FAA Prescription Drug List: Allowed, Banned, and Wait Times

The FAA does not publish a single “approved” or “banned” prescription drug list. Instead, the FAA prescription drug list is organized through the Guide for Aviation Medical Examiners into two working categories: Do Not Issue (DNI), meaning your Aviation Medical Examiner cannot grant a medical certificate without FAA clearance, and Do Not Fly (DNF), meaning you can be prescribed the drug but must stop taking it and wait a specified period before flying.¹²³ A 91.17 violation can cost you your certificate.⁴

The FAA is explicit that its published lists are “not meant to be totally inclusive or comprehensive.”¹ Any medication with a label warning about drowsiness or operating machinery should be treated as unsafe for flight, regardless of how well you personally tolerate it.⁵

Do Not Issue Medications

These are the drugs that block a routine certificate issuance. If you take one, your AME will defer the exam and the FAA decides whether to authorize you. As of the FAA’s June 2023 DNI/DNF tables, the DNI list includes:⁵

Any Schedule I–V controlled substance, including medical marijuana regardless of state legality.
Psychiatric and psychotropic drugs: antidepressants, antipsychotics, anti-anxiety drugs, mood stabilizers, ADHD medications, stimulants, and tranquilizers. Some antidepressants have a separate pathway, discussed below.
Seizure medications, even when prescribed for migraines or nerve pain.
Centrally acting antihypertensives: clonidine, guanabenz, methyldopa, reserpine.
Chemotherapy, radiation therapy, and immunotherapy for cancer.
Angina drugs: nitrates such as nitroglycerin and isosorbide dinitrate, plus ranolazine (Ranexa).
Oral anticholinergics including atropine, overactive bladder drugs (tolterodine, oxybutynin), and Parkinsonism agents such as benztropine.
Dopamine agonists: bromocriptine, pramipexole, ropinirole, rotigotine.
Pramlintide (Symlin) for diabetes.
Mefloquine (Lariam) for malaria.
Weight loss sympathomimetics such as phentermine (Adipex), and the bupropion/naltrexone combination (Contrave).
Steroids above 20 mg prednisone equivalent per day.

Two categorical rules apply on top of the list. Any drug approved by the FDA less than 12 months ago is out, because the FAA wants a year of post-marketing data. Investigational or trial-stage drugs are out as well.⁶

Do Not Fly Medications and the Five-Times Rule

DNF drugs are ones you can use, but not while flying. The general grounding rule is five times the maximum pharmacologic half-life or five times the dosing interval after the last dose.⁵ Put simply: about 30 hours for a medication dosed every four to six hours, 40 hours for every-eight-hour dosing, and 60 hours for every-twelve-hour dosing.⁷

The main DNF categories are:

Sedating (first-generation) antihistamines. Diphenhydramine (Benadryl) and doxylamine (Unisom): 60 hours. Chlorpheniramine and clemastine: five days. Cetirizine (Zyrtec) and levocetirizine (Xyzal): 48 hours. The FAA notes that diphenhydramine is the most common medication found on autopsy in aircraft accidents.⁸
Narcotic pain medications: morphine, codeine, oxycodone, hydrocodone, and the non-narcotic tramadol (Ultram).
Benzodiazepines and sedatives: alprazolam (Xanax), lorazepam (Ativan), temazepam (Restoril), triazolam (Halcion).
Muscle relaxants: carisoprodol (Soma), cyclobenzaprine (Flexeril).
All sleep aids, prescription and over-the-counter. Only occasional use is allowed; daily or nightly use is prohibited.⁹
Certain supplements: kava-kava, kratom, valerian.
Any medication given for outpatient surgery or dental work.⁵

Sleep Aid Wait Times

The FAA sets individual grounding periods for common prescription sleep drugs:⁹

Zolpidem (Ambien, Ambien CR): 24 hours
Zolpidem sublingual (Edluar, Intermezzo): 36 hours
Zolpidem oral spray (Zolpimist): 48 hours
Eszopiclone (Lunesta): 30 hours
Zaleplon (Sonata): 12 hours
Temazepam (Restoril): 72 hours
Ramelteon (Rozerem): 24 hours

