Medication Reference

FAA medication compatibility database

Look up any medication to see its FAA medical certification status, pathway requirements, and practical guidance for pilots. Based on publicly available FAA guidance including the AME Guide and Do-Not-Issue/Do-Not-Fly tables.

Generally Approved

(123)

These medications are generally compatible with FAA medical certification. Your AME can typically issue your certificate at the time of exam.

ACE Inhibitor (Blood Pressure)
Generally Approved

Lisinopril

Zestril, Prinivil

Lisinopril and other ACE inhibitors are generally compatible with FAA medical certification. Most AMEs can issue your certificate at the time of exam if blood pressure is well-controlled and there are no significant side effects.

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Calcium Channel Blocker (Blood Pressure)
Generally Approved

Amlodipine

Norvasc

Amlodipine is generally acceptable for FAA medical certification. As a peripheral-acting calcium channel blocker, it is not on the Do Not Issue list. Report it on your application and ensure blood pressure is controlled.

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Statin (Cholesterol)
Generally Approved

Atorvastatin

Lipitor

Atorvastatin and other statin medications are generally compatible with FAA medical certification. AMEs can typically issue certificates at the time of exam. Report the medication on your application and note any side effects.

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Beta Blocker (Blood Pressure / Heart Rate)
Generally Approved

Metoprolol

Lopressor, Toprol-XL

Metoprolol is generally acceptable for pilots when used for hypertension. The underlying cardiac condition being treated may require additional evaluation. Beta blockers used post-cardiac event require Special Issuance.

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ARB (Blood Pressure)
Generally Approved

Losartan

Cozaar

Losartan and other ARBs (angiotensin receptor blockers) are generally compatible with FAA medical certification for hypertension treatment.

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Proton Pump Inhibitor (GERD)
Generally Approved

Omeprazole

Prilosec

Omeprazole and other PPIs are generally acceptable for FAA medical certification when used for GERD or acid reflux. The underlying condition should be stable and not cause symptoms that could impair flight safety.

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Thyroid Hormone Replacement
Generally Approved

Levothyroxine

Synthroid, Levoxyl

Levothyroxine for hypothyroidism is generally compatible with FAA certification. Pilots must demonstrate stable thyroid levels (TSH within normal range) and be free of symptoms.

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NSAID (Over-the-Counter)
Generally Approved

Ibuprofen

Advil, Motrin

Ibuprofen is generally acceptable for pilots when used as directed. The FAA primarily requires that the underlying condition being treated does not itself disqualify you, and that you are not experiencing side effects that affect flight safety.

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Analgesic (Over-the-Counter)
Generally Approved

Acetaminophen

Tylenol

Acetaminophen is one of the most commonly used OTC medications among pilots. It is generally acceptable with no required wait time, provided the underlying condition being treated is not disqualifying.

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Antihistamine (Allergy)
Generally Approved

Loratadine

Claritin

Loratadine is generally the preferred antihistamine for pilots. Non-sedating in most individuals, but the FAA still recommends a ground trial before flying to confirm no individual sedation response.

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Statin (Cholesterol)
Generally Approved

Simvastatin

Zocor

Simvastatin is generally compatible with FAA certification. Same pathway as other statins — report it, ensure no significant muscle-related side effects.

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Statin (Cholesterol)
Generally Approved

Rosuvastatin

Crestor

Rosuvastatin is generally compatible with FAA medical certification. Like other statins, report the medication and ensure no significant muscle-related side effects such as rhabdomyolysis.

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Statin (Cholesterol)
Generally Approved

Pravastatin

Pravachol

Pravastatin is generally compatible with FAA certification. It has a lower risk of muscle-related side effects compared to some other statins, making it a common choice among pilots.

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ACE Inhibitor (Blood Pressure)
Generally Approved

Enalapril

Vasotec

Enalapril is an ACE inhibitor generally compatible with FAA medical certification. Blood pressure must be well-controlled and the pilot should not experience significant side effects such as dizziness or persistent cough.

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ACE Inhibitor (Blood Pressure)
Generally Approved

Ramipril

Altace

Ramipril is an ACE inhibitor acceptable for FAA certification when blood pressure is controlled. Report any side effects such as dizziness or dry cough to your AME.

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ACE Inhibitor (Blood Pressure)
Generally Approved

Benazepril

Lotensin

Benazepril is an ACE inhibitor generally compatible with FAA certification. Same pathway as other ACE inhibitors — report the medication and ensure blood pressure is well-controlled.

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ARB (Blood Pressure)
Generally Approved

Valsartan

Diovan

Valsartan is an ARB generally compatible with FAA medical certification for hypertension. Report on your application and ensure blood pressure is controlled.

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ARB (Blood Pressure)
Generally Approved

Irbesartan

Avapro

Irbesartan is an ARB acceptable for FAA certification. Like other ARBs, it is not on the Do Not Issue list and AMEs can issue certificates when blood pressure is well-controlled.

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ARB (Blood Pressure)
Generally Approved

Olmesartan

Benicar

Olmesartan is an ARB generally compatible with FAA certification. Standard antihypertensive pathway applies — report medication and demonstrate controlled blood pressure.

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ARB (Blood Pressure)
Generally Approved

Candesartan

Atacand

Candesartan is an ARB acceptable for FAA medical certification. Report on your application and ensure blood pressure is well-controlled with no significant side effects.

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ARB (Blood Pressure)
Generally Approved

Telmisartan

Micardis

Telmisartan is an ARB generally compatible with FAA certification. Same pathway as losartan and other ARBs — report and demonstrate controlled blood pressure.

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Calcium Channel Blocker (Blood Pressure / Heart Rate)
Generally Approved

Diltiazem

Cardizem, Tiazac

Diltiazem is a calcium channel blocker generally acceptable for FAA certification when used for hypertension. If prescribed for arrhythmia, the underlying cardiac condition may require Special Issuance evaluation.

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Calcium Channel Blocker (Blood Pressure)
Generally Approved

Nifedipine

Procardia, Adalat

Nifedipine is a calcium channel blocker generally acceptable for FAA certification. As a peripheral vasodilator, it is preferred over centrally-acting antihypertensives. Report on your application.

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Calcium Channel Blocker (Blood Pressure / Heart Rate)
Generally Approved

Verapamil

Calan, Verelan

Verapamil is generally acceptable for FAA certification when used for hypertension. Like diltiazem, if prescribed for arrhythmia control, the underlying condition may require additional evaluation.

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Beta Blocker (Blood Pressure)
Generally Approved

Atenolol

Tenormin

Atenolol is a beta blocker generally acceptable for pilots when prescribed for hypertension. Like metoprolol, if used post-cardiac event or for arrhythmia, Special Issuance may be required.

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Beta Blocker (Blood Pressure / Tremor)
Generally Approved

Propranolol

Inderal

Propranolol is a non-selective beta blocker generally acceptable for FAA certification when used for hypertension. If prescribed for performance anxiety, tremor, or migraine prevention, discuss the underlying indication with your AME.

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Beta Blocker (Blood Pressure / Heart Failure)
Generally Approved

Carvedilol

Coreg

Carvedilol is acceptable for FAA certification when used for hypertension. However, it is commonly prescribed for heart failure, which itself requires Special Issuance evaluation. The indication matters significantly.

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Beta Blocker (Blood Pressure)
Generally Approved

Bisoprolol

Zebeta

Bisoprolol is a selective beta blocker generally acceptable for FAA certification when used for hypertension. Report the medication and ensure no exercise intolerance or symptomatic bradycardia.

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Beta Blocker (Blood Pressure)
Generally Approved

Nebivolol

Bystolic

Nebivolol is a newer selective beta blocker acceptable for FAA certification. It may have fewer fatigue-related side effects than older beta blockers, making it popular among active pilots.

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Thiazide Diuretic (Blood Pressure)
Generally Approved

Hydrochlorothiazide

Microzide, HydroDIURIL

Hydrochlorothiazide (HCTZ) is one of the most commonly used diuretics and is generally acceptable for FAA certification. Pilots should be aware of electrolyte imbalances and dehydration risk, especially in hot cockpit environments.

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Loop Diuretic
Generally Approved

Furosemide

Lasix

Furosemide is generally acceptable for FAA certification, but the underlying condition requiring a loop diuretic (heart failure, edema) may require Special Issuance. The medication itself is not on the DNI list.

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Potassium-Sparing Diuretic
Generally Approved

Spironolactone

Aldactone

Spironolactone is not on the FAA's Do Not Issue list and may be acceptable for certification. The underlying condition (heart failure, hypertension, hormonal) drives the certification pathway. Report medication and indication.

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Thiazide-like Diuretic (Blood Pressure)
Generally Approved

Chlorthalidone

Thalitone

Chlorthalidone is a thiazide-like diuretic acceptable for FAA certification. Like HCTZ, it is commonly used for hypertension and is not on the Do Not Issue list. Monitor electrolytes and hydration.

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Proton Pump Inhibitor (GERD)
Generally Approved

Pantoprazole

Protonix

Pantoprazole is a PPI generally acceptable for FAA certification. Like omeprazole, ensure the underlying GI condition is stable and not causing symptoms that could impair flight safety.

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Proton Pump Inhibitor (GERD)
Generally Approved

Lansoprazole

Prevacid

Lansoprazole is a PPI acceptable for FAA certification. Same pathway as omeprazole — report the medication and ensure the underlying condition is well-managed.

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Proton Pump Inhibitor (GERD)
Generally Approved

Esomeprazole

Nexium

Esomeprazole is a PPI generally acceptable for FAA certification. Report it on your application and ensure the underlying GERD or acid reflux is well-controlled.

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Proton Pump Inhibitor (GERD)
Generally Approved

Rabeprazole

Aciphex

Rabeprazole is a PPI acceptable for FAA medical certification. Same pathway as other PPIs — the medication itself is not an issue; focus is on the underlying GI condition being well-controlled.

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H2 Blocker (GERD / OTC)
Generally Approved

Famotidine

Pepcid

Famotidine is an H2 blocker available over the counter and is generally acceptable for pilots. It does not cause sedation and is commonly used for heartburn and GERD. Report on your application.

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H2 Blocker (GERD)
Generally Approved

Ranitidine

Zantac (discontinued)

Ranitidine was an H2 blocker previously acceptable for pilots. It was withdrawn from most markets in 2020 due to NDMA contamination concerns. If still in use outside the US, same pathway as famotidine applies.

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Anti-Thyroid Medication
Generally Approved

Methimazole

Tapazole

Methimazole for hyperthyroidism is generally compatible with FAA certification once thyroid function is stable and within normal range. The pilot must be free of symptoms such as tremor, palpitations, or heat intolerance.

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Antiplatelet (Cardiovascular Prophylaxis)
Generally Approved

Aspirin (Low-Dose)

Bayer Low-Dose, Baby Aspirin

Low-dose aspirin (81mg) for cardiovascular prevention is generally acceptable for pilots. The underlying cardiovascular condition being managed may require additional evaluation, but the medication itself is not an issue.

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Antiplatelet Agent
Generally Approved

Clopidogrel

Plavix

Clopidogrel is not on the FAA DNI list and is generally acceptable. However, the underlying condition requiring antiplatelet therapy (coronary stent, stroke prevention) typically requires Special Issuance evaluation.

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Xanthine Oxidase Inhibitor (Gout)
Generally Approved

Allopurinol

Zyloprim

Allopurinol for gout prevention is generally compatible with FAA certification. The medication is not on the DNI list. Ensure gout is well-controlled and not causing acute flares that could impair flight duties.

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Anti-Gout Agent
Generally Approved

Colchicine

Colcrys, Mitigare

Colchicine for gout treatment and prevention is generally acceptable for FAA certification. During an acute gout flare, pilots should not fly due to pain and mobility impairment rather than the medication itself.

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Penicillin Antibiotic
Generally Approved

Amoxicillin

Amoxil, Trimox

Amoxicillin is generally acceptable for pilots. The key consideration is the underlying infection being treated — pilots should not fly while acutely ill. Once feeling well and infection is resolving, flying is typically permissible.

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Macrolide Antibiotic
Generally Approved

Azithromycin

Zithromax, Z-Pack

Azithromycin is generally acceptable for pilots. The underlying infection is the primary concern. Do not fly while acutely ill. Once symptoms resolve and you are feeling well, flying is typically permissible.

