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United States Department of TransportationUnited States Department of Transportation

Guide for Aviation Medical Examiners

Pharmaceuticals (Therapeutic Medications)
Antihypertensive

  1. Code of Federal Regulations:

  2. Medical History: Item 18.h., High or low blood pressure.

  3. Aeromedical Decision Considerations:

  4. Protocol: N/A. See Hypertension Worksheet (PDF).

  5. Pharmaceutical Considerations
    • Seven-day (7) no fly/ground trial is required when starting a new hypertension (HTN) medication to verify no side effects.
    • AME should issue (if otherwise qualified) if the airmen is on 3 or fewer medications.
    • Uses of beta-adrenergic blockers ARE allowed with insulin, meglitinides, or sulfonylureas.
  6. Acceptable HTN Medications
    (when certification criteria are met)
    Alpha adrenergic blockers Calcium channel blockers
    Angiotensin converting enzyme (ACE) inhibitors Direct renin inhibitors
    Angiotensin II receptor antagonists (ARBs) Direct vasodilators
    Beta-adrenergic blockers Diuretics
    UNACCEPTABLE HTN Medications
    (as a single agent or in any combination product)
    DO NOT ISSUE
    Clonidine (ex. Catapres/Clorpres)
    guanabenz
    guanfacine/Tenex
    methyldopa
    Nitrates (ex. nitroglycerin/isosorbide dinitrate/isosorbide mononitrate)
    reserpine

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