aeromedical Impact Examples
Medication Group Example Aeromedical Impact
Angina medications Nitroglycerin Cause dilation of arteries
Anticholinergics Atropine Change in vision; fast heartbeat
Cancer treatment Chemotherapy & Radiation
The FAA does not permit airmen who are undergoing
cancer treatment to fly until treatment is completed.
Concerns mental state, side effects of meds and radiation.
Controlled substances Marijuana Affects mental state; NOTE: even though marijuana is
approved in some states, not at all permitted for flight.
Centrally Acting HTN meds Clonidine (Catapres) Centrally acting can cause sedation and dizziness.
Over-active Bladder meds Detrol Ditropan
(Oxybutinin) Sedation and confusion or hallucinations
Psychiatric/Psychotropic
meds
Xanax (Alprazolam), Ritalin
(Methylphenidate) Prozac
(tranquilizers)
In this class it is the condition that becomes primary reason.
Many of them are disqualifying for flying.
Seizure medications Keppra (Levetiracetam),
Dilantin (Phenytoin)
Once again it is the condition. Seizure condition is
unacceptable for flight.
Steroids Prednisone
(greater than 20mg)
Can cause psychiatric problems such as psychosis or high
blood sugar
For additional guidance contact your AME or refer to the DNI list online at: www.faa.gov/go/dni