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Fluoroquinolone Antibiotic
Generally Approved

Ciprofloxacin

Cipro

Ciprofloxacin is generally acceptable for FAA certification. However, fluoroquinolones can cause tendon issues, CNS effects, and peripheral neuropathy. Pilots should complete the course and ensure no significant side effects before flying.

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Tetracycline Antibiotic
Generally Approved

Doxycycline

Vibramycin, Doryx

Doxycycline is generally acceptable for pilots. Commonly used for infections and malaria prophylaxis. Sun sensitivity is the main side effect concern for pilots. Ensure no dizziness or visual disturbance.

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Cephalosporin Antibiotic
Generally Approved

Cephalexin

Keflex

Cephalexin is generally acceptable for pilots. A first-generation cephalosporin with minimal CNS effects. The underlying infection is the primary concern for flight safety, not the medication itself.

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Fluoroquinolone Antibiotic
Generally Approved

Levofloxacin

Levaquin

Levofloxacin is generally acceptable for FAA certification with the same precautions as ciprofloxacin. Monitor for CNS effects, tendon issues, and peripheral neuropathy. Ground trial recommended before flying.

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Antifungal
Generally Approved

Fluconazole

Diflucan

Fluconazole is generally acceptable for pilots for short-term antifungal treatment. No significant CNS effects at standard doses. The underlying condition should not impair flight safety.

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PDE5 Inhibitor (Erectile Dysfunction)
Generally Approved

Sildenafil

Viagra, Revatio

Sildenafil is acceptable for FAA certification with a mandatory 8-hour wait period after each dose. Pilots must not fly within 8 hours of taking a dose due to potential visual disturbances (blue-tinted vision) and hemodynamic effects.

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PDE5 Inhibitor (Erectile Dysfunction)
Generally Approved

Tadalafil

Cialis, Adcirca

Tadalafil is acceptable for FAA certification with a mandatory wait period. For as-needed use, a 24-hour wait is required. For daily low-dose use (2.5mg or 5mg), a 7-day ground trial is required to ensure no adverse effects before flying.

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NSAID (Over-the-Counter)
Generally Approved

Naproxen

Aleve, Naprosyn

Naproxen is generally acceptable for pilots when used as directed. Like ibuprofen, the underlying condition being treated is the primary concern. No specific grounding period for occasional use.

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NSAID / Analgesic (Over-the-Counter)
Generally Approved

Aspirin

Bayer, Bufferin, Ecotrin

Aspirin is generally acceptable for pilots for both pain relief and cardiovascular prophylaxis. No specific grounding period. The underlying condition being treated is the primary consideration.

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Decongestant (OTC)
Generally Approved

Pseudoephedrine

Sudafed

The FAA lists pseudoephedrine (Sudafed) as an acceptable decongestant, alone or in combination products, with no post-dose no-fly time once you have completed a 48-hour ground trial after first using it. It can speed up your heart rate, so use caution if you have a heart condition, and be careful about adding extra caffeine. Check combination products — many nighttime or "PM" formulas also contain a sedating antihistamine.

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Expectorant (OTC)
Generally Approved

Guaifenesin

Mucinex, Robitussin

Guaifenesin is an expectorant generally acceptable for pilots. It has no sedating properties when used alone. However, many combination products contain additional ingredients (dextromethorphan, antihistamines) that may affect flying.

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Leukotriene Modifier (Asthma / Allergies)
Generally Approved

Montelukast

Singulair

The FAA lists montelukast (Singulair) as an acceptable allergy medication, and the CACI Asthma Worksheet lists leukotriene receptor antagonists such as montelukast as acceptable for asthma. When you first start it, the FAA requires a 48-hour ground trial with no side effects before you fly. If you take it for asthma, your AME can issue only if your asthma meets the CACI criteria, including limits on symptoms and rescue inhaler use.

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GLP-1 Receptor Agonist (Weight Loss)
Generally Approved

Semaglutide (for Weight Loss)

Wegovy

As of the FAA's August 26, 2026 weight loss medication update, semaglutide (Wegovy, injection or oral) is acceptable for weight loss when certification criteria are met: an A1C of 6.4 or less, no diagnosis of diabetes, and no history of hypoglycemia requiring intervention. Do not fly for one week after starting, or for 48 hours after any dose increase or formulation change. If you take semaglutide for diabetes (Ozempic, Rybelsus), the diabetes Special Issuance pathway applies instead.

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Antihistamine (Allergy)
Generally Approved

Fexofenadine

Allegra

Fexofenadine is a second-generation antihistamine generally acceptable for pilots. It is non-sedating in most individuals. A ground trial is recommended to confirm no individual sedation response.

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5-Alpha Reductase Inhibitor (BPH / Hair Loss)
Generally Approved

Finasteride

Proscar, Propecia

Finasteride for BPH or hair loss is generally compatible with FAA certification. The medication has no significant CNS effects and is not on the DNI list. Report on your application.

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Alpha Blocker (BPH)
Generally Approved

Tamsulosin

Flomax

Tamsulosin for benign prostatic hyperplasia is generally acceptable for FAA certification. The main concern is orthostatic hypotension (dizziness upon standing), which should be assessed during ground trial.

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Alpha Blocker (Blood Pressure / BPH)
Generally Approved

Doxazosin

Cardura

Doxazosin is generally acceptable for FAA certification when used for BPH or hypertension. The main aviation concern is orthostatic hypotension (dizziness on standing). A ground trial is recommended.

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Cholesterol Absorption Inhibitor
Generally Approved

Ezetimibe

Zetia

Ezetimibe is generally compatible with FAA certification. Used alone or with statins for cholesterol management, it has a favorable side effect profile and is not on the DNI list.

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Fibrate (Cholesterol / Triglycerides)
Generally Approved

Fenofibrate

TriCor, Fenoglide

Fenofibrate for triglyceride management is generally compatible with FAA certification. Report the medication and ensure no significant side effects, particularly muscle pain when used with statins.

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Antibiotic / Antiprotozoal
Generally Approved

Metronidazole

Flagyl

Metronidazole is generally acceptable for pilots for short-term use. The main concern is the underlying infection. Avoid alcohol while on metronidazole due to severe interaction. Some pilots report metallic taste and mild nausea.

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Sulfonamide Antibiotic
Generally Approved

Trimethoprim-Sulfamethoxazole

Bactrim, Septra

TMP-SMX (Bactrim) is generally acceptable for pilots. The underlying urinary tract or other infection is the primary concern. Ensure adequate hydration and no significant side effects before flying.

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Urinary Antibiotic
Generally Approved

Nitrofurantoin

Macrobid, Macrodantin

Nitrofurantoin is generally acceptable for pilots for UTI treatment. Minimal systemic effects. The underlying infection is the primary concern for flight safety.

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Intranasal Corticosteroid (Allergy)
Generally Approved

Fluticasone (Nasal Spray)

Flonase, Veramyst

Fluticasone nasal spray is generally acceptable for pilots. It is a topical corticosteroid with minimal systemic absorption. No wait period or grounding required.

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Intranasal Corticosteroid (Allergy)
Generally Approved

Mometasone (Nasal Spray)

Nasonex

Mometasone nasal spray is generally acceptable for pilots. Like fluticasone nasal, it is a topical corticosteroid with minimal systemic effects and no grounding requirement.

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Antidiarrheal (OTC)
Generally Approved

Loperamide

Imodium

Loperamide is generally acceptable for pilots for short-term diarrhea management. The underlying GI condition is more important. Do not fly while experiencing active gastrointestinal illness.

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Proton Pump Inhibitor (OTC)
Generally Approved

Omeprazole (OTC)

Prilosec OTC

OTC omeprazole is acceptable for pilots, same as prescription omeprazole. Report even OTC medications on your application. The underlying GERD should be well-controlled.

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Antiviral
Generally Approved

Acyclovir

Zovirax, Sitavig

Acyclovir for herpes simplex or herpes zoster is generally acceptable for FAA certification. The medication has minimal CNS effects. The underlying condition (particularly if involving the eye or causing significant pain) should be assessed.

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Antiviral
Generally Approved

Valacyclovir

Valtrex

Valacyclovir is a prodrug of acyclovir and is generally acceptable for FAA certification. Same considerations as acyclovir — the underlying condition matters more than the medication.

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GI Protective Agent
Generally Approved

Sucralfate

Carafate

Sucralfate is generally acceptable for FAA certification. Used for gastric/duodenal ulcer protection, it acts locally in the GI tract with minimal systemic absorption. Report the underlying condition.

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Xanthine Oxidase Inhibitor (Gout)
Generally Approved

Febuxostat

Uloric

Febuxostat for gout prevention is generally compatible with FAA certification. Same pathway as allopurinol. Report on your application and ensure gout is well-controlled.

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Bisphosphonate (Osteoporosis)
Generally Approved

Alendronate

Fosamax

Alendronate for osteoporosis is generally compatible with FAA certification. The medication has no CNS effects and is not on the DNI list. Report on your application and note any GI side effects.

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Selective Estrogen Receptor Modulator (Osteoporosis)
Generally Approved

Raloxifene

Evista

Raloxifene for osteoporosis prevention is generally compatible with FAA certification. No significant CNS effects. The DVT risk should be discussed with your AME, but the medication itself is not on the DNI list.

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COX-2 Inhibitor (NSAID)
Generally Approved

Celecoxib

Celebrex

Celecoxib is a COX-2 selective NSAID generally acceptable for FAA certification. Like other NSAIDs, the underlying condition being treated is the primary concern. Report on your application.

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NSAID (Anti-Inflammatory)
Generally Approved

Meloxicam

Mobic

Meloxicam is an NSAID generally acceptable for FAA certification. Same considerations as ibuprofen and naproxen — the underlying condition matters more than the medication itself.

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Hormone Replacement Therapy (Estrogen)
Generally Approved

Estradiol (Hormone Replacement)

Estrace, Vivelle, Climara

Estradiol hormone replacement therapy is generally acceptable for FAA certification. Report on your application. The underlying condition and any thromboembolic risk should be discussed with your AME.

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GI Agent (IBS-C / Chronic Constipation)
Generally Approved

Linaclotide

Linzess

Linaclotide for IBS with constipation is generally compatible with FAA certification. The medication acts locally in the gut with minimal systemic absorption. Report the underlying condition on your application.

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Stool Softener (OTC)
Generally Approved

Docusate Sodium

Colace

Docusate sodium is an OTC stool softener that is generally acceptable for pilots. No CNS effects, no wait period required. Report on your application if using regularly.

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Osmotic Laxative (OTC)
Generally Approved

Polyethylene Glycol 3350

MiraLAX

MiraLAX is an OTC osmotic laxative generally acceptable for pilots. No systemic absorption. Ensure you are not experiencing active GI symptoms while flying.

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Vitamin Supplement
Generally Approved

Vitamin D (Cholecalciferol)

Various OTC brands

Vitamin D supplementation is generally acceptable for pilots. No aviation safety concerns. Report on your application if prescribed (as opposed to OTC supplement), and note the underlying reason for supplementation.

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Lipid-Lowering Supplement
Generally Approved

Omega-3 Fatty Acids (Fish Oil)

Lovaza, Vascepa, OTC Fish Oil

Fish oil and omega-3 supplements are generally acceptable for pilots. Prescription-strength versions (Lovaza, Vascepa) for triglyceride management are also acceptable. Report on your application.

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Sleep Supplement (OTC)
Generally Approved

Melatonin

Various OTC brands

The FAA's pilot OTC guide lists melatonin as generally safe to fly. No post-dose wait time is specified, but the FAA notes that taking melatonin at the wrong time can worsen jet lag and cause daytime drowsiness. As with any new medication, wait 48 hours after your first dose to confirm you have no side effects before flying.

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NSAID (Anti-Inflammatory)
Generally Approved

Diclofenac

Voltaren, Cataflam

Diclofenac is an NSAID generally acceptable for FAA certification, whether oral or topical (Voltaren gel). The underlying condition is the primary concern. Topical formulations have minimal systemic absorption.

