Important Rules When Using This Guide:

1. Underlying Condition: Evaluating medication use requires considering the impact of safety of flight from both the medication and underlying condition. Wait times are not determined solely by the medication; an extended observation period may be required to verify clinical stability of the condition.
2. Initial Wait Times: When starting a new medication, in most cases, a 48-hour wait time is required before returning to safety-related duties.  This period allows the medication to take effect and ensures no aeromedically significant side effects develop.  Longer wait times may apply to higher risk medications, whereas medications with minimal systemic effects may be shortened.  Please see the specific medications for guidance.
3. Adverse Effects & Reporting: Cease flying or safety-related duties (SRD) immediately if any aeromedically concerning adverse side effects develop prior to duty, according to 14 CFR § 61.53 for pilots and Order 3930.3C for ATCS.  Pilots should notify their treating physician and/or FAA prior to flight; ATCSs should notify their Regional Flight Surgeon (RFS) before starting their shift.
4. Future Releases: This is version 1.0 of the MedGuide. Additional information and medications will be added to the tool in upcoming releases.

Key Definitions at a Glance

Definitions are provided below for quick reference.

Use Categories

• ALLOWED: The medication is acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.

Frequency

• Within label directions or as prescribed: Medications are generally safe for use in aviation.

Wait Times

• INITIAL Wait Time (after first dose): The initial observation period required after starting a new medication to allow for therapeutic effect and ensure no adverse side effects occur. NOTE: ATCSs must notify Regional Flight Surgeon prior to their next shift.
• SUBSEQUENT Dose Wait Time (after each dose): The observation period required after the last dose before reporting for flight or SRDs. This additional time is needed to mitigate aeromedically significant adverse effects.
• DISCONTINUATION Wait Time (after final dose): For medications that are allowed, the observation time needed to verify no symptom recurrence (rebound), withdrawal risk, and condition stability after stopping the medication.

Users

• “FAA ATCS” refers to Air Traffic Control Specialist employed by the FAA
• “Pilot” refers to all pilots and contract controllers (any Air traffic controller who is not employed by the FAA. E.g. civilian contract towers or the military.)