Guide for Aviation Medical Examiners

Pharmaceuticals (Therapeutic Medications)

  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.
 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
(as a single agent or in any combination product)
  Clonidine (ex. Catapres/Clorpres)
  Nitrates (ex. nitroglycerin/isosorbide dinitrate/isosorbide mononitrate)
Last updated: Friday, June 24, 2022