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ACE Inhibitor (Blood Pressure)
Generally Approved

Fosinopril

Monopril

Fosinopril is an ACE inhibitor generally compatible with FAA medical certification. Blood pressure must be well-controlled and the pilot should not experience significant side effects such as dizziness or persistent cough.

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ACE Inhibitor (Blood Pressure)
Generally Approved

Quinapril

Accupril

Quinapril is an ACE inhibitor acceptable for FAA certification when blood pressure is controlled. Same pathway as other ACE inhibitors — report the medication and demonstrate stable blood pressure.

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ACE Inhibitor (Blood Pressure)
Generally Approved

Trandolapril

Mavik

Trandolapril is an ACE inhibitor generally compatible with FAA certification. Report the medication and ensure blood pressure is well-controlled with no significant side effects.

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ARB (Blood Pressure)
Generally Approved

Eprosartan

Teveten

Eprosartan is an ARB acceptable for FAA medical certification. Like other ARBs, it is not on the Do Not Issue list. Report on your application and demonstrate controlled blood pressure.

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Calcium Channel Blocker (Blood Pressure)
Generally Approved

Felodipine

Plendil

Felodipine is a dihydropyridine calcium channel blocker generally acceptable for FAA certification. It is a peripheral vasodilator used for hypertension and is not on the Do Not Issue list.

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Calcium Channel Blocker (Blood Pressure)
Generally Approved

Isradipine

DynaCirc

Isradipine is a calcium channel blocker acceptable for FAA certification when used for hypertension. Report the medication and ensure blood pressure is controlled without significant side effects.

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Calcium Channel Blocker (Blood Pressure)
Generally Approved

Nicardipine

Cardene

Nicardipine is a calcium channel blocker generally compatible with FAA certification for hypertension. It is a peripheral vasodilator and is not on the Do Not Issue list.

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Calcium Channel Blocker (Blood Pressure)
Generally Approved

Nisoldipine

Sular

Nisoldipine is a dihydropyridine calcium channel blocker acceptable for FAA certification. Same pathway as other CCBs — report the medication and demonstrate controlled blood pressure.

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Combined Alpha/Beta Blocker (Blood Pressure)
Generally Approved

Labetalol

Trandate

Labetalol is a combined alpha- and beta-blocker generally acceptable for FAA certification when used for hypertension. Report the medication and ensure no exercise intolerance, orthostatic hypotension, or excessive fatigue.

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Beta Blocker (Blood Pressure)
Generally Approved

Nadolol

Corgard

Nadolol is a non-selective beta blocker generally acceptable for FAA certification when prescribed for hypertension. If used for cardiac arrhythmia, the underlying condition may require Special Issuance evaluation.

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Beta Blocker (Blood Pressure)
Generally Approved

Pindolol

Visken

Pindolol is a beta blocker with intrinsic sympathomimetic activity, generally acceptable for FAA certification when used for hypertension. Less likely to cause bradycardia than other beta blockers.

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Beta Blocker (Blood Pressure)
Generally Approved

Acebutolol

Sectral

Acebutolol is a cardioselective beta blocker generally acceptable for FAA certification when used for hypertension. If prescribed for ventricular arrhythmias, the underlying condition may require Special Issuance evaluation.

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Thyroid Hormone (T3)
Generally Approved

Liothyronine

Cytomel

Liothyronine (T3) for hypothyroidism is generally compatible with FAA certification when thyroid levels are stable. Less commonly used than levothyroxine, but follows the same pathway. Stable TSH and free T3/T4 levels are required.

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Short-Acting Anticholinergic Bronchodilator
Generally Approved

Ipratropium

Atrovent

Ipratropium inhalers are generally acceptable for FAA certification. Used for COPD and sometimes asthma, the medication has minimal systemic effects. Pulmonary function testing must meet FAA standards.

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Proton Pump Inhibitor (GERD)
Generally Approved

Dexlansoprazole

Dexilant

Dexlansoprazole is a PPI acceptable for FAA certification. Same pathway as other PPIs — report the medication and ensure the underlying GI condition is well-managed.

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NSAID (Prescription)
Generally Approved

Nabumetone

Relafen

Nabumetone is a prescription NSAID generally acceptable for FAA certification. It is a prodrug with lower GI toxicity than some NSAIDs. The underlying condition being treated is the primary concern.

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NSAID (Prescription)
Generally Approved

Piroxicam

Feldene

Piroxicam is a prescription NSAID generally acceptable for FAA certification. It has a long half-life allowing once-daily dosing. Same pathway as other NSAIDs — underlying condition is the primary consideration.

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5-Alpha Reductase Inhibitor (BPH)
Generally Approved

Dutasteride

Avodart

Dutasteride is generally acceptable for FAA certification when used for BPH. Same pathway as finasteride — no CNS effects and not on the DNI list. Report on your application.

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Alpha Blocker (BPH)
Generally Approved

Silodosin

Rapaflo

Silodosin is a highly selective alpha blocker for BPH generally acceptable for FAA certification. Very uroselective with minimal blood pressure effects. Report on your application.

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Alpha Blocker (BPH)
Generally Approved

Alfuzosin

Uroxatral

Alfuzosin is an alpha blocker for BPH generally compatible with FAA certification. It is uroselective and less likely to cause systemic hypotension than older alpha blockers. Report the medication on your application.

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Alpha Blocker (BPH / Blood Pressure)
Generally Approved

Terazosin

Hytrin

Terazosin is an alpha blocker acceptable for FAA certification for BPH or hypertension. It can cause orthostatic hypotension and a ground trial is recommended before flying.

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GLP-1/GIP Receptor Agonist (Weight Loss)
Generally Approved

Tirzepatide (for Weight Loss)

Zepbound

As of the FAA's August 26, 2026 weight loss medication update, tirzepatide (Zepbound) is acceptable for weight loss when certification criteria are met: an A1C of 6.4% or less, no diagnosis of diabetes, and no history of hypoglycemia requiring intervention. Do not fly for one week after starting, or for 48 hours after any dose increase or formulation change. If you have prediabetes, your AME can issue using the CACI Prediabetes Worksheet. If you take tirzepatide for diabetes (Mounjaro), the diabetes Special Issuance pathway applies instead.

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Lipase Inhibitor (Weight Loss)
Generally Approved

Orlistat

Alli, Xenical

The FAA lists orlistat (Alli, Xenical) as an acceptable weight loss medication when certification criteria are met. Do not fly for 48 hours after first starting it. It can be combined with one diabetic medication used for weight loss, such as metformin or a GLP-1 agonist, under the FAA's weight loss criteria.

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Smoking Cessation Aid
Generally Approved

Varenicline

Chantix

Varenicline (Chantix) is an acceptable smoking cessation medication. Your AME can issue if you have no history of psychiatric conditions or concerns, and will annotate its use on your exam. Do not fly for one week after starting. No wait is required after each dose. If it is used as part of treatment for a psychiatric condition, the FAA's anxiety and depression guidance applies instead.

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Smoking Cessation Aid
Generally Approved

Nicotine Replacement Therapy

Nicorette, NicoDerm CQ, Nicotrol

The FAA lists nicotine replacement as an acceptable smoking cessation medication. Gum, lozenges, and patches need no ground trial and no wait after each dose. Nicotine nasal spray requires a 48-hour ground trial when you first start it.

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PDE5 Inhibitor (Erectile Dysfunction)
Generally Approved

Vardenafil

Levitra, Staxyn

The FAA's ED/BPH guidance lists vardenafil (Levitra, Staxyn) with a required 8-hour wait after the last dose before resuming pilot duties. It is not disqualifying when used for erectile dysfunction or benign prostatic hyperplasia without side effects, as long as the underlying condition isn't aeromedically significant. If you use it for any other condition, the AME must defer. Nitrates are not allowed.

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PDE5 Inhibitor (Erectile Dysfunction)
Generally Approved

Avanafil

Stendra

The FAA's ED/BPH guidance lists avanafil (Stendra) with a required 8-hour wait after the last dose before resuming pilot duties. It is not disqualifying when used for erectile dysfunction or benign prostatic hyperplasia without side effects, as long as the underlying condition isn't aeromedically significant. If you use it for any other condition, the AME must defer. Nitrates are not allowed.

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Antihistamine (Allergy)
Generally Approved

Desloratadine

Clarinex

The FAA lists desloratadine (Clarinex) as an acceptable non-sedating antihistamine, alone or in combination products, if you otherwise meet certification criteria. Wait 48 hours after your first dose to confirm you have no side effects; after that, no wait is required after each dose.

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Nasal Decongestant (OTC)
Generally Approved

Oxymetazoline (Nasal Spray)

Afrin

The FAA lists oxymetazoline nasal spray (Afrin) as an acceptable decongestant. Wait 48 hours after your first use to confirm you have no side effects; after that, no wait is required after each dose. Decongestants can speed up your heart rate, so use caution if you have a heart condition. Don't fly if congestion keeps you from clearing your ears at ground level.

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Bisphosphonate (Osteoporosis)
Generally Approved

Ibandronate

Boniva

The FAA lists oral ibandronate (Boniva) as an acceptable osteoporosis medication when certification criteria are met, with no initial observation period and no wait after each dose. This guidance applies to osteoporosis treatment only; cancer-related use may carry additional requirements.

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Bisphosphonate (Osteoporosis)
Generally Approved

Risedronate

Actonel

The FAA lists oral risedronate (Actonel) as an acceptable osteoporosis medication when certification criteria are met, with no initial observation period and no wait after each dose. This guidance applies to osteoporosis treatment only; cancer-related use may carry additional requirements.

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RANK Ligand Inhibitor (Osteoporosis)
Generally Approved

Denosumab

Prolia

The FAA lists denosumab (Prolia) as an acceptable osteoporosis medication when certification criteria are met. Do not fly for 48 hours after your first dose, and for 4 hours after each later dose. This guidance applies to osteoporosis treatment only; cancer-related use may carry additional requirements.

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PCSK9 Inhibitor (Cholesterol)
Generally Approved

Evolocumab

Repatha

The FAA lists evolocumab (Repatha) as an acceptable cholesterol medication, alone or in any combination product. Like all cholesterol medications, it requires a 48-hour ground trial when you first start it. No wait is required after each dose.

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PCSK9 Inhibitor (Cholesterol)
Generally Approved

Alirocumab

Praluent

The FAA lists alirocumab (Praluent) as an acceptable cholesterol medication, alone or in any combination product. Like all cholesterol medications, it requires a 48-hour ground trial when you first start it. No wait is required after each dose.

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ACL Inhibitor (Cholesterol)
Generally Approved

Bempedoic Acid

Nexletol

The FAA lists bempedoic acid (Nexletol) as an acceptable cholesterol medication, alone or in any combination product. Like all cholesterol medications, it requires a 48-hour ground trial when you first start it. No wait is required after each dose.

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Conditionally Approved

(101)

These medications may be approved through the FAA's Special Issuance process. Additional documentation, wait periods, or monitoring may be required.

Antihistamine (Allergy)
Conditionally Approved

Cetirizine

Zyrtec

The FAA classifies cetirizine (Zyrtec) as a sedating second-generation antihistamine. It is conditionally acceptable: you may use it occasionally (1–2 times a week), but daily use is not acceptable, and you must not fly for 48 hours after each dose. Loratadine (Claritin), fexofenadine (Allegra), and desloratadine (Clarinex) are acceptable without a post-dose wait.

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SSRI Antidepressant
Conditionally Approved

Sertraline

Zoloft

Sertraline (Zoloft) is one of nine conditionally acceptable antidepressants under the FAA's Antidepressant Protocol (formerly the SSRI Protocol). The AME cannot issue your first certificate; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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SSRI Antidepressant
Conditionally Approved

Fluoxetine

Prozac

Fluoxetine (Prozac) is one of nine conditionally acceptable antidepressants under the FAA's Antidepressant Protocol (formerly the SSRI Protocol). It was one of the original four SSRIs the FAA allowed in 2010. The AME cannot issue your first certificate; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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SSRI Antidepressant
Conditionally Approved

Citalopram

Celexa

Citalopram (Celexa) is one of nine conditionally acceptable antidepressants under the FAA's Antidepressant Protocol (formerly the SSRI Protocol). The AME cannot issue your first certificate; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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SSRI Antidepressant
Conditionally Approved

Escitalopram

Lexapro

Escitalopram (Lexapro) is one of nine conditionally acceptable antidepressants under the FAA's Antidepressant Protocol (formerly the SSRI Protocol). The AME cannot issue your first certificate; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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Type 2 Diabetes Medication
Conditionally Approved

Metformin

Glucophage, Fortamet

Metformin is approved for pilots with Type 2 diabetes under the Special Issuance process. Pilots must demonstrate stable blood glucose control and absence of significant diabetes-related complications.

