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Guide for Aviation Medical Examiners

Pharmaceuticals (Therapeutic Medications)
Allergy - Immunotherapy

  1. Code of Federal Regulations

  2. Medical History: See Item 18.e., Hay fever or allergy.
    The applicant should report frequency and duration of symptoms, any incapacitation by the condition, treatment, and side effects. The Examiner should inquire whether the applicant has ever experienced any barotitis (ear block), barosinusitis, alternobaric vertigo, or any other symptoms that could interfere with aviation safety.

  3. Aeromedical Decision Considerations:

  4. Protocol:
    See Disease Protocols - Allergies, Severe .

  5. Pharmaceutical Considerations:
    • Allergy Shots: For conditions controlled by desensitization, AME must warn the airman to not operate aircraft until four hours after each injection.
    • Sublingual immunotherapy (SLIT) used for allergic rhinitis is acceptable.
      • Allowed with a 24-hour no fly after the first dose each season AND a 4-hour no fly after each subsequent dose
      • Not allowed in airmen 65 or older who have a diagnosis of asthma which does not meet CACI criteria.
      • Airman should confirm with the treating physician that the airman is not taking any other medication(s) that would impair the effectiveness of epinephrine, should it be needed, or Increase the risk of heart rhythm disturbances.

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