REGULATORY GUIDANCE
FAA Do Not Issue – Do Not Fly Medications
Certain medications are not approved for use while exercising FAA pilot privileges. Some medications automatically disqualify a pilot from receiving a medical certificate, while others require evaluation or a waiting period before flying. This page highlights common FAA “Do Not Issue – Do Not Fly” medications and explains when pilots should consult an Aviation Medical Examiner (AME).
What is the FAA DNI/DNF list?
The FAA identifies certain medications as Do Not Issue (DNI) or Do Not Fly (DNF) to help protect flight safety and guide aeromedical decision-making.
-
Do Not Issue (DNI): Medications that generally prevent an Aviation Medical Examiner from issuing a medical certificate without further FAA review.
-
Do Not Fly (DNF): Medications that may impair alertness, judgment, coordination, or reaction time. Pilots should not fly while using these medications and may need to observe a waiting period after use.
These categories exist because some medications can affect cognitive or physical performance in ways that may reduce flight safety.
The FAA does not publish a simple “approved medication list.” Medication review depends on both the drug itself and the underlying medical condition being treated.
If you are unsure whether a medication may affect your FAA medical certification or flight status, review the current FAA AME Guide and discuss your situation with an AME before flying or applying for a medical certificate.
Medication decisions are case-specific and based on current FAA guidance.
Common Medication Categories That May Affect FAA Medical Certification
Many medications that affect the central nervous system, alertness, judgment, or reaction time may affect a pilot’s medical certification or ability to fly.
The FAA identifies certain medications as Do Not Issue (DNI) or Do Not Fly (DNF) due to potential safety concerns. The examples below represent common medication categories that may require FAA review, special authorization, or waiting periods before flying.
Sedatives and sleep medications
Examples: Ambien (zolpidem), Lunesta (eszopiclone), and benzodiazepines such as Xanax, Valium, and Ativan.
These medications can impair alertness, coordination, and reaction time. Pilots generally must not fly while using these medications, and significant waiting periods may apply.
Opioid pain medications
Examples: Hydrocodone, oxycodone, morphine, and other opioid analgesics.
Due to sedation, impaired judgment, and slowed reaction time, these medications are typically disqualifying for flight duties while in use and require FAA review for medical certification.
Certain neurological medications
Examples: Gabapentin (Neurontin) and other medications that may cause sedation or cognitive side effects.
Depending on the medication and the underlying condition being treated, pilots may require FAA review, special issuance, or observation periods before returning to flight.
Strong anticholinergic medications
Examples: Dicyclomine (Bentyl), hyoscyamine (Levsin), and diphenoxylate/atropine (Lomotil).
These medications can cause blurred vision, confusion, and impaired focus, which may affect flight safety and require medical review.
Some psychiatric medications
Examples: Certain antipsychotics, sedative medications, and some antidepressants.
While many psychiatric medications are not permitted for pilots, some antidepressants may be allowed under the FAA SSRI protocol with careful monitoring and FAA authorization.
What Pilots Should Do If Taking a Restricted Medication
-
Do not fly while using a medication on the FAA Do Not Fly list.
-
Consult an Aviation Medical Examiner (AME) before returning to flight.
-
Bring a complete medication list and relevant medical records to your appointment.
-
Discuss possible treatment alternatives that may be acceptable under FAA guidelines.
-
Follow FAA guidance regarding observation periods, waiting times, or special issuance review.
The FAA often recommends waiting several dosing intervals after taking certain medications before flying to ensure that no impairment remains. Because medication decisions depend on both the drug and the underlying medical condition, pilots should review FAA guidance and consult an Aviation Medical Examiner before returning to flight.
Important Reminder
The FAA Do Not Issue (DNI) medication tables are not exhaustive. Medication decisions are made case-by-case based on both the medication itself and the underlying medical condition.
Some medications may initially prevent issuance of a medical certificate but may become acceptable after a stabilization period, observation period, or FAA Special Issuance review.
Pilots should always review current FAA guidance and consult an Aviation Medical Examiner (AME) before flying while taking a new medication.
If you have questions about a medication, schedule an Aviation Medical Consultation before your FAA medical exam.
How We Help Pilots Navigate FAA Medical Certification
Medication & Certification Review
Pre-Exam Preparation
We evaluate whether a medication or treatment may affect your FAA medical certification and help identify potential concerns before your exam.
We review your medical history and medications to ensure you meet FAA certification requirements and have the proper documentation ready before your exam.
Preventing Unexpected Deferrals
Documentation Coordination
Identifying medication issues early can prevent unexpected deferrals and delays in obtaining your FAA medical certificate.
When additional medical documentation is required, we help coordinate records and reports needed for FAA review or special issuance.