Medication

Guidance for medical examiners when assessing a patient for either a general topic or condition - Medication.

  • This guidance applies to all drugs, whether herbal, over-the-counter or prescription
  • Just because a medication is available over-the-counter doesn’t mean it is automatically safe in aviation
  • All medications are considered hazardous; specific exceptions are listed below
  • Inclusion in the 'Approved List' does not mean these medications are without hazard. In case of any concern, medical advice must be sought
  • Starting a medication or changing a dose up or down is a “Change in medical condition” (See CASR Part 67 definition) and must be reported to your DAME or CASA within 5 days if lasting for more than:
  • Class 1: 7 days
  • Class 2 and 3: 30 days
  • For all treatments, the safety-relevance of the condition as well as medication must be considered; e.g. the condition being treated must be considered as well as any treatment used
  • Some treatments e.g. desensitisation for allergies, hormone injections for cancer of the prostate, may be single injections which last for extended periods of time. You must check with your DAME or CASA if this is a safety-relevant treatment.

Approved medications:

For occasional use in minor, self-limiting ailments lasting < 1 week.

  • Paracetamol (Panadol™, Panamax™)
  • Ibuprofen (Nurofen™, Advil™)
  • Aspirin (Aspro™, Disprin™)
  • Antacids (Mylanta™, Gaviscon™)
  • Ranitidine (Zantac™, Rani™)
  • Laxatives
  • Suppositories such as Anusol™ or Proctosedyl™
  • Non-sedating antihistamines:
    • Fexofenadine/Telfast™
    • Loratadine/Claratyne™
    • Desloratadine/Aerius™.

Ongoing use:

  • Combined Oral Contraceptive Pill
  • Progesterone-Only Contraceptive Pill
  • Depo-Progesterone (Depo-Provera™/Depo-Ralovera™) injection
  • Implanon™ implant
  • Intrauterine contraceptive device (including Mirena™) - Note: 24 hour grounding following insertion.
  • Topical ointments and creams:
    • antiseptics
    • topical antibiotics
    • aciclovir/Zovirax™
    • antifungal creams
    • weak steroid creams (eg Hydrocortisone 1%)
    • tar preparations
  • Vaginal creams and suppositories
  • Skin cancer treatments
    • Imiquimod/Aldara™
    • Fluorouracil/Efudix™.

Medications hazardous in aviation

The following are a selection of commonly used medications which are hazardous in aviation. They must not be used without express clearance by CASA or your DAME.

Just because a medication is not on this list, does not imply it is approved.

  • Acne treatments:
    • Isotretinoin (Roaccutane™)
  • Blood thinners:
    • Apixaban (Eliquis™)
    • Dabigatran (Pradaxa™)
    • Rivaroxaban (Xarelto™)
    • Warfarin (Coumadin™, Marevan™)
    • Clopidogrel (Plavix™, Clovix™)
  • Erection medications:
    • Sildenafil (Viagra™)
    • Tadalafil (Cialis™)
    • Vardenafil (Levitra™)
  • Pain Medications:
    • Pregabalin (Lyrica™)
  • Sleeping tablets:
    • Temazepam (Temaze™, Normison™)
    • Zolpidem (Stilnox™)
    • Zopiclone (Imovane™)
  • Vaccinations/Immunisations:
    • Aviation related duties should not be undertaken for 24 hours after receiving a vaccination/immunisation.

Medications prohibited in aviation

The following are a selection of commonly used medications which are prohibited for use in aviation. You must not exercise the privileges of your medical certificate while taking these medications, and must be cleared by your DAME (or CASA) following cessation.

Just because a medication is not on this list, does not imply it is approved.

  • Sedating antihistamines
    • Cetirizine (Alzene™, Zyrtec™)
  • Heart medications
    • Glyceryl Trinitrate (Minitran™, Nitro-Dur™, Transiderm-Nitro™, Anginine™)
    • Isosorbine Mononitrate (Duride™, Imdur™, Imtrate™, Monodur™)
  • Pain medications
    • Codeine (Codalgin™, Panadeine™, Codalgin Forte™, Panadeine Forte™, Aspalgin™)
    • Oxycodone (Endone™, Oxycontin™, Oxynorm™, Targin™)
    • Tramadol (Tramal™, Tramedo™, Zydol™)
  • Smoking cessation:
    • Varenicline (Champix™)
  • Weight loss medication:
    • Phentermine (Duromine™).

Summary

Always consult your DAME or CASA about the safe use of medication. Many may be used with appropriate guidance and safeguards.

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Disclaimer

The clinical practice guidelines is provided by way of guidance only and subject to the clinical practice guidelines disclaimer.

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