Official Air Force Aerospace Medicine Approved Medications
Effective: 13 May 2019
(Note: This list supersedes the medication list dated 25 Sep 2018)
This approved medication list shall be utilized for all aircrew and special operations duties including ATC/GBC. For MOD, see the Approved Missile
Operators Quick Reference List.
For Special Warfare Operators, no approved medication list exists. All new medications provided to Special Warfare Operators must be carefully evaluated for potential side effects
and impact on mission. If a medication is to have known potential to affect alertness, judgment, cognition, special sensory function, mood, or coordination, the member should be
placed in Duties Not Including Special Operations (DNISO) status until the medication is discontinued.
The approved medication list consists of drugs for acute and chronic conditions, listed by generic name under one of three categories, based on whether they may be self-prescribed
without flight surgeon consultation (see over the counter medication list), may be prescribed by the flight surgeon without higher approval, or require waiver. Drugs for acute
conditions generally fall under one of the first two categories, while medications for chronic conditions commonly fit into the last category. At the end of the document are listed a
number of drugs which are known to be unacceptable for all flying classes. Waiver of such drugs is highly unlikely.
In general, for all 2992 holders use of any medication whose known actions may affect alertness, judgment, cognition, special sensory function, mood, or coordination requires
DNIF/DNIC or appropriate duty restriction.
A large number of FDA-approved drugs are not listed under either section. If such drugs are used for acute conditions, it should be assumed that the drug is disqualifying for flying
duty, with the member returning to operational status after the condition has resolved, the medication has been discontinued, and its effects have dissipated, which usually entails one
additional day (the “24-hour rule”). For chronic conditions, most common conditions are treatable by one or more of the listed drugs, and use of these drugs is likely to receive
favorable consideration and a more expeditious result. If the member is intolerant of, or inadequately controlled by, a listed medication, but is successfully treated by a non-listed
drug, a waiver request for that drug may be submitted to AFMSA/SG3/5PF through the appropriate MAJCOM/SG (for rated officers and non-rated personnel). Such requests are not
delegated for initial or renewal waivers. The process for approval of such drugs is much more complicated because of the thorough review required. Note: Waivers for non-FDA
approved medications will not be considered. All medications and immunizations used by flying personnel must be FDA approved.
Note that while a specific drug may be acceptable without waiver, the treated condition may still require waiver.
Members pending waiver action must remain DNIF/DNIC until waiver has been granted. Verbal waivers are NOT authorized. Consult Aerospace Medicine Waiver Guide prior to
waiver submission.
For flying personnel, the following medications require ground testing, documented IAW AFI 48-123 paragraph 1.6., on the individual’s DD form 2766 under
“Medications” block on Page 1, IAW AF and MAJCOM guidance and restrictions (KX Operational/Flight Medicine): Ciprofloxacin (mandatory ground test), Temazepam/
zolpidem/zaleplon (no-go pills) and dextroamphetamine/modafinil (go pills) must be ground tested (if member is eligible for use) OR declination of ground test must be documented.
Ground testing results (or declination) must also be updated in ASIMS. Once successfully ground tested, the operational use of go/no-go medications does not require DNIF/DNIC.
Clinical use of go/no-go medications DOES require DNIF/DNIC, despite prior ground testing. Only aircrew designated in current AF/SG, AF/A3O and MAJCOM guidance are
eligible for ground testing and operational use of hypnotics (no-go pills) or stimulants (go pills).
SUMMARY OF CHANGES:
1. Addition of Isotretinoin for acne. Use of this medication requires a waiver, approved at MAJCOM. 2. Addition of Wellbutrin (Zyban) and Varenicline for smoking cessation. 3.
Addition of BoTox for axillary hyperhidrosis. 4. Addition of topical Diclofenac for short term use for musculoskeletal pain. 5. Changed Ketamine DNIF time. 6. Addition of
Aluminum Chlroide Hexahydrate (DrySol) Topical. 7. Addition of Clarithromycin. 8. Addition of Phenylephrine and Tropicamide for eye dilation.