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Sulfonylurea (Type 2 Diabetes)
Conditionally Approved

Glipizide

Glucotrol

Glipizide is conditionally approved for pilots with Type 2 diabetes. Because sulfonylureas can cause hypoglycemia, the FAA requires additional glucose monitoring documentation compared to metformin alone.

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Insulin (Diabetes)
Conditionally Approved

Insulin (all types)

Humalog, Lantus, Novolog, Tresiba

Since November 2019, the FAA allows insulin-treated pilots to hold 1st, 2nd, and 3rd class medical certificates through a rigorous Special Issuance protocol. This was a landmark policy change. The process requires extensive documentation and continuous glucose monitoring.

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Anticoagulant (Blood Thinner)
Conditionally Approved

Warfarin

Coumadin, Jantoven

Warfarin may be approved through Special Issuance, depending on the underlying condition requiring anticoagulation. The INR must be stable and within therapeutic range. The underlying condition (DVT, AFib, mechanical valve) drives the certification pathway.

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Sedative-Hypnotic (Sleep Aid)
Conditionally Approved

Zolpidem

Ambien, Ambien CR

Zolpidem (Ambien) is a Do Not Fly medication with a mandatory 24-hour wait period after each dose. Occasional use is permitted, but daily or nightly use is not allowed for pilots. Pilots may hold a medical certificate while using zolpidem occasionally, but must not fly within 24 hours of taking a dose.

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Triptan (Migraine)
Conditionally Approved

Sumatriptan

Imitrex

The FAA's migraine medication guidance (updated 08/26/2026) lists sumatriptan (all formulations) as CACI acceptable for migraine relief when used occasionally. You must not fly for 24 hours after each dose. Daily use is not acceptable, and needing multiple relief medications on a recurring basis is considered complicated migraine, which requires the AME to defer.

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DPP-4 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Sitagliptin

Januvia

Sitagliptin is a DPP-4 inhibitor on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

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Thiazolidinedione (Type 2 Diabetes)
Conditionally Approved

Pioglitazone

Actos

Pioglitazone is a thiazolidinedione on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

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Prostaglandin Analog (Ophthalmic)
Conditionally Approved

Latanoprost

Xalatan

Latanoprost eye drops are on the FAA's list of CACI glaucoma medications, alone or in combination products. Your AME can issue a certificate if you meet the criteria. Bring a current, detailed clinical progress note from your eye doctor, from a visit no more than 90 days before your exam, covering your history, medications and side effects, exam findings, test results, diagnosis, and plan.

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Beta Blocker Eye Drops (Glaucoma)
Conditionally Approved

Timolol (Ophthalmic)

Timoptic

Timolol eye drops are on the FAA's list of CACI glaucoma medications, alone or in combination products. Your AME can issue a certificate if you meet the criteria. Bring a current, detailed clinical progress note from your eye doctor, from a visit no more than 90 days before your exam, covering your history, medications and side effects, exam findings, test results, diagnosis, and plan.

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Short-Acting Beta Agonist (Asthma)
Conditionally Approved

Albuterol (Inhaler)

ProAir, Ventolin, Proventil

Albuterol, an inhaled short-acting beta agonist, is on the FAA's list of acceptable medications for asthma under the CACI Asthma Worksheet. Whether your AME can issue depends on how well your asthma is controlled, not the inhaler alone. The worksheet limits rescue inhaler use to no more than 2 times per week. If your only treatment is albuterol as needed on one or two days a week, you don't need spirometry.

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Inhaled Corticosteroid (Asthma)
Conditionally Approved

Fluticasone (Inhaler)

Flovent, ArmonAir

Inhaled corticosteroids such as fluticasone are on the FAA's list of acceptable medications for asthma under the CACI Asthma Worksheet. Your AME can issue at the exam if your asthma meets every worksheet criterion, including a breathing test (spirometry) from the last 90 days with FEV1 and FVC at or above 80% of predicted. If you don't meet every item, the FAA decides.

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SGLT2 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Empagliflozin

Jardiance

Empagliflozin is an SGLT2 inhibitor that may be approved for pilots with Type 2 diabetes through the Special Issuance process. While it has cardiovascular benefits, the FAA requires documentation of stable glucose control and absence of diabetic ketoacidosis risk.

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GLP-1 Receptor Agonist (Type 2 Diabetes)
Conditionally Approved

Liraglutide

Victoza, Saxenda

Liraglutide is a GLP-1 receptor agonist that may be approved through the FAA diabetes Special Issuance pathway. Low hypoglycemia risk as monotherapy. When branded as Saxenda for weight loss, the indication may affect the pathway.

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GLP-1 Receptor Agonist (Type 2 Diabetes)
Conditionally Approved

Dulaglutide

Trulicity

Dulaglutide is a weekly GLP-1 agonist that may be approved through the FAA diabetes Special Issuance process. Same pathway as other diabetes medications — stable glucose control and appropriate monitoring required.

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SGLT2 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Canagliflozin

Invokana

Canagliflozin is an SGLT2 inhibitor available through the FAA diabetes Special Issuance pathway. Like empagliflozin, documentation must confirm no DKA risk and stable glucose control.

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SGLT2 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Dapagliflozin

Farxiga

Dapagliflozin is an SGLT2 inhibitor that may be approved through the FAA diabetes Special Issuance process. Standard diabetes pathway requirements apply — stable glucose, A1C monitoring, and no DKA episodes.

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Direct Oral Anticoagulant (DOAC)
Conditionally Approved

Apixaban

Eliquis

Apixaban may be approved through Special Issuance depending on the underlying condition requiring anticoagulation (atrial fibrillation, DVT/PE). The medication itself is increasingly accepted as an alternative to warfarin, but the underlying condition drives the pathway.

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Direct Oral Anticoagulant (DOAC)
Conditionally Approved

Rivaroxaban

Xarelto

Rivaroxaban may be approved through Special Issuance depending on the underlying indication. Like apixaban, the DOAC itself is not specifically prohibited, but the condition requiring anticoagulation must be certifiable.

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Direct Oral Anticoagulant (DOAC)
Conditionally Approved

Dabigatran

Pradaxa

Dabigatran may be approved through Special Issuance depending on the underlying condition. Same pathway as other DOACs — the anticoagulant is not specifically prohibited, but the condition requiring it must be certifiable.

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Antiarrhythmic (Class III)
Conditionally Approved

Amiodarone

Cordarone, Pacerone

Amiodarone requires Special Issuance evaluation. The underlying arrhythmia is the primary concern, and amiodarone's significant side effect profile (thyroid, pulmonary, liver, neurological) requires extensive monitoring. Certification is possible but complex.

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Antiarrhythmic (Class IC)
Conditionally Approved

Flecainide

Tambocor

Flecainide requires Special Issuance evaluation. Used for atrial fibrillation and supraventricular tachycardia, the underlying arrhythmia and the medication's proarrhythmic potential both require thorough cardiac evaluation.

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Antiarrhythmic (Class III) / Beta Blocker
Conditionally Approved

Sotalol

Betapace, Sorine

Sotalol requires Special Issuance evaluation due to its antiarrhythmic properties and the underlying cardiac condition. It combines beta blocker and class III antiarrhythmic effects, requiring thorough cardiac workup.

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Thyroid Hormone Replacement (Post-Surgical)
Conditionally Approved

Levothyroxine (Post-Thyroidectomy)

Synthroid, Levoxyl

Levothyroxine after thyroidectomy for thyroid cancer requires Special Issuance evaluation. While levothyroxine itself is approved, the cancer history necessitates documentation of remission status, surveillance labs, and endocrinologist follow-up.

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Benzodiazepine (Sleep Aid)
Conditionally Approved

Temazepam

Restoril

Temazepam (Restoril) is listed on the FAA sleep aids page with a mandatory 72-hour wait period after each dose. Despite being a benzodiazepine, the FAA permits occasional use for sleep with this extended wait period. Daily or nightly use is not allowed. Note: other benzodiazepines used for anxiety (alprazolam, diazepam, lorazepam, clonazepam) remain fully disqualifying.

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Sedative-Hypnotic (Sleep Aid)
Conditionally Approved

Eszopiclone

Lunesta

Eszopiclone (Lunesta) is a Do Not Fly medication with a mandatory 30-hour wait period after each dose. Occasional use is permitted, but daily or nightly use is not allowed for pilots. The longer wait period compared to zolpidem reflects its longer half-life.

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Sedative-Hypnotic (Sleep Aid)
Conditionally Approved

Zaleplon

Sonata

Zaleplon (Sonata) is a Do Not Fly medication with a mandatory 12-hour wait period after each dose — the shortest wait of all FAA-listed sleep aids due to its very short half-life. Occasional use is permitted, but daily or nightly use is not allowed for pilots.

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Antidepressant (NDRI)
Conditionally Approved

Bupropion

Wellbutrin, Zyban

Bupropion's FAA status depends on the formulation and why you take it. Sustained-release (SR) and extended-release (ER/XL) Wellbutrin were added to the FAA's conditionally acceptable antidepressants on May 31, 2023, and are considered case by case through Special Issuance with a HIMS AME evaluation. Immediate-release (IR) bupropion is unacceptable. For smoking cessation (Zyban), the FAA does not issue a medical during a first treatment course and requires a 7-day no-fly after the last dose. Bupropion combined with naltrexone (Contrave) for weight loss is on the Do Not Issue list.

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First-Generation Antihistamine (Allergy / Sleep)
Conditionally Approved

Diphenhydramine

Benadryl

The FAA classifies diphenhydramine (Benadryl) as a sedating first-generation antihistamine. It is conditionally acceptable only for occasional use (1–2 times a week), never daily, and you must not fly for 60 hours after each dose. It is found in many OTC allergy, cold, and sleep products, including most "PM" formulas, and the FAA notes it is the medication most commonly found on autopsy after aircraft accidents.

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DPP-4 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Linagliptin

Tradjenta

Linagliptin is a DPP-4 inhibitor on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

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DPP-4 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Saxagliptin

Onglyza

Saxagliptin is a DPP-4 inhibitor on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

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Disease-Modifying Antirheumatic Drug (DMARD)
Conditionally Approved

Methotrexate

Trexall, Rheumatrex

Methotrexate may be conditionally approved depending on the underlying autoimmune condition. Used for rheumatoid arthritis and psoriasis, the medication requires monitoring but is not specifically on the DNI list. The underlying condition drives the pathway.

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TNF Inhibitor (Biologic)
Conditionally Approved

Adalimumab

Humira

The FAA lists adalimumab (Humira) as an acceptable biologic when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 4 hours after each dose. FDA-approved biosimilars (such as Hadlima) are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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Corticosteroid (Anti-Inflammatory)
Conditionally Approved

Prednisone

Deltasone, Rayos

Prednisone is conditionally acceptable. Short-term courses (e.g., for asthma exacerbation) may be acceptable after the course is completed and symptoms resolve. Chronic systemic steroid use requires evaluation for side effects including mood changes, glucose elevation, and adrenal suppression.

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Antiemetic (Anti-Nausea)
Conditionally Approved

Ondansetron

Zofran

The FAA's migraine medication guidance (updated 08/26/2026) lists ondansetron (Zofran) as CACI acceptable for occasional use for nausea and vomiting associated with migraine, with a 24-hour no-fly period after each dose. Daily use is not acceptable. Do not fly while you are nauseated or ill; for other causes of nausea, the underlying condition determines eligibility.

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Prokinetic / Antiemetic
Conditionally Approved

Metoclopramide

Reglan

The FAA's migraine medication guidance (updated 08/26/2026) lists metoclopramide as CACI acceptable for nausea and vomiting associated with migraine when used occasionally, with a 36-hour no-fly period after each dose. It is not on the FAA's Do Not Issue or Do Not Fly tables. Do not fly while symptomatic. For other uses, the underlying condition determines eligibility — discuss it with your AME.

