FAA General OTC Med Reference Guide

Page Contents
Subtitle
What OTC Medications Can I Take and Still Be Safe to Fly or Control?
Description
Extracts from FAA General OTC Guidance
FlightPhysical.com Abbreviated Briefing

1. First, ask yourself "Do I have an underlying condition that makes me unsafe to fly?"

Title 14 CFR 61.53 is the regulation, which prohibits flight with a known medical deficiency (unless cleared by the FAA) and requires that you determine that you are fit to fly prior to each flight.
  • Am I sick?
  • Am I having trouble clearing my ears at ground level?
  • Do I feel bad enough that I keep thinking about how I feel?
  • Are others asking me if I am ok?
  • Do I feel good enough to fly ONLY if I take medication?
  • Am I getting worse?

2. Next, consider these issues before operating an aircraft:

  • In the last few days, have you taken, or do you plan to take any medications before flying?
  • If currently taking a medication only for symptom relief, would you be safe to fly without it?
  • Do you have any other underlying health conditions?
  • Discuss these conditions with your AME or family physician to determine if you are safe to fly.
  • Specifically ask about your ability "to operate machinery" (including any aircraft).
  • Discuss if the medication, OTC or otherwise, will pose a problem with the underlying condition or other health conditions and/or other medications that you are taking.

3. When choosing an OTC Medication, follow these steps:

  • #1. IDENTIFY the active ingredient(s). Verify you have taken this medication in the past with no side effects. (Note: Multi-ingredient products are preferred over combination products because it is easier to spot disqualifying ingredients).
  • #2. READ the label. If there is a warning that it "May cause drowsiness" or it advises the user to "be careful when driving a motor vehicle or operating machinery," then this medication is NOT safe for flying.
  • #3. READ carefully. Do not fly while taking a new medication; wait at least 48 dosage intervals and ensure that you suffer no adverse effects from it before flying while on this medication. (See the table below for the recommended observation period).
FlightPhysical's Staff Take Home Message
The above are fairly useful common sense decision criteria for self-grounding, but aviation medicine specialists are often asked:

What if I take one of the No-Go Medications during an illness and I ground myself. How long do I have to wait before I can fly again?

If you take any of the NO GO medications listed in the OTC Medications listed in the red (No-Go) section of the FAA medication reference guide OR if you have previously had side effects from the medication, wait at least five (5) dosage intervals after the last dose before flying.

Dosage Interval Wait Time

*If there is a range, use the higher number

Package Instructions

5 Times Dosage Interval

No Fly Time Recommendation

Every 4-6 hours*
(Up to 6 times daily)

x 5 = 30 hours

Wait at least 30 hours before flying if taking a medication directed to take every 4-6 hours.

Every 8 hours
(OR three times daily)

x 5 = 40 hours

Wait at least 40 hours before flying if taking a medication directed to take every 8 hours.

Every 12 hours
(OR twice daily)

x 5 = 60 hours

Wait at least 60 hours before flying if taking a medication directed to take every 12 hours.

Caution: Sedating antihistamine medications have a long half-life so wait time is 60 hours for both diphenhydramine (Benadryl) and doxylamine (Unisom), 5 days for both chlorpheniramine and clemastine.

Disclaimer: Neither the FAA nor FlightPhysical.com will attempt to publish all-inclusive references. Online guidance does not replace medical advice from your PCP and/or AME. Most doctors are not AMEs, and your regular Primary Care Provider (PCP) or specialist will know more about you and/or your specific medical condition than an AME, but is probably untrained or unfamiliar with aviation medicine. Follow 14 CFR 61.53 (duty to self-ground when ill) for your safety and that of your passengers. Don't fly after taking a new medication for the first time until 48 hours have past without side effects. When in doubt - DO NOT FLY.
References
FAA AME Guide Dec 2025 version and FAA.gov and FAA OTC Med Ref Guide 8 Aug 2024