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Heart Medications

FAA Guidance to AMEs on the Cardiac Exam

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Item 36. Heart Medications

The FAA will consider an Authorization for a Special Issuance of a Medical Certificate (Authorization) for most cardiac conditions. Applicants seeking further FAA consideration should be prepared to submit all past records and a report of a complete current cardiovascular evaluation in accordance with FAA specifications.

  1. Medications acceptable to the FAA for treatment of hypertension in applicants include all Food and Drug Administration approved diuretics, alpha-adrenergic blocking agents, beta-adrenergic blocking agents, calcium channel blocking agents, angiotension converting enzyme (ACE inhibitors) agents, and direct vasodilators. Centrally acting agents (such as, reserpine, guanethidine, guanadrel, guanabenz, and methyldopa) are usually not acceptable to the FAA. Dosage levels should be the minimum necessary to obtain optimal clinical control and should not be modified to influence the certification decision.


  2. The AME may submit for the Federal Air Surgeon's review requests for Authorization under the special issuance section of
    Part 67 (14 CFR 67.401) in cases in which these or other usually unacceptable medications are used. Specialty evaluations are required in such cases and must provide information on why the specific drug is required. The AME's own recommendation should be included. The AME must defer issuance of a medical certificate to any applicant whose hypertension is being treated with unacceptable medications. The use of nitrates for the treatment for coronary artery disease or to modify hemodynamics is unacceptable.


The use of flecainide is unacceptable when there is evidence of left ventricular dysfunction or recent myocardial infarction.


Note: Numbers correspond to the required entry in the AME portion of the FAA Form 8500-8

25. Head, Face, Neck, and Scalp 42. Upper and Lower Extremities
26. Nose 43. Spine and other Musculoskeletal
27. Sinuses 44. Identifying Body Marks, Scars, Tattoos
28. Mouth and Throat 45. Lymphatics
29. Ear 46. Neurologic
30. Ear Drums 47. Psychiatric Conditions
31. Eyes 48. General Systemic
32. Ophthalmoscopic 49. Hearing
33. Pupils 50. Distant Vision
34. Ocular Motility 51. Near and Intermediate Vision
35. Lungs and Chest 52. Color Vision
36. Heart 53. Field of Vision
37. Vascular System 54. Heterophoria
38. Abdomen and Viscera 55. Blood Pressure
39. Anus (No Disposition) 56. Pulse
40. Skin 57. Urinalysis
41. G-U System 58. ECG (No Disposition)

Note: Numbers correspond to the required entry in the AME portion of the FAA Form 8500-8

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