PDE-5 Inhibitor Wait Times

Erectile dysfunction drugs have their own wait times after the last dose. Sildenafil (Viagra), vardenafil (Levitra, Staxyn), and avanafil (Stendra) each require eight hours. Tadalafil (Cialis) taken as needed requires 24 hours, while daily-use tadalafil requires a seven-day ground trial to confirm no side effects. Anyone taking nitrates cannot use these drugs. Alpha blockers for BPH are permitted with a seven-day ground trial.¹⁰

Medications Generally Allowed

Many common prescriptions are compatible with flying, assuming the underlying condition itself isn’t disqualifying and you experience no side effects. When starting any new medication for the first time, the FAA recommends at least a 48-hour ground trial to check for reactions.¹¹

Allergy, Cold, and Pain

Non-sedating antihistamines are cleared for daily use, including fexofenadine (Allegra), loratadine (Claritin), desloratadine (Clarinex), and montelukast (Singulair). Nasal corticosteroid sprays such as fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort) are fine. Pseudoephedrine (Sudafed) is allowed with a note that it can raise heart rate. Guaifenesin (Mucinex) and dextromethorphan (Delsym) are acceptable, but any “PM” formulation or product with a sedating antihistamine is not.¹¹⁸ For pain: acetaminophen (Tylenol), aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), lidocaine patches, and topical muscle rubs are all cleared.

Blood Pressure and Cholesterol

Aside from the centrally acting antihypertensives on the DNI list, most blood pressure classes are acceptable: ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, alpha-adrenergic blockers, direct renin inhibitors, direct vasodilators, and diuretics. A seven-day ground trial is required when starting any new hypertension drug, and an AME can issue a certificate if you take three or fewer of them.¹² All major statins are acceptable, along with ezetimibe (Zetia), fibrates, bile acid sequestrants, omega-3-acid ethyl esters, bempedoic acid (Nexletol), and niacin. PCSK9 inhibitors alirocumab (Praluent) and evolocumab (Repatha) were upgraded from “conditional” to fully “acceptable” in August 2025, removing any wait time. Every cholesterol drug requires a 48-hour initial ground trial.¹³

Diabetes

Most oral and injectable diabetes drugs are permitted. Metformin, thiazolidinediones, GLP-1 agonists, DPP-4 inhibitors, alpha-glucosidase inhibitors, sulfonylureas, meglitinides, and SGLT2 inhibitors are all included in the FAA’s acceptable combinations chart. You can use up to three diabetes drugs, no more than one from each group. Pramlintide (Symlin) is the sole exception on the DNI list. Insulin requires FAA authorization and observation periods of 90 to 180 days depending on certificate class and whether continuous glucose monitoring is used.¹⁴⁵

Antidepressants and the Special Issuance Pathway

Psychiatric drugs are DNI as a class, but the FAA has carved out a route for certain antidepressants through its Antidepressant Protocol (formerly the SSRI Protocol). This pathway, expanded in April 2024 beyond SSRIs, lets pilots fly on a single approved antidepressant under monitoring.¹⁵

As of August 2025 the conditionally acceptable single agents are:¹⁶

SSRIs: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft)
SNRIs: desvenlafaxine (Pristiq), duloxetine (Cymbalta), venlafaxine (Effexor)
Bupropion (Wellbutrin) in SR or ER form only
Vilazodone (Viibryd), moved to conditionally acceptable in August 2025

Still unacceptable: paroxetine (Paxil), fluvoxamine (Luvox), levomilnacipran (Fetzima), immediate-release bupropion, vortioxetine (Trintellix), esketamine (Spravato), all tricyclics, and all MAO inhibitors. You must have been on a stable dose for at least three continuous months without significant side effects, and the process runs through a HIMS AME rather than a routine exam. Disqualifiers include a history of psychosis, suicidal ideation, electroconvulsive therapy, or use of more than one psychiatric drug at a time. Once authorized, follow-up reports are due every six months.¹⁵¹⁷

GLP-1 Weight Loss Medications

As of April 2026, the FAA considers semaglutide (Wegovy, Ozempic), liraglutide (Saxenda), and tirzepatide (Mounjaro, Zepbound) acceptable for weight loss as a single agent, with no special issuance required if you meet the conditions: A1C of 6.4 or below, no diabetes diagnosis, and no history of hypoglycemia requiring intervention.¹⁸ A two-week grounding period applies at the start, with 48 hours of observation after every dose increase or formulation change. Using two diabetic medications in combination for weight loss becomes “conditionally acceptable” and does require special issuance. Older amphetamine-type weight loss drugs such as phentermine remain prohibited.¹⁹

