Avoiding Adverse Drug Interactions

2020 10 1 gajsc avoiding adverse drug interactions

2020 10 2 gajsc avoiding adverse drug interactions



What OTC Medications Can I Take and Still Be Safe To Fly? www.faa.gov/go/pilotmeds

AME Guide — Pharmaceuticals www.faa.gov/about/office_org/headquarters_offices/avs/aam/ame/guide/pharm/

 AME Guide — Do Not Issue — Do Not Fly www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/



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Avoiding Adverse Drug Interactions

Outreach Guidance and Presentation Notes

This outreach guidance is provided to all FAA and aviation industry groups that are participating in outreach efforts sponsored by the General Aviation Joint Steering Committee (GAJSC).  It is important that all outreach on a given topic is coordinated and is free of conflicts.  Therefore, all outreach products should be in alignment with the outline and concepts listed below for this topic.


Outreach Month:  October 2020


Topic: Avoiding Adverse Drug Interactions The FAA and industry will conduct a public education campaign emphasizing dangers of interactions between multiple prescription and/or over-the-counter drugs.



Several studies published by the FAA Toxicology Laboratory on toxicology samples of deceased pilots indicated the presence of illicit drugs, and prescription or over-the counter medications in 42% of subjects tested.  While NTSB and FAA have not necessarily cited drug or medication use as a causal factor in these accidents; the magnitude of these findings poses two questions.  Have the drugs found in recent investigations, diminished pilots ability to safely conduct flight operations?  Have the medical conditions requiring use of those drugs compromised pilots ability to fly safely?  It may be impossible to say after the fact to what extent a drug compromised a pilot’s capability but it’s safe to say that a consultation with one’s Aviation Medical Examiner (AME) is a good idea before flying while using any drug. 

The sometimes adverse reactions between prescribed and OTC drugs and between drugs and food, beverages, and dietary supplements is also cause for concern – particularly so because most pilots are not sufficiently knowledgable to predict these adverse reactions.  AMEs are trained to identify possible adverse reactions and to recommend appropriate courses of action.


Teaching Points:

  • 42% of pilots in fatal crashes had some sort of drug/medication in their systems during the flight.
  • In the United States, 65% of visits to medical doctors result in the writing of a prescription.
  • Some of these medications carry very specific warnings against operating machinery or motor vehicles or performing tasks requiring alertness. Flying certainly is included, even in a glider or hot-air balloon.
  • Illicit drugs always impair human performance.
  • Healthcare providers may prescribe drugs that could compromise pilot’s abilities – especially if the doctor is not aware that the patient is a pilot.
  • Combinations of prescription and OTC medications can be particularly dangerous. Pilots should consult their AME before taking a combination of medications.
  • Adverse reactions can also occur between prescribed or OTC medications and certain foods, beverages, and dietary supplements.
  • AMEs are trained to advise pilots on negative and positive effects of drugs with respect to aviation.
  • Pilots must truthfully report all medical conditions and drug use on their medical application forms and should consult their AME with respect to all medical conditions and drug use before flight.