EASA does not publish an approved medication list—each case is evaluated individually. The fundamental principle: pilots must not fly while using any substance that could impair safe aircraft operation. Both the medication and the underlying condition matter for certification decisions.
Key Principles
EASA Considers
- • Side effect profile (sedation, dizziness)
- • Underlying condition severity
- • Stability of treatment
- • Individual response variation
- • Flight safety implications
Pilot Responsibilities
- • Declare all medications to AME
- • Include OTC drugs & supplements
- • Report new prescriptions promptly
- • Self-assess fitness before each flight
- • When in doubt, don't fly
Condition vs Medication
Often the underlying condition requiring medication is more significant than the drug itself. A pilot taking antihistamines for hay fever may be fine; taking them for a serious infection indicates the infection makes you unfit to fly.
Generally Compatible Medications
| Category | Examples | Notes |
|---|---|---|
| Non-sedating antihistamines | Loratadine, cetirizine, fexofenadine | Mild allergies only |
| Simple pain relief | Paracetamol, ibuprofen | If condition resolved |
| Blood pressure | ACE inhibitors, beta-blockers, CCBs | Stable, no side effects |
| Hormonal | Contraceptives, HRT | Usually no issues |
| Anti-ulcer | Omeprazole, ranitidine | Generally acceptable |
| Anti-diarrhoeal | Loperamide | If fit otherwise |
| Asthma inhalers | Salbutamol, corticosteroid inhalers | Controlled asthma |
| Anti-malaria | Chloroquine, doxycycline, atovaquone | NOT mefloquine |
Grounding Medications
| Category | Examples | Reason |
|---|---|---|
| Sedating antihistamines | Diphenhydramine, chlorpheniramine | Drowsiness, impaired reaction |
| Opioid painkillers | Codeine, tramadol, oxycodone | Cognitive impairment |
| Sedatives/hypnotics | Zopiclone, zolpidem, benzodiazepines | Sedation, impaired alertness |
| Most antidepressants | TCAs, MAOIs, many SSRIs | CNS effects, underlying condition |
| Antipsychotics | All types | Sedation, underlying condition |
| Anticonvulsants | Phenytoin, carbamazepine, valproate | Underlying condition + sedation |
| Muscle relaxants | Cyclobenzaprine, baclofen | Sedation, impaired coordination |
| Some cough medicines | Codeine-based, dextromethorphan | CNS depression |
| Mefloquine | Lariam (anti-malaria) | Spatial disorientation, mood |
ED Medications
Sildenafil (Viagra): 6 hours minimum before flying. Tadalafil/vardenafil: 36 hours minimum. These can cause color vision disturbances and dizziness.
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| Medication Type | Minimum Wait |
|---|---|
| Paracetamol, ibuprofen | 8-12 hours if condition resolved |
| Non-sedating antihistamines | First dose: 24h to check reaction |
| Sedating antihistamines | 24-48 hours |
| Dental local anesthesia | 24 hours |
| Codeine-based painkillers | 48-72 hours |
| Sleep medications | 48-72 hours |
| General anesthesia | 48 hours minimum, often longer |
| New blood pressure medication | 2-4 weeks stable on medication |
When Starting New Medication
Always consult your AME before starting new regular medication. Try first doses on ground days to assess personal response. Never fly until you know how a medication affects you.
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