Cartoon: Boarding, from Chris Manno

Eddie Sez:

When I was flying single-pilot-authorized aircraft in the Air Force, the flight surgeon looked upon self-medication with a frown and the power of military penalties. We couldn't so much as take an aspirin without permission. These days, I've flown with pilots carrying their own personal pharmacies. There ought to be a middle ground.

The FAA leaves this to your judgement, so you probably ought to get some of that. Judgement, that is. A good place to start is to find out what the Aviation Medical Examiner is going to be thinking, and they get their knowledge from: FlightPhysical.com (AME Area).

Most of this comes from FAA Publication OK 05-005 Medications and Flying. Good advice on this subject is hard to find. I think your best source is an Aviation Medical Examiner who is also an Airline Transport Pilot.

You are probably looking for a list of FAA approved medications, right? Well they don't provide that for pilots but they do for air traffic control specialists, who also have physical requirements. More on that below.

What follows comes from the references shown below and my comments shown in blue.


Regulatory

[14 CFR 67, §67.113 First-Class Airman Medical Certificate / General Condition]

The general medical standards for a first-class airman medical certificate are:

(a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control.

(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

(c) No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds—

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

[Aeronautical Information Manual, ¶8-1-1.c.]

  1. Pilot performance can be seriously degraded by both prescribed and over-the-counter medications, as well as by the medical conditions for which they are taken. Many medications, such as tranquilizers, sedatives, strong pain relievers, and cough-suppressant preparations, have primary effects that may impair judgment, memory, alertness, coordination, vision, and the ability to make calculations. Others, such as antihistamines, blood pressure drugs, muscle relaxants, and agents to control diarrhea and motion sickness, have side effects that may impair the same critical functions. Any medication that depresses the nervous system, such as a sedative, tranquilizer or antihistamine, can make a pilot much more susceptible to hypoxia.

  2. The CFRs prohibit pilots from performing crewmember duties while using any medication that affects the faculties in any way contrary to safety. The safest rule is not to fly as a crewmember while taking any medication, unless approved to do so by the FAA.

Advice from the Feds to Pilots

[Medications and Flying]

Common side effects of frequently used OTC medications:


Advice from the Feds to AMEs

Finding a good AME can be a chore but it is worth the effort. Over a four year span I had an AME who was thrown in jail for pedophilia, another died flying his Sabreliner into a mountain, a third was thrown in jail for tax evasion. And then I found one who is also an airline pilot for a major carrier. Jackpot!

The process made we wonder about the first three AMEs and how they managed to do their jobs despite other problems. The answer, or at least part of it, is at FlightPhysical.com (AME Area). It gives them the advice they need to answer your questions.


An Approved List of Medications?

The U.S. Federal Aviation Administration does not publish a list of "approved" medications for pilots. However, FAR 61.53, 67.113, 67.213, 67.313 and 91.17 preclude flying while having a condition or taking a medication that might affect flight safety. The following link contains medication information specific for Air Traffic Control duty (note that even if allowed for ATCS duty, medication use must be reported to the Regional Flight Surgeon before return to controlling): ATCS Drugs 2009-05-13.

The Aviation Medicine Advisory Service offers a search engine which provides advice for specific medications: AMAS Medication List.


References

14 CFR 67, Title 14: Aeronautics and Space, Medical Standards and Certification, Federal Aviation Administration, Department of Transportation

Aeronautical Information Manual

Medications and Flying, FAA Publication OK 05-005, Rev 6/10