The medication dilemma

March 3, 2014

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Gary Crump

Gary Crump

  • Director, AOPA Medical Certification Services 
  • 25 years assisting AOPA members 
  • Former operating room technician and Emergency Medical Technician 
  • Pilot since 1973

We have written and spoken quite a bit the last couple of years about the use of medications while flying. We certainly have an abundance of medications, both prescription and over the counter (OTC), available to us, and as a result, tend to take advantage of the opportunity to treat our aches and pains, especially by “self-medicating” with OTCs.

We also need to consider the potential impact of medication therapy while flying, as the environment does change once we leave the ground and assume even relatively modest general aviation altitudes. During this time of year, the cough and cold remedies are in high demand. These medications successfully treat the symptoms of itchy eyes and noses, nasal congestion, or sneezing and runny nose. The ingredients, though, such as chlorpheniramine and diphenhydramine, can also produce side effects such as sedation and blurred vision. These side effects can be subtle, too, in some people; and that climb from the airport up to altitude can also result in a minute changes in the blood chemistry and concentration of the active ingredients, and the side effects can become more pronounced.

The federal aviation regulations are vague on the use of medications. FAR 91.17(a)(3) reminds us that we are not to exercise our privileges as pilot in command or as a required flight crewmember while using any drug that “affects the person’s faculties in any way contrary to safety.” Additionally, the FAA does not make available to the public a database of allowed medications. There are good reasons from the FAA’s perspective for that, but AOPA feels that a pilot who has specific guidance about the possible implications of the meds he or she is taking, as well as knowledge about the underlying condition that requires the medication, makes that pilot safer, and that’s everyone’s goal.

AOPA has for many years provided members with a database of medications that contains hundreds of prescription and nonprescription medications, and their status with the FAA. This is a dynamic issue, though, and the FAA periodically changes the status of a medication based on a number of variables. All in all, though, a large number of medications are allowed for use by pilots, albeit with some restrictions.

Gary Crump