Guide for Aviation Medical Examiners

Pharmaceuticals (Therapeutic Medications)
Do Not Issue - Do Not Fly

The information in this section addresses two medication categories that are generally unacceptable for flight or safety-related duties:

  1. DO NOT ISSUE (DNI) MEDICATIONS: AMEs cannot issue. Clearance from the FAA required.


  2. DO NOT FLY (DNF) MEDICATIONS: AMEs must provide additional safety information to applicants and caution them not to fly until a specific period of time has elapsed.

The AME should first consider the safety impact of the underlying condition being treated and then determine the frequency, duration, and side effects (if any) of the medication being used. Contact your Regional Flight Surgeon's (RFS) office or the Aerospace Medicine Certification Division (AMCD) regarding any questions or concerns.

The FAA does not typically review medications with the following characteristics:

Do Not Issue. AMEs should not issue airmen medical certificates to applicants who are using these classes of medications or medications.

  • Investigational/experimental study drugs:
    These medications may currently be in clinical trials and have not been review by the Food and Drug Administration (FDA). They have not been evaluated for a complete safety review.

  • FDA approved less than 12 months ago:
    The FAA generally requires at least one year of post-marketing experience with a new drug class before consideration. This observation period allows time for uncommon, but aeromedically significant adverse effects to manifest.

Contact your RFS office or AMCD for guidance on specific applicants or to request consideration for a particular medication.

See DO NOT ISSUE - DO NOT FLY Medications
and general No Fly wait times


The lists in the link above are not intended as all-inclusive or comprehensive, but rather address the most common concerns and provide aeromedical guidance about specific medications or classes of pharmaceutical preparations.

No independent interpretation of the FAA's position with respect to a medication included or excluded should be assumed.

Last updated: Monday, July 10, 2023