Migraine Medications

The FAA updated migraine guidance in December 2025. For prevention, beta-blockers, calcium channel blockers, ACE inhibitors, ARBs, and CGRP antagonists (atogepant, erenumab, fremanezumab, galcanezumab, eptinezumab) are acceptable after a seven-day ground trial, with no ongoing wait between doses. Botox for migraines requires special issuance and a 72-hour observation after each injection. For acute treatment, most triptans (sumatriptan, rizatriptan, almotriptan, naratriptan, zolmitriptan) carry a 24-hour wait; the longer-acting eletriptan and frovatriptan require 48 hours. CGRP antagonists used as abortives (rimegepant, ubrogepant, zavegepant) require 48 hours. Lasmiditan (Reyvow) is acceptable only for abortive use, with a 48-hour wait. Butalbital combinations (Fioricet, Fiorinal), all opioid analgesics, and Midrin remain unacceptable, and preventive use of tricyclics, gabapentin, topiramate, and valproic acid is prohibited.²⁰

Anticoagulants

Warfarin is permitted, but you must submit at least monthly INR results for the six months before your medical exam. If more than 20% of INR values fall outside the 2.0 to 3.0 range, the AME must defer to the FAA.²¹ Direct oral anticoagulants such as rivaroxaban (Xarelto), apixaban (Eliquis), and dabigatran (Pradaxa) require a two-week observation after starting and a treating-physician statement covering tolerance and side effects. Any bleeding episode requiring medical attention triggers a deferral.²²

Cannabis and CBD

Because marijuana is a DEA Schedule I substance under federal law, its use is disqualifying regardless of what your state allows.²³²⁴

BasicMed Is Different

If you fly under BasicMed instead of a traditional FAA medical certificate, the DNI/DNF framework does not directly apply. Your state-licensed physician reviews your medications using standard medical judgment during the comprehensive examination. The federal safety rules still bind you: 14 CFR 61.53 and 91.17 apply the same way. A drug that would be DNI under the traditional system does not automatically ground you under BasicMed, but the physician and pilot together have to make an honest call about whether it interferes with safe flight.²⁵

How to Verify a Specific Drug

The authoritative reference is the Guide for Aviation Medical Examiners, which organizes pharmaceutical guidance by category and includes the DNI/DNF tables as a downloadable PDF.¹²⁶²⁷

When in doubt, call your AME. If you are asking a non-aviation physician, the FAA suggests framing the question as whether the medication would “interfere with the operation of dangerous machinery.” If the answer is yes, treat it as unsafe for flight.²⁶

1
FAA. Guide for Aviation Medical Examiners – Pharmaceuticals
2
FAA. Medical Certification
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eCFR. 14 CFR 91.17
4
FAA. Drug and Alcohol Policy Q&A
5
FAA. DNI DNF Tables
6
FAA. DNI DNF Medications
7
FAA. OTC Medications for Pilots
8
FAA. Allergy Antihistamine Immunotherapy Medication
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FAA. Sedatives and Sleep Aids
10
FAA. Erectile Dysfunction and Benign Prostatic Hyperplasia Medications
11
FAA. OTC Medications for Pilots
12
FAA. Antihypertensive Medications
13
FAA. Cholesterol Medications
14
FAA. Acceptable Combinations of Diabetes Medications
15
FAA. Antidepressants
16
FAA. Antidepressant Medications
17
FAA. Airman Information SSRI Initial Certification
18
FAA. Weight Loss Medications
19
ALPA. What Airline Pilots Need to Know About Weight Loss Medications
20
FAA. Migraine Medication
21
FAA. Anticoagulants
22
FAA. Venous Thromboembolism
23
FAA. Controlled Substances and CBD Products
24
AOPA. CBD Can Be Risky for Pilots
25
AOPA. AOPA BasicMed Pilot and Physicians Guide
26
FAA. Pharmaceuticals (Therapeutics)
27
AOPA. Medications Database