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SNRI Antidepressant
Conditionally Approved

Duloxetine

Cymbalta

Duloxetine (Cymbalta) is one of the FAA's conditionally acceptable antidepressants under the Antidepressant Protocol (formerly the SSRI Protocol), which added SNRIs on April 24, 2024. The AME cannot issue; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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SNRI Antidepressant
Conditionally Approved

Venlafaxine

Effexor, Effexor XR

Venlafaxine (Effexor) is one of the FAA's conditionally acceptable antidepressants under the Antidepressant Protocol (formerly the SSRI Protocol), which added SNRIs on April 24, 2024. The AME cannot issue; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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Long-Acting Anticholinergic (COPD / Asthma)
Conditionally Approved

Tiotropium (Inhaler)

Spiriva

Tiotropium may be conditionally approved depending on the severity of the underlying COPD or asthma. Mild, well-controlled cases with adequate pulmonary function may qualify. Severe COPD is generally disqualifying.

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Inhaled Corticosteroid (Asthma)
Conditionally Approved

Budesonide (Inhaler)

Pulmicort

Budesonide is an inhaled corticosteroid, a medication class the FAA lists as acceptable for asthma on the CACI Asthma Worksheet. Your AME can issue at the exam if your asthma meets every worksheet criterion, including spirometry from the last 90 days with FEV1 and FVC at or above 80% of predicted. If you don't meet every item, the FAA decides.

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Long-Acting Beta Agonist (LABA)
Conditionally Approved

Formoterol (Inhaler)

Foradil, Perforomist

Formoterol is an inhaled long-acting beta agonist, a medication class the FAA lists as acceptable for asthma on the CACI Asthma Worksheet. For asthma, your AME can issue if you meet every worksheet criterion. For COPD, emphysema, or chronic bronchitis, the FAA's disposition table tells the AME to defer and send your records to the FAA for a possible Special Issuance.

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Long-Acting Beta Agonist (LABA)
Conditionally Approved

Salmeterol (Inhaler)

Serevent

Salmeterol is an inhaled long-acting beta agonist, a medication class the FAA lists as acceptable for asthma on the CACI Asthma Worksheet. For asthma, your AME can issue if you meet every worksheet criterion. For COPD, emphysema, or chronic bronchitis, the FAA's disposition table tells the AME to defer and send your records to the FAA for a possible Special Issuance.

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Triptan (Migraine)
Conditionally Approved

Rizatriptan

Maxalt

The FAA's migraine medication guidance (updated 08/26/2026) lists rizatriptan as CACI acceptable for migraine relief when used occasionally. You must not fly for 24 hours after each dose. Daily use is not acceptable, and needing multiple relief medications on a recurring basis is considered complicated migraine, which requires the AME to defer.

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Cardiac Glycoside
Conditionally Approved

Digoxin

Lanoxin

Digoxin requires Special Issuance evaluation. Used for heart failure and atrial fibrillation, both the medication and underlying cardiac condition require thorough evaluation. Narrow therapeutic index makes monitoring critical.

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Antiarrhythmic
Conditionally Approved

Dronedarone

Multaq

Dronedarone requires Special Issuance evaluation. Used for atrial fibrillation, the underlying arrhythmia and medication both require comprehensive cardiac workup for FAA certification.

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Antiarrhythmic (Class IC)
Conditionally Approved

Propafenone

Rhythmol

Propafenone requires Special Issuance evaluation. Used for atrial fibrillation and supraventricular tachycardia, the medication and underlying arrhythmia require comprehensive cardiac documentation.

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GLP-1 Receptor Agonist (Type 2 Diabetes)
Conditionally Approved

Semaglutide (for Diabetes)

Ozempic, Rybelsus

Semaglutide for Type 2 diabetes (Ozempic/Rybelsus) may be approved through the FAA diabetes Special Issuance pathway. This is distinct from the weight loss indication (Wegovy). Standard diabetes monitoring and documentation requirements apply.

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Hormone Replacement (Testosterone)
Conditionally Approved

Testosterone (Replacement Therapy)

AndroGel, Testim, Depo-Testosterone

Testosterone replacement therapy may be conditionally acceptable for FAA certification. Testosterone levels must be within normal physiologic range and the underlying hypogonadism must be documented. Supraphysiologic dosing is not acceptable.

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Phenothiazine Antiemetic / Antihistamine
Conditionally Approved

Promethazine

Phenergan

The FAA's migraine medication guidance (updated 08/26/2026) lists promethazine as CACI acceptable for nausea and vomiting associated with migraine when used occasionally, with a 96-hour no-fly period after each dose. It is not on the FAA's Do Not Issue or Do Not Fly tables. Do not fly while symptomatic. For other uses, the underlying condition determines eligibility — discuss it with your AME.

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Antidiuretic Hormone Analog
Conditionally Approved

Desmopressin

DDAVP, Stimate

Desmopressin may be conditionally approved depending on the underlying condition (diabetes insipidus, bedwetting, von Willebrand disease). The condition and electrolyte stability determine the certification pathway.

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DMARD / Antimalarial
Conditionally Approved

Hydroxychloroquine

Plaquenil

Hydroxychloroquine may be conditionally approved depending on the underlying autoimmune condition. The main aviation concern is retinal toxicity with long-term use, which can affect visual fields. Regular ophthalmologic screening is required.

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DMARD (Rheumatoid Arthritis)
Conditionally Approved

Leflunomide

Arava

Leflunomide may be conditionally approved depending on the underlying rheumatoid arthritis severity and medication side effects. Not on the DNI list, but the underlying condition and immunosuppression require evaluation.

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DMARD (Rheumatoid Arthritis / IBD)
Conditionally Approved

Sulfasalazine

Azulfidine

Sulfasalazine may be conditionally approved depending on whether used for rheumatoid arthritis or inflammatory bowel disease. The medication itself is not on the DNI list, but the underlying condition drives the certification pathway.

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5-ASA Agent (Inflammatory Bowel Disease)
Conditionally Approved

Mesalamine

Asacol, Lialda, Pentasa

Mesalamine for ulcerative colitis or Crohn's disease may be conditionally approved. The medication itself is not on the DNI list, but the underlying IBD severity and symptom control determine the certification pathway.

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Immunosuppressant
Conditionally Approved

Azathioprine

Imuran, Azasan

Azathioprine may be conditionally approved depending on the underlying autoimmune condition. As an immunosuppressant, infection risk and the underlying disease activity must be well-documented for certification.

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Immunosuppressant (Transplant)
Conditionally Approved

Tacrolimus

Prograf

Tacrolimus for organ transplant recipients may be considered through Special Issuance, though the pathway is complex. Organ transplant certification is one of the most challenging Special Issuance categories, requiring extensive documentation of graft function and overall health.

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Immunosuppressant (Transplant / Autoimmune)
Conditionally Approved

Mycophenolate

CellCept, Myfortic

Mycophenolate may be conditionally approved through Special Issuance depending on whether used for transplant or autoimmune disease. Same extensive evaluation pathway as other immunosuppressants.

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Heart Rate Reducer (Heart Failure)
Conditionally Approved

Ivabradine

Corlanor

Ivabradine requires Special Issuance evaluation. Used for heart failure with reduced ejection fraction, the underlying cardiac condition is the primary concern. Comprehensive cardiac documentation required.

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ARNI (Heart Failure)
Conditionally Approved

Sacubitril-Valsartan

Entresto

Sacubitril-valsartan requires Special Issuance evaluation. As a heart failure medication, the underlying cardiac condition must be thoroughly documented including ejection fraction, functional status, and exercise tolerance.

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Direct Oral Anticoagulant (DOAC)
Conditionally Approved

Edoxaban

Savaysa

Edoxaban may be approved through Special Issuance depending on the underlying condition requiring anticoagulation. Like other DOACs, the medication itself is not specifically prohibited, but the underlying condition must be certifiable.

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Antiarrhythmic (Class III)
Conditionally Approved

Dofetilide

Tikosyn

Dofetilide requires Special Issuance evaluation. Used for atrial fibrillation and atrial flutter, the underlying arrhythmia and the medication's QT-prolonging potential both require thorough cardiac evaluation and monitoring.

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DPP-4 Inhibitor (Type 2 Diabetes)
Conditionally Approved

Alogliptin

Nesina

Alogliptin is a DPP-4 inhibitor on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

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Leukotriene Modifier (Asthma)
Conditionally Approved

Zafirlukast

Accolate

Zafirlukast is a leukotriene receptor antagonist, a medication class the FAA lists as acceptable for asthma on the CACI Asthma Worksheet. Your AME can issue at the exam if your asthma meets every worksheet criterion, including spirometry from the last 90 days with FEV1 and FVC at or above 80% of predicted. If you don't meet every item, the FAA decides.

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Methylxanthine Bronchodilator (Asthma / COPD)
Conditionally Approved

Theophylline

Theo-24, Elixophyllin

Theophylline has a narrow therapeutic index and can cause significant side effects at supratherapeutic levels. The FAA may require documentation of stable therapeutic levels and absence of CNS side effects such as tremor, insomnia, or seizures.

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NSAID (Prescription — Short-Term)
Conditionally Approved

Ketorolac

Toradol

The FAA's migraine medication guidance (updated 08/26/2026) lists ketorolac, by all routes of administration, as SI Conditional. It is intended for short-term use (less than 5 days) for severe or intractable headaches, not mild symptoms, and requires a 36-hour no-fly period after each dose. Do not fly while in acute pain, and report any use to your AME.

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Retinoid (Severe Acne Treatment)
Conditionally Approved

Isotretinoin

Accutane, Claravis, Absorica

You cannot fly while taking oral isotretinoin. The FAA requires that it be permanently discontinued for at least 2 weeks, confirmed by the prescribing physician, before you can be considered, because it can cause decreased night vision and depression — effects that can occur even after stopping. You will also need an eye evaluation and a signed statement confirming no visual or psychiatric symptoms and acknowledging that you must get FAA clearance before flying if you resume it. Topical acne medications and oral antibiotics such as tetracycline are acceptable.

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Alpha-2 Agonist Eye Drops (Glaucoma)
Conditionally Approved

Brimonidine (Ophthalmic)

Alphagan, Alphagan P

Brimonidine eye drops are on the FAA's list of CACI glaucoma medications, alone or in combination products. Your AME can issue a certificate if you meet the criteria. Bring a current, detailed clinical progress note from your eye doctor, from a visit no more than 90 days before your exam, covering your history, medications and side effects, exam findings, test results, diagnosis, and plan.

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Carbonic Anhydrase Inhibitor Eye Drops (Glaucoma)
Conditionally Approved

Dorzolamide (Ophthalmic)

Trusopt

Dorzolamide eye drops are on the FAA's list of CACI glaucoma medications, alone or in combination products. Your AME can issue a certificate if you meet the criteria. Bring a current, detailed clinical progress note from your eye doctor, from a visit no more than 90 days before your exam, covering your history, medications and side effects, exam findings, test results, diagnosis, and plan.

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GLP-1/GIP Receptor Agonist (Type 2 Diabetes)
Conditionally Approved

Tirzepatide (for Diabetes)

Mounjaro

Tirzepatide (Mounjaro) is on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization. If you take tirzepatide for weight loss without a diabetes diagnosis (Zepbound), a different FAA pathway applies.

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Sulfonylurea (Type 2 Diabetes)
Conditionally Approved

Glimepiride

Amaryl

Glimepiride (Amaryl) is a sulfonylurea on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. Sulfonylureas carry the FAA's longest non-insulin observation period: 60 days after starting.

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Sulfonylurea (Type 2 Diabetes)
Conditionally Approved

Glyburide

Diabeta

Glyburide (Diabeta) is a sulfonylurea on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. Sulfonylureas carry the FAA's longest non-insulin observation period: 60 days after starting.

