The FAA’s Office of Aerospace Medicine this month introduced an online tool that can tell pilots and Air Traffic Control Specialists which medications are considered acceptable for use while performing flight or safety-related duties, partially addressing a longstanding information gap.
The agency on its website says its MedGuide tool is not a stand-in for medical diagnosis or treatment and “should not be used as the sole basis in making aeromedical determinations, which must include an individualized assessment.” But it provides a reference for airman medical certification and ATCS clearance.
Version 1.0 of MedGuide contains only approved medications. Future iterations will add conditional and unacceptable medications.
Users can select generic or brand-name drugs and over-the-counter medications using a drop down menu or type them manually. The page then returns FAA frequency limits—typically as prescribed on the label—and wait times for the medication, depending on the user’s role.
For most drugs, that includes an initial wait time, or the observation period required after starting a new medication before returning to safety-related duties. This is typically 48 hours but can be longer or shorter depending on the drug.
Some medications have a different wait time after subsequent doses to mitigate aeromedically significant side effects. They may also have a discontinuation wait time, required to verify that the user’s condition is stable and there is no risk of rebound symptoms or withdrawal after stopping a medication.
MedGuide also allows users to select the underlying conditions for which they are being treated, which the FAA said is critical to determining safety of flight and can impact wait times.
“This tool, while still a work in progress, equips aviators to make safe, fit-for-flight decisions about medication use,” said Mark Larsen, director of safety and flight operations for the National Business Aviation Association (NBAA), in a news release. “Pilots are accustomed to clear, if-then directions, and MedGuide offers a more direct way to understand both prescription and over-the-counter medications, including any wait time after an initial or subsequent dose.”
Addressing Mental Health in Aviation
The NBAA is one of several organizations that has backed the Aviation Medication Transparency Act (AMTA) of 2026. The legislation would require the FAA to create a comprehensive list of medications safe for pilots, ATCS, and trainees, as well as indicate what period of time individuals holding an FAA medical certificate must have limited or no duties while taking certain medications.
The Aircraft Owners and Pilots Association (AOPA) maintains a list of what medications are appropriate for use as a general aviation pilot, but the FAA lacks such an index.
The Senate passed the AMTA in September, and it is pending House approval.
“MedGuide is a big step in the right direction, and the agency is well positioned relative to the proposed legislative requirements,” said Larsen. “NBAA will continue collaborating with the FAA and advocating for clear guidance paired with reasonable policies and practical timelines.”
NBAA and other groups also support the John A. Hauser Mental Health in Aviation Act (MHAA), which the Senate also passed in September.
That legislation would reduce barriers to seeking mental health treatment, accelerate the FAA’s medical approval process, increase funding to the Office of Aerospace Medicine, and implement other recommendations from the FAA’s Mental Health and Aviation Medical Clearances Aviation Rulemaking Committee.
The bill is named after Hauser, a University of North Dakota student who took his own life in an airplane crash in 2021 while training to become a commercial pilot. Pilots and other aviation professionals must disclose to the FAA any physical and psychological conditions as well as medications they are taking, but many do not for fear of career repercussions.