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  1. Code of Federal Regulations for Airmen
    • First-Class Airman Medical Certificate: 67.113(c)
    • Second-Class Airman Medical Certificate: 67.213(c)
    • Third-Class Airman Medical Certificate: 67.313(c)
  2. Medical History - This medication is absolutely disqualifying for pilots and air traffic controllers (ATCSs). Mefloquine (Lariam) is associated with adverse neuropsychiatric
    side-effects, even weeks after the drug is discontinued. Because of the association with adverse neuropsychiatric side-effects, even weeks after discontinuation, a pilot or ATCS who elects to use mefloquine for malaria prophylaxis or who contracts malaria and is treated with mefloquine will be disqualified for pilot/ATCS duties for the duration of use of mefloquine and for 4 weeks after the last dose. In this instance, the pilot or ATCS must contact the FAA or his/her Aviation Medical AME prior to returning to flight duties after use (Agency ATCSs must contact an agency flight surgeon).
  3. Aeromedical Decision Considerations - N/A
  4. Protocol - N/A
  5. Pharmaceutical Considerations - For return to pilot or ATCS duties there must be no history of neurologic or psychiatric symptoms during and or after mefloquine use. Examples of symptoms related to mefloquine use include: dizziness or vertigo, tinnitus, and loss of balance; anxiety, paranoia, depression, restlessness or confusion, hallucinations and psychotic behavior.
    • Use of mefloquine must be discontinued for at least 4 weeks prior to consideration and:
    • The airman or contract tower ATCS must contact the FAA agency flight surgeon or their AME before resuming pilot or contract tower ATCS duties
    • The agency ATCS must contact the agency flight surgeon for clearance determination prior to resuming safety sensitive duties.
    • For return to pilot or ATCS duties there must be no history of neurologic or psychiatric symptoms during and or after mefloquine use.
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