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SNRI Antidepressant
Conditionally Approved

Desvenlafaxine

Pristiq

Desvenlafaxine (Pristiq) is one of nine conditionally acceptable antidepressants under the FAA's Antidepressant Protocol (formerly the SSRI Protocol). It was added when the FAA expanded the protocol to SNRIs on April 24, 2024. The AME cannot issue your first certificate; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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SSRI / 5-HT1A Partial Agonist Antidepressant
Conditionally Approved

Vilazodone

Viibryd

Vilazodone (Viibryd) is one of nine conditionally acceptable antidepressants under the FAA's Antidepressant Protocol (formerly the SSRI Protocol). The AME cannot issue your first certificate; the FAA decides case by case through Special Issuance. You must be stable on the same dose for at least 3 continuous months without aeromedically significant side effects, take it as your only antidepressant, and be evaluated by a HIMS AME.

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Melatonin Receptor Agonist (Sleep Aid)
Conditionally Approved

Ramelteon

Rozerem

Ramelteon (Rozerem) is listed on the FAA's sleep aids page with a required 24-hour wait after each dose before resuming pilot duties. Occasional or limited use of sleep aids is allowed, but daily or nightly use is not allowed for any reason. Conditions that chronically interfere with sleep are disqualifying on their own.

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CGRP Receptor Antagonist (Migraine)
Conditionally Approved

Rimegepant

Nurtec ODT

The FAA's migraine medication guidance (updated 08/26/2026) lists rimegepant (Nurtec ODT) as CACI acceptable for migraine relief when used occasionally. You must not fly for 24 hours after each dose. Daily use is not acceptable, and needing multiple relief medications on a recurring basis is considered complicated migraine, which requires the AME to defer.

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CGRP Receptor Antagonist (Migraine)
Conditionally Approved

Ubrogepant

Ubrelvy

The FAA's migraine medication guidance (updated 08/26/2026) lists ubrogepant (Ubrelvy) as CACI acceptable for migraine relief when used occasionally. You must not fly for 24 hours after each dose. Daily use is not acceptable, and needing multiple relief medications on a recurring basis is considered complicated migraine, which requires the AME to defer.

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Triptan (Migraine)
Conditionally Approved

Eletriptan

Relpax

The FAA's migraine medication guidance (updated 08/26/2026) lists eletriptan (Relpax) as CACI acceptable for migraine relief when used occasionally. You must not fly for 48 hours after each dose. Daily use is not acceptable, and needing multiple relief medications on a recurring basis is considered complicated migraine, which requires the AME to defer.

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CGRP Antagonist (Migraine Prevention)
Conditionally Approved

Atogepant

Qulipta

The FAA's migraine medication guidance lists atogepant (Qulipta) as CACI acceptable for migraine prevention. You must complete a 7-day ground trial to confirm it works and causes no adverse effects before flying. No wait is required after each dose.

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CGRP Antagonist (Migraine Prevention)
Conditionally Approved

Erenumab

Aimovig

The FAA's migraine medication guidance lists erenumab (Aimovig) as CACI acceptable for migraine prevention. You must complete a 7-day ground trial to confirm it works and causes no adverse effects before flying. No wait is required after each dose.

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CGRP Antagonist (Migraine Prevention)
Conditionally Approved

Fremanezumab

Ajovy

The FAA's migraine medication guidance lists fremanezumab (Ajovy) as CACI acceptable for migraine prevention. You must complete a 7-day ground trial to confirm it works and causes no adverse effects before flying. No wait is required after each dose.

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CGRP Antagonist (Migraine Prevention)
Conditionally Approved

Galcanezumab

Emgality

The FAA's migraine medication guidance lists galcanezumab (Emgality) as CACI acceptable for migraine prevention. You must complete a 7-day ground trial to confirm it works and causes no adverse effects before flying. No wait is required after each dose.

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5-HT1F Receptor Agonist (Migraine)
Conditionally Approved

Lasmiditan

Reyvow

The FAA's migraine medication guidance lists lasmiditan (Reyvow) as SI Conditional for migraine relief, with a 48-hour no-fly period after each dose. It is unacceptable for migraine prevention. Discuss your migraine history and treatment with your AME before flying.

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Neurotoxin (Chronic Migraine Prevention)
Conditionally Approved

Botulinum Toxin (for Migraine)

Botox

The FAA's migraine medication guidance lists botulinum toxin (Botox) for migraine prevention as SI Conditional. It is reserved for severe, refractory headaches and may cause delayed side effects such as muscle weakness, excessive fatigue, or eye symptoms. You must complete a 1-month ground trial and not fly for 72 hours after each treatment.

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Antihistamine (Allergy)
Conditionally Approved

Levocetirizine

Xyzal

The FAA classifies levocetirizine (Xyzal) as a sedating second-generation antihistamine. It is conditionally acceptable: you may use it occasionally (1–2 times a week), but daily use is not acceptable, and you must not fly for 48 hours after each dose. Loratadine (Claritin), fexofenadine (Allegra), and desloratadine (Clarinex) are acceptable without a post-dose wait.

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First-Generation Antihistamine (Allergy / Cold)
Conditionally Approved

Chlorpheniramine

Chlor-Trimeton, Coricidin

The FAA classifies chlorpheniramine as a sedating first-generation antihistamine. It is conditionally acceptable only for occasional use (1–2 times a week), never daily, and you must not fly for 5 days after each dose because of its long half-life. It is common in cold and allergy combination products — including Coricidin HBP — so check labels carefully.

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First-Generation Antihistamine (Sleep Aid)
Conditionally Approved

Doxylamine

Unisom SleepTabs, NyQuil

The FAA classifies doxylamine as a sedating first-generation antihistamine. It is conditionally acceptable only for occasional use (1–2 times a week), never daily, and you must not fly for 60 hours after each dose. It is the active ingredient in many OTC sleep aids and nighttime cold medicines, including Unisom SleepTabs and NyQuil.

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TNF Inhibitor (Biologic)
Conditionally Approved

Etanercept

Enbrel

The FAA lists etanercept (Enbrel) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 4 hours after each dose. FDA-approved biosimilars are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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TNF Inhibitor (Biologic)
Conditionally Approved

Infliximab

Remicade, Inflectra, Renflexis

The FAA lists infliximab (Remicade, Inflectra, Renflexis) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 24 hours after each dose. FDA-approved biosimilars are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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Interleukin Inhibitor (Biologic)
Conditionally Approved

Ustekinumab

Stelara

The FAA lists ustekinumab (Stelara) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 4 hours after each dose. FDA-approved biosimilars are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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Interleukin Inhibitor (Biologic)
Conditionally Approved

Secukinumab

Cosentyx

The FAA lists secukinumab (Cosentyx) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 4 hours after each dose. FDA-approved biosimilars are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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Interleukin Inhibitor (Biologic)
Conditionally Approved

Risankizumab

Skyrizi

The FAA lists risankizumab (Skyrizi) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 4 hours after each dose. FDA-approved biosimilars are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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Interleukin Inhibitor (Biologic)
Conditionally Approved

Dupilumab

Dupixent

The FAA lists dupilumab (Dupixent) as a conditionally acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and not fly for 4 hours after each dose. FDA-approved biosimilars are also acceptable, and switching between biologics for the same condition requires a 48-hour ground trial.

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Kinase Inhibitor (Non-Biologic)
Conditionally Approved

Tofacitinib

Xeljanz

The FAA lists tofacitinib (Xeljanz) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and no wait is required after each dose. The FAA lists it among non-biologic medications in its biologics guidance.

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Kinase Inhibitor (Non-Biologic)
Conditionally Approved

Upadacitinib

Rinvoq

The FAA lists upadacitinib (Rinvoq) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and no wait is required after each dose. The FAA lists it among non-biologic medications in its biologics guidance.

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PDE4 Inhibitor (Non-Biologic)
Conditionally Approved

Apremilast

Otezla

The FAA lists apremilast (Otezla) as an acceptable medication when used alone, as long as the underlying condition qualifies for certification — your diagnosis is what determines eligibility. You must complete a 2-week ground trial when starting and no wait is required after each dose. The FAA lists it among non-biologic medications in its biologics guidance.

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Antiviral (COVID-19)
Conditionally Approved

Nirmatrelvir-Ritonavir

Paxlovid

The FAA accepts FDA-approved COVID-19 treatments such as Paxlovid, but you cannot fly while taking them or while you are symptomatic or infected. Before returning to flying, you must wait 24 hours after your last dose, be free of significant side effects, meet current CDC and FAA recovery guidelines, and meet the FAA's COVID-19 disposition requirements.

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Disqualifying

(78)

These medications are on the FAA's Do Not Issue or Do Not Fly lists. A washout period and evaluation are typically required after discontinuation.

CNS Stimulant (ADHD Medication)
Disqualifying

Amphetamine/Dextroamphetamine

Adderall, Adderall XR

Adderall (amphetamine/dextroamphetamine) is an ADHD medication on the FAA's Do Not Issue list. If you currently take it, including as needed, the AME must defer. If your prescriber says you can safely stop, you must be off it at least 90 days before Standard Track testing by an FAA HIMS neuropsychologist. Any ADHD medication use in the past 4 years rules out the Fast Track.

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CNS Stimulant (ADHD Medication)
Disqualifying

Methylphenidate

Ritalin, Concerta, Focalin

Methylphenidate (Ritalin, Concerta, Focalin) is an ADHD medication on the FAA's Do Not Issue list. If you currently take it, including as needed, the AME must defer. Once stopped, you must be off it at least 90 days before Standard Track testing. Any use in the past 4 years means the Standard Track; the Fast Track is only for people with no ADHD medication, symptoms, or instability in 4 years.

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Benzodiazepine (Anti-Anxiety)
Disqualifying

Alprazolam

Xanax

The FAA's Do Not Fly table lists alprazolam (Xanax) among anti-anxiety medications that can impair performance even when you feel alert. If you use it routinely, the AME must defer, and an ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose. The underlying anxiety condition is evaluated separately.

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Benzodiazepine (Anti-Anxiety / Muscle Relaxant)
Disqualifying

Diazepam

Valium

Diazepam (Valium) is a benzodiazepine. The FAA's Do Not Fly table covers anti-anxiety medications ("including but not limited to" alprazolam and lorazepam), which can impair performance even when you feel alert. If you use it routinely, the AME must defer, and an ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose — diazepam's long half-life makes that wait especially long.

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Opioid Analgesic (Pain)
Disqualifying

Tramadol

Ultram, ConZip

The FAA's Do Not Fly table allows tramadol (Ultram) to be used occasionally for a time-limited condition, such as recovery from surgery or dental work, but you must not fly while taking it or until the no-fly time has passed after your last dose (at least 5 times its maximum half-life). An ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list, and the underlying pain condition is evaluated separately.

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Anticonvulsant / Neuropathic Pain
Disqualifying

Gabapentin

Neurontin, Gralise

Gabapentin is on the FAA's Do Not Issue list due to its CNS effects. It is disqualifying regardless of whether it is prescribed for seizures, neuropathic pain, or off-label uses like anxiety.

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Cannabinoid
Disqualifying

Marijuana / Cannabis (all forms)

Medical marijuana, THC products, CBD with THC

Marijuana in all forms, including medical marijuana that is legal under your state's law, is disqualifying for FAA medical certification. A federal order effective April 28, 2026 moved only marijuana in FDA-approved drugs and state-licensed medical marijuana to Schedule III; all other marijuana remains Schedule I, and full rescheduling is not final. The FAA's policy has not changed: its Do Not Issue list covers controlled substances in Schedules I through V, including medical marijuana. CBD itself is not specifically disqualifying, but a marijuana-positive DOT drug test caused by a CBD product is treated as positive.

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Wakefulness-Promoting Agent
Disqualifying

Modafinil

Provigil

Modafinil is on the FAA's Do Not Issue list. It is disqualifying regardless of indication — whether prescribed for narcolepsy, shift work disorder, or off-label ADHD use. The underlying sleep disorder also requires evaluation.

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Opioid Analgesic (Pain)
Disqualifying

Hydrocodone

Vicodin, Norco, Lortab

The FAA's Do Not Fly table allows hydrocodone (Vicodin, Norco) to be used occasionally for a time-limited condition, such as recovery from surgery or dental work, but you must not fly while taking it or until the no-fly time has passed after your last dose (at least 5 times its maximum half-life). An ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list, and the underlying pain condition is evaluated separately.

