CDME Module 9: Scheduled Drug Use and Alcoholism (2025)-FAA Do Not Issue, Do Not Fly

FAA Do Not Issue, Do Not Fly

Pdf Summary

The document provides guidance for Aviation Medical Examiners (AMEs) regarding medications that should not be issued (DNI) or allowed for pilots (DNF) due to concerns about their impact on safety. <br /><br />### Do Not Issue (DNI) Medications<br />AMEs should defer issuing a medical certificate to applicants using the following drug classes or medications, as they may impair pilot performance or involve conditions that warrant concern:<br /><br />- **Angina Medications:** Includes nitrates and ranolazine.<br />- **Anticholinergics:** Involves medications like atropine and those for overactive bladder (e.g., tolterodine, oxybutynin).<br />- **Cancer Treatments:** Includes chemotherapy, radiation, and immunotherapy.<br />- **Controlled Substances:** Covers substances in Schedules I-V, including medical marijuana.<br />- **Diabetic Medications:** Specific mention of pramlintide.<br />- **Dopamine Agonists:** For conditions like Parkinson’s disease.<br />- **Hypertension Medications:** Centrally acting agents like clonidine.<br />- **Malaria Medications:** Specifically mefloquine.<br />- **Psychiatric/Psychotropic Medications:** Includes antidepressants, antipsychotics, and ADHD medications.<br />- **Seizure Medications:** Regardless of their use for non-seizure conditions.<br />- **High-Dose Steroids:** Over 20 mg prednisone/day.<br />- **Weight Loss Medications:** Such as phentermine.<br /><br />### Do Not Fly (DNF) Medications<br />Medications within this category, even if used temporarily, may impair cognitive function or cause sedation. Such medications include:<br /><br />- **Allergy Medications:** Particularly sedating antihistamines like diphenhydramine.<br />- **Anti-Anxiety Drugs:** Such as alprazolam.<br />- **Muscle Relaxants:** Includes carisoprodol.<br />- **Pain Medications:** Narcotic and certain non-narcotic relievers.<br />- **Sedatives/Sleep Aids:** Prescription and OTC, including those with diphenhydramine.<br /><br />### General Guidance<br />Pilots should not operate aircraft until a waiting period of five times the medication's half-life or dosage interval has passed. This also applies to any medication with warnings about drowsiness or operating machinery. Caution is emphasized as impairment may not be apparent to the individual.

Keywords

Aviation Medical Examiners

Do Not Issue medications

Do Not Fly medications

pilot safety

cognitive impairment

medication guidelines

sedating antihistamines

psychiatric medications

controlled substances

waiting period