Code of Federal Regulations (Legal Extract)
- First-Class Airman Medical Certificate: 67.113(b)(c)
- Second-Class Airman Medical Certificate: 67.213(b)(c)
- Third-Class Airman Medical Certificate: 67.313(b)(c)
Medical History: Item 18.h., High or low blood pressure.
The applicant should provide history and treatment, type of medication, purpose, and duration of use. Issuance of a medical certificate is dependant on current blood pressure levels and whether the applicant is taking anti-hypertensive medication. The AME should also determine if the applicant has a history of complications, adverse reactions to therapy, hospitalization, etc.Aeromedical Decision Considerations:
- See Item 36, Heart-Hypertension
- Also see Item 55, Blood Pressure
Protocol: N/A. See Hypertension Worksheet.
| Acceptable HTN Medication Options (when other certification criteria are met) |
|
|---|---|
| Alpha adrenergic blockers | Calcium channel blockers |
| Angiotensin converting enzyme (ACE) inhibitors | Direct renin inhibitors |
| Angiotensin II receptor antagonists (ARBs) | Direct vasodilators |
| Beta-adrenergic blockers | Diuretics |
- Seven-day (7) no fly/ground trial is required when starting a new hypertension (HTN) medication to verify no side effects.
- AME should issue (if otherwise qualified) if the airmen is on 3 or fewer medications.
- Uses of beta-adrenergic blockers ARE allowed with insulin, meglitinides, or sulfonylureas.
| UNACCEPTABLE HTN Medications (as a single agent or in any combination product) |
|---|
| Clonidine (ex. Catapres/Clorpres) |
| Guanabenz |
| Guanfacine/Tenex |
| Methyldopa |
| Nitrates (ex. nitroglycerin/isosorbide dinitrate/isosorbide mononitrate) |
| Reserpine |
| AME Instruction: DO NOT ISSUE Medical Certificate for pilots on these medications |
FAA AME Guide Dec 2025 version