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Muscle Relaxant
Disqualifying

Methocarbamol

Robaxin

The FAA's Do Not Fly table lists muscle relaxants as a class ("including but not limited to" carisoprodol and cyclobenzaprine) because they can impair performance even when you feel alert. Methocarbamol (Robaxin) is not named individually but belongs to this class. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose. If you use it routinely, the AME must defer.

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Anticonvulsant / Mood Stabilizer
Disqualifying

Lamotrigine

Lamictal

Lamotrigine is not acceptable for FAA medical certification. The FAA's Do Not Issue table covers seizure medications even when used for non-seizure conditions, and mood stabilizers are also on the list. The FAA's migraine guidance lists lamotrigine as unacceptable for migraine prevention. An AME cannot issue while you are taking it; clearance from the FAA is required.

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Benzodiazepine (Anti-Anxiety)
Disqualifying

Lorazepam

Ativan

The FAA's Do Not Fly table lists lorazepam (Ativan) among anti-anxiety medications that can impair performance even when you feel alert. If you use it routinely, the AME must defer, and an ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose. The underlying anxiety condition is evaluated separately.

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Benzodiazepine (Anti-Anxiety / Seizure)
Disqualifying

Clonazepam

Klonopin

Clonazepam (Klonopin) is not acceptable for FAA medical certification while you are taking it on an ongoing basis. It is both an anti-anxiety medication and a seizure medication, and the FAA's Do Not Issue table covers seizure medications even when they are used for non-seizure conditions, as well as any ongoing prescription for chronic use of a controlled substance. The underlying anxiety or seizure condition also requires FAA evaluation.

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Opioid Analgesic (Pain)
Disqualifying

Oxycodone

OxyContin, Percocet, Roxicodone

The FAA's Do Not Fly table allows oxycodone (OxyContin, Percocet) to be used occasionally for a time-limited condition, such as recovery from surgery or dental work, but you must not fly while taking it or until the no-fly time has passed after your last dose (at least 5 times its maximum half-life). An ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list, and the underlying pain condition is evaluated separately.

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Opioid Analgesic (Pain)
Disqualifying

Morphine

MS Contin, Kadian

The FAA's Do Not Fly table allows morphine to be used occasionally for a time-limited condition, such as recovery from surgery or dental work, but you must not fly while taking it or until the no-fly time has passed after your last dose (at least 5 times its maximum half-life). An ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list, and the underlying pain condition is evaluated separately.

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Opioid Analgesic (Pain / Cough)
Disqualifying

Codeine

Tylenol with Codeine

The FAA's Do Not Fly table allows codeine to be used occasionally for a time-limited condition, such as recovery from surgery or dental work, but you must not fly while taking it or until the no-fly time has passed after your last dose (at least 5 times its maximum half-life). An ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list, and the underlying pain condition is evaluated separately.

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Opioid Analgesic (Pain — Patch/Transmucosal)
Disqualifying

Fentanyl

Duragesic, Actiq, Subsys

Fentanyl (patches, lozenges, and other forms) is a potent narcotic and a controlled substance. Patches and other long-acting forms are used for ongoing pain, and the FAA's Do Not Issue table covers any ongoing prescription for chronic use of a controlled substance. Narcotic pain relievers are also on the Do Not Fly table, so do not fly while using fentanyl or until the no-fly time has passed after your last dose. The underlying pain condition is evaluated separately.

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Opioid Partial Agonist (Addiction Treatment)
Disqualifying

Buprenorphine

Suboxone, Subutex, Sublocade

Buprenorphine (Suboxone, Subutex, Sublocade) is a controlled substance usually taken on an ongoing basis for opioid use disorder or chronic pain. The FAA's Do Not Issue table covers any ongoing prescription for chronic use of a controlled substance, so an AME cannot issue while you are taking it. Opioid use disorder also requires its own FAA review, which runs through a HIMS AME.

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Orexin Receptor Antagonist (Sleep Aid)
Disqualifying

Suvorexant

Belsomra

Suvorexant is on the FAA's DNI list. As a dual orexin receptor antagonist used for insomnia, it is disqualifying due to its sedating mechanism of action.

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Atypical Antipsychotic
Disqualifying

Quetiapine

Seroquel

Quetiapine is on the FAA's DNI list. All antipsychotic medications are disqualifying. Even low-dose quetiapine prescribed off-label for sleep is disqualifying. The underlying condition also requires evaluation.

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Atypical Antipsychotic
Disqualifying

Olanzapine

Zyprexa

Olanzapine is on the FAA's DNI list. All antipsychotic medications are disqualifying regardless of indication. The underlying psychiatric condition also requires evaluation.

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Atypical Antipsychotic
Disqualifying

Risperidone

Risperdal

Risperidone is on the FAA's DNI list. All antipsychotic medications are disqualifying for aviation certification due to sedation, cognitive effects, and the underlying conditions they treat.

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Atypical Antipsychotic
Disqualifying

Aripiprazole

Abilify

Aripiprazole is on the FAA's DNI list. Despite being considered less sedating than other antipsychotics, all medications in this class are disqualifying. Even when used as augmentation for depression, it remains disqualifying.

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Mood Stabilizer
Disqualifying

Lithium

Lithobid, Eskalith

Lithium is on the FAA's DNI list. As a mood stabilizer for bipolar disorder, both the medication and the underlying condition are disqualifying. Lithium's narrow therapeutic index and potential for toxicity make it incompatible with aviation.

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Anticonvulsant / Mood Stabilizer
Disqualifying

Valproic Acid

Depakote, Depakene

Valproic acid is on the FAA's DNI list. Whether prescribed for seizures, bipolar disorder, or migraine prevention, it is disqualifying. The underlying conditions it treats are also typically disqualifying.

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Anticonvulsant / Mood Stabilizer
Disqualifying

Carbamazepine

Tegretol, Carbatrol

Carbamazepine is on the FAA's DNI list. Used for seizures, bipolar disorder, and trigeminal neuralgia, it is disqualifying regardless of indication. Both the medication and underlying conditions are problematic for certification.

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CNS Stimulant (ADHD Medication)
Disqualifying

Lisdexamfetamine

Vyvanse

Lisdexamfetamine (Vyvanse) is an ADHD medication on the FAA's Do Not Issue list. If you currently take it, the AME must defer. After stopping, you must be off it at least 90 days before Standard Track testing by an FAA HIMS neuropsychologist. If you haven't taken any ADHD medication in 4 years and meet the other Fast Track criteria, your AME may be able to issue.

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Non-Stimulant ADHD Medication (SNRI)
Disqualifying

Atomoxetine

Strattera

Atomoxetine (Strattera) is a non-stimulant, but the FAA's Do Not Issue list covers all ADHD medications, so current use is not acceptable. You must be off it at least 90 days before Standard Track testing. Use in the past 4 years puts you on the Standard Track; the Fast Track requires 4 years without any ADHD medication.

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Anxiolytic (Non-Benzodiazepine)
Disqualifying

Buspirone

BuSpar

Buspirone is on the FAA's DNI list. Although it is a non-benzodiazepine anxiolytic with less sedation risk, it is still disqualifying for aviation. The underlying anxiety disorder also requires evaluation.

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Muscle Relaxant (Centrally-Acting)
Disqualifying

Cyclobenzaprine

Flexeril, Amrix

The FAA's Do Not Fly table names cyclobenzaprine (Flexeril) among muscle relaxants that can impair performance even when you feel alert. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose. If you use it routinely, the AME must defer.

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Muscle Relaxant (Centrally-Acting)
Disqualifying

Carisoprodol

Soma

The FAA's Do Not Fly table names carisoprodol (Soma) among muscle relaxants that can impair performance even when you feel alert. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose. If you use it routinely, the AME must defer.

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Muscle Relaxant (Centrally-Acting)
Disqualifying

Tizanidine

Zanaflex

Tizanidine is on the FAA's DNI list. As a centrally-acting muscle relaxant, it causes sedation and hypotension that are incompatible with safe flight operations.

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Muscle Relaxant (Centrally-Acting)
Disqualifying

Baclofen

Lioresal, Gablofen

Baclofen is on the FAA's DNI list. It is a centrally-acting muscle relaxant with sedating effects that are disqualifying for aviation. The underlying spasticity condition may also affect certification.

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Anticonvulsant (Migraine Prevention / Seizure)
Disqualifying

Topiramate

Topamax, Qudexy

Topiramate is on the FAA's DNI list. Whether prescribed for migraine prevention, seizures, or weight loss, it is disqualifying due to cognitive side effects ('brain fog') and its anticonvulsant classification.

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CNS Stimulant (Weight Loss)
Disqualifying

Phentermine

Adipex-P, Lomaira

Phentermine is on the FAA's DNI list. As a sympathomimetic amine chemically related to amphetamine, it is disqualifying. It can cause cardiovascular effects, insomnia, and CNS stimulation incompatible with aviation safety.

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Anticonvulsant / Neuropathic Pain
Disqualifying

Pregabalin

Lyrica

Pregabalin is on the FAA's DNI list. Like gabapentin, it has significant CNS effects including dizziness, somnolence, and cognitive impairment. It is disqualifying regardless of indication.

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Serotonin Modulator (Antidepressant / Sleep Aid)
Disqualifying

Trazodone

Desyrel

Trazodone (Desyrel) is not acceptable for FAA medical certification. The FAA's Do Not Issue table covers psychiatric medications, including antidepressants, even when they are used for other conditions such as insomnia, and trazodone is not on the FAA's list of conditionally acceptable antidepressants. An AME cannot issue while you are taking it.

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Atypical Antidepressant
Disqualifying

Mirtazapine

Remeron

Mirtazapine (Remeron) is not acceptable for FAA medical certification. The FAA's Do Not Issue table covers psychiatric medications, including antidepressants, even when they are used for other conditions such as insomnia, and mirtazapine is not on the FAA's list of conditionally acceptable antidepressants. An AME cannot issue while you are taking it.

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Tricyclic Antidepressant
Disqualifying

Amitriptyline

Elavil

Amitriptyline is on the FAA's DNI list. All tricyclic antidepressants are disqualifying due to their sedating, anticholinergic, and cardiac effects. Even low doses for migraine or neuropathy are disqualifying.

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Tricyclic Antidepressant
Disqualifying

Nortriptyline

Pamelor

Nortriptyline is on the FAA's DNI list. Like all tricyclic antidepressants, it is disqualifying regardless of indication (depression, neuropathic pain, migraine prevention).

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Antihistamine (Anti-Anxiety / Sedating)
Disqualifying

Hydroxyzine

Vistaril, Atarax

Hydroxyzine is disqualifying for FAA certification. As a first-generation antihistamine with significant sedating properties, it is used for anxiety and insomnia. Both the sedation and the underlying anxiety condition require evaluation.

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Central Alpha Agonist (Blood Pressure / ADHD)
Disqualifying

Clonidine

Catapres, Kapvay

Clonidine is on the FAA's DNI list. As a centrally-acting antihypertensive, it causes significant sedation, drowsiness, and cognitive effects. Whether prescribed for hypertension or ADHD, it is disqualifying.

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Anticonvulsant
Disqualifying

Levetiracetam

Keppra

Levetiracetam is on the FAA's DNI list. All anticonvulsant medications are disqualifying. The underlying seizure disorder is also independently disqualifying for FAA certification.

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Anticonvulsant
Disqualifying

Phenytoin

Dilantin

Phenytoin is on the FAA's DNI list. All anticonvulsant medications are disqualifying. The underlying seizure disorder is independently disqualifying.

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Anticonvulsant
Disqualifying

Oxcarbazepine

Trileptal

Oxcarbazepine is on the FAA's DNI list. Like all anticonvulsants, it is disqualifying regardless of indication (seizures, bipolar disorder, neuropathic pain).

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SSRI Antidepressant
Disqualifying

Paroxetine

Paxil, Pexeva

Paroxetine (Paxil) is an SSRI, but the FAA's Antidepressant Medications table lists it as unacceptable, alone or in any combination product, so it cannot be used under the Antidepressant Protocol. Nine other antidepressants are conditionally acceptable. Never stop or switch medication on your own — talk with your psychiatrist and a HIMS AME, and expect to need 3 months of stability on any new medication.

