Oral Medications for Diabetes : Rules for Pilots

FAA Policies on Pharmaceuticals for Airmen

Apr 2014

Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).


  1. Code of Federal Regulations: Legal Extract

  2. Medical History: Item 18.k. Diabetes.
    The applicant should describe the condition to include symptoms and treatment. Comment on the presence or absence of hyperglycemic and/or hypoglycemic episodes. A medical history or clinical diagnosis of diabetes mellitus requiring insulin or other hypoglycemic drugs for control is disqualifying. The AME can help expedite the FAA review by assisting the applicant in gathering medical records and submitting a current specialty report.

  3. Aeromedical Decision Considerations: See Item 48, Diabetes

  4. Protocol: See Diabetes Mellitus Type II - Medication Controlled

  5. Pharmaceutical Considerations:

    1. Combination of DM medications with antihypertensives:
      • Disqualifying Combinations. Certification of airmen using meglitinides or sulfonylureas, along with beta-blockers is not permitted. Commonly used meglitinides include repaglinide (Prandin) and nateglinide (Starlix). Commonly used sulfonylureas include: acetohexamide (Dymelor); chloropropamide (Diabinese); tolazamide (Tolinase); tolbutamide (Orinase); glimepiride (Amaryl); glipizide (Glucotrol, Glucotrol XL); glyburide (DiaBeta, Micronase, Glynase); glyburide plus metformin (Glucovance); glipizide plus metformin (Metaglip).
      • Allowable Combinations. Certification of airmen using the combination of a beta blocker with the following diabetes medications is permitted: alpha-glucosidase inhibitors [acarbose (Precose), miglitol (Glyset)]; biguanides [metformin (Glucophage)]; thiazolidinediones [pioglitazone (Actos)]; DDP-4 inhibitors [sitagliptin (Januvia)]; and incretin mimetics [exenatide (Byetta)].
    2. DM medication monotherapy versus combination therapy. Not all combinations of DM medications are acceptable to the FAA, even if each medication within the combination is acceptable as monotherapy. AMEs should contact the Regional Flight SurgeonRegional Flight Surgeon's office or AMCD for questions.

    FAA Note: The drugs in parenthesis are examples and lists presented here are not all-inclusive.

Summary: This page reviewed the medical and legal aviation aspects of Oral Medications for Diabetes compiled from recent FAA and FDA reports.

This page discussed Oral Medications for Diabetes : Rules for Pilots

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