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SSRI Antidepressant
Disqualifying

Fluvoxamine

Luvox

Fluvoxamine (Luvox) is an SSRI, but the FAA's Antidepressant Medications table lists it as unacceptable, alone or in any combination product, so it cannot be used under the Antidepressant Protocol. Nine other antidepressants are conditionally acceptable. Never stop or switch medication on your own — talk with your psychiatrist and a HIMS AME, and expect to need 3 months of stability on any new medication.

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CNS Stimulant (ADHD Medication)
Disqualifying

Dextroamphetamine

Dexedrine, Zenzedi

Dextroamphetamine (Dexedrine, Zenzedi) is a stimulant ADHD medication on the FAA's Do Not Issue list. If you currently take it, the AME must defer. After stopping, you must be off it at least 90 days before Standard Track testing. Any ADHD medication use in the past 4 years rules out the Fast Track.

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Central Alpha Agonist (ADHD / Blood Pressure)
Disqualifying

Guanfacine

Intuniv, Tenex

Guanfacine is Do Not Issue for any use. The FAA's antihypertensive guidance lists guanfacine (Tenex) as an unacceptable blood pressure medication, and ADHD medications (Intuniv) are on the Do Not Issue list. If it was prescribed for ADHD, you must be off it at least 90 days before Standard Track testing, and use in the past 4 years rules out the ADHD Fast Track.

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Anticonvulsant / Fibromyalgia
Disqualifying

Pregabalin (for Fibromyalgia)

Lyrica

Pregabalin prescribed for fibromyalgia is still on the FAA's DNI list. The indication does not change its disqualifying status. Fibromyalgia itself may also require evaluation depending on severity.

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Anticholinergic (Overactive Bladder)
Disqualifying

Oxybutynin

Ditropan

Oxybutynin is on the FAA's Do Not Issue list. The FAA names it among overactive bladder medications that carry strong warnings about sedation and impaired cognition. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required. The FAA's pilot OTC guide also lists the over-the-counter patch (Oxytrol) as a NO GO medication.

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Anticholinergic (Overactive Bladder)
Disqualifying

Solifenacin

Vesicare

Solifenacin is on the FAA's Do Not Issue list. The FAA names it, along with oxybutynin and tolterodine, among overactive bladder medications that carry strong warnings about sedation and impaired cognition. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required.

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Antidiarrheal (Opioid-Related)
Disqualifying

Diphenoxylate-Atropine

Lomotil

Diphenoxylate-atropine (Lomotil) is disqualifying as it contains an opioid derivative. Pilots should use loperamide (Imodium) as an alternative antidiarrheal that is generally acceptable.

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Anticholinergic (Motion Sickness)
Disqualifying

Scopolamine

Transderm Scop

Scopolamine patches are disqualifying for pilots. Despite being used for motion sickness, scopolamine causes significant anticholinergic effects including blurred vision, drowsiness, and disorientation that are incompatible with aviation.

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Antihistamine (Anti-Vertigo / Motion Sickness)
Disqualifying

Meclizine

Antivert, Bonine, Dramamine Less Drowsy

Meclizine is disqualifying for pilots. Although marketed as 'less drowsy,' it is still a first-generation antihistamine with sedating properties. The underlying vertigo or motion sickness also raises flight safety concerns.

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Gabapentinoid (Restless Legs Syndrome)
Disqualifying

Gabapentin Enacarbil

Horizant

Gabapentin enacarbil is on the FAA's DNI list, same as gabapentin. Used for restless legs syndrome, both the medication and the sleep-disrupting condition require evaluation. The underlying RLS may affect sleep quality and fitness to fly.

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Nitrate (Angina)
Disqualifying

Nitroglycerin

Nitrostat, Nitro-Dur

Nitroglycerin and all nitrate medications are explicitly listed as "not allowed" on the FAA AME Guide antihypertensives page. The use of nitrates indicates underlying coronary artery disease requiring active angina management, which is disqualifying. Pilots with CAD who no longer require nitrates may pursue Special Issuance for the underlying cardiac condition.

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Nitrate (Angina Prevention)
Disqualifying

Isosorbide Mononitrate

Imdur, Monoket

Isosorbide mononitrate and all nitrate medications are explicitly listed as "not allowed" on the FAA AME Guide antihypertensives page. Chronic nitrate use for angina prevention indicates active coronary artery disease management, which is disqualifying. Pilots may pursue Special Issuance for the underlying CAD if nitrates are discontinued.

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Anti-Anginal (Non-Nitrate)
Disqualifying

Ranolazine

Ranexa

Ranolazine is on the FAA's Do Not Issue list under angina medications, alongside nitrates. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required. The underlying coronary artery disease also requires its own FAA cardiac review.

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Antispasmodic / Anticholinergic (IBS)
Disqualifying

Dicyclomine

Bentyl

Dicyclomine is on the FAA's DNI list due to its anticholinergic effects which can cause drowsiness, blurred vision, dizziness, and cognitive impairment. These effects are incompatible with safe flight operations.

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Antispasmodic / Anticholinergic (GI)
Disqualifying

Hyoscyamine

Levsin, Anaspaz

Hyoscyamine is on the FAA's DNI list due to anticholinergic effects including blurred vision, drowsiness, dizziness, and cognitive impairment that are incompatible with aviation safety.

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Tricyclic Antidepressant / Sleep Aid
Disqualifying

Doxepin

Sinequan, Silenor

Doxepin is on the FAA's DNI list. Whether used at antidepressant doses (Sinequan) or low doses for insomnia (Silenor), it is disqualifying. All tricyclic antidepressants are incompatible with aviation.

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Anticholinergic (Overactive Bladder)
Disqualifying

Tolterodine

Detrol, Detrol LA

Tolterodine is on the FAA's DNI list due to anticholinergic effects. Although marketed as having fewer CNS effects than oxybutynin, it still causes blurred vision and drowsiness that are incompatible with aviation safety.

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Sympathomimetic + Anticonvulsant (Weight Loss)
Disqualifying

Phentermine-Topiramate

Qsymia

The FAA lists phentermine-topiramate (Qsymia) as an unacceptable weight loss medication, prohibited as a single agent or in any combination product. Sympathomimetic weight loss drugs such as phentermine are also on the FAA's Do Not Issue list. An AME cannot issue while you are taking it.

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NDRI + Opioid Antagonist (Weight Loss)
Disqualifying

Bupropion-Naltrexone

Contrave

Bupropion-naltrexone (Contrave) is on the FAA's Do Not Issue list and is listed as an unacceptable weight loss medication. An AME cannot issue a medical certificate while you are taking it. Bupropion alone in SR/ER form is handled differently, under the FAA's Antidepressant Protocol.

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Amylinomimetic (Diabetes)
Disqualifying

Pramlintide

Symlin

Pramlintide (Symlin) is the one diabetes medication specifically named on the FAA's Do Not Issue list. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required. Most other diabetes medications are allowed through Special Issuance.

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SSRI / 5-HT1A Partial Agonist Antidepressant
Disqualifying

Vortioxetine

Trintellix

The FAA's Antidepressant Medications table lists vortioxetine (Trintellix) as unacceptable, alone or in any combination product, so it cannot be used under the Antidepressant Protocol. Nine other antidepressants are conditionally acceptable through Special Issuance. Never stop or switch medication on your own — talk with your psychiatrist and a HIMS AME, and expect to need 3 months of stability on any new medication.

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NMDA Receptor Antagonist (Treatment-Resistant Depression)
Disqualifying

Esketamine

Spravato

The FAA's Antidepressant Medications table lists esketamine (Spravato) as unacceptable, alone or in any combination product, so it cannot be used under the Antidepressant Protocol. Nine other antidepressants are conditionally acceptable through Special Issuance. Never stop or switch medication on your own — talk with your psychiatrist and a HIMS AME, and expect to need 3 months of stability on any new medication.

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Benzodiazepine (Sleep / Anti-Anxiety)
Disqualifying

Triazolam

Halcion

The FAA's Do Not Fly table names triazolam (Halcion) among anti-anxiety medications that can impair performance even when you feel alert. If you use it routinely, the AME must defer, and an ongoing prescription for chronic use of a controlled substance is on the Do Not Issue list. Do not fly while taking it or until at least 5 times its maximum half-life has passed since your last dose.

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Barbiturate Combination (Headache)
Disqualifying

Butalbital Combinations

Fioricet, Fiorinal

The FAA's migraine medication guidance lists butalbital combinations — acetaminophen with butalbital (Fioricet) and aspirin with butalbital (Fiorinal) — as unacceptable, alone or in any combination product. An AME cannot issue while you are using them. Other migraine relief options, such as triptans and gepants, are acceptable for occasional use with specific no-fly times.

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Antimalarial
Disqualifying

Mefloquine

Lariam

The FAA considers mefloquine (Lariam) absolutely disqualifying for pilots because it can cause neuropsychiatric side effects even weeks after you stop taking it. It must be discontinued for at least 4 weeks before consideration, you must contact an FAA flight surgeon or your AME before resuming pilot duties, and you must have had no neurologic or psychiatric symptoms during or after use. Most other malaria medications are allowed.

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Dopamine Agonist (Parkinson's / Restless Legs)
Disqualifying

Pramipexole

Mirapex

Pramipexole (Mirapex) is on the FAA's Do Not Issue list. Dopamine agonists are disqualifying whether used for Parkinson's disease, restless legs syndrome, or another condition. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required. The underlying condition is also evaluated separately.

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Dopamine Agonist (Parkinson's / Restless Legs)
Disqualifying

Ropinirole

Requip

Ropinirole (Requip) is on the FAA's Do Not Issue list. Dopamine agonists are disqualifying whether used for Parkinson's disease, restless legs syndrome, or another condition. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required. The underlying condition is also evaluated separately.

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Anticholinergic (Parkinsonism)
Disqualifying

Benztropine

Cogentin

Benztropine (Cogentin) is on the FAA's Do Not Issue list among oral anticholinergics used for parkinsonism. An AME cannot issue a medical certificate while you are taking it; clearance from the FAA is required. The condition it treats, including medication-induced movement disorders, is also evaluated separately.

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Cholinergic Agonist Eye Drops (Presbyopia / Glaucoma)
Disqualifying

Pilocarpine (Eye Drops)

Vuity, Isopto Carpine

The FAA considers pilocarpine eye drops unacceptable. Vuity, prescribed for age-related blurry near vision, works by shrinking the pupil, which can impair night vision and makes your visual acuity depend on ambient lighting. The manufacturer also warns about night driving and operating machinery. Pilocarpine for glaucoma is likewise listed as unacceptable.

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Dietary Supplement (Sedating)
Disqualifying

Kava

Various OTC supplements

The FAA's Do Not Fly table names kava among active dietary supplements that can cause sedation and impair performance even when you feel alert. Do not fly while using it. If you use it routinely, the AME should defer. Supplements aren't FDA-regulated like medications, so tell your AME about any you take.

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Dietary Supplement (Sedating)
Disqualifying

Kratom

Various OTC supplements

The FAA's Do Not Fly table names kratom among active dietary supplements that can cause sedation and impair performance even when you feel alert. Do not fly while using it. If you use it routinely, the AME should defer. Supplements aren't FDA-regulated like medications, so tell your AME about any you take.

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Dietary Supplement (Sedating)
Disqualifying

Valerian

Various OTC supplements

The FAA's Do Not Fly table names valerian among active dietary supplements that can cause sedation and impair performance even when you feel alert. Do not fly while using it. If you use it routinely, the AME should defer. Supplements aren't FDA-regulated like medications, so tell your AME about any you take.

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Important Notice

The U.S. Federal Aviation Administration does not publish a comprehensive list of “approved” medications for pilots. The information in this database represents our interpretation of publicly available FAA guidance documents including the AME Guide, Do-Not-Issue/Do-Not-Fly tables, and related Advisory Circulars. It is provided for informational and educational purposes only.

FAR regulations (61.53, 67.113, 67.213, 67.313, and 91.17) prohibit exercising pilot privileges while using any medication or substance that affects your faculties in a way contrary to safety. The primary issue with the FAA is always whether the underlying medical condition — not just the medication — is compatible with safe flight.

This database is not a substitute for consultation with a qualified Aviation Medical Examiner (AME). You should only start, stop, or change medications after consulting with your treating physician. FAA policies are subject to change without notice. ClearedMed is not affiliated with or endorsed by the FAA.