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Medication Class — Anti-Inflammatory/Arthritis Medications

Medication Class Description:

OTC medications such as aspirin, Tylenol, Advil, Aleve, Mediprin, Motrin IB, and so forth are allowed for flight deck use. Prescriptions for similar medications, including Motrin, Naprosyn, Voltaren, Ansaid, and Indocin, are allowed as long as you experience no side effects after 48 hours of use.  As noted above, Celebrex and Bextra are also authorized.   This assumes that the condition that a pilot is using the medication for will not interfere with the safe performance of flight duties.  Vioxx was voluntarily removed from the market on September 30, 2004 because of an increased risk of cardiac events. 

Mobic (meloxicam) is a new oxicam derivative non-steroidal  anti-inflammatory drug that was approved by the FDA in April 00.  Other medications in this class have already been authorized by the FAA.
 

Remicade (infliximab) is monocolonal antibody which binds to human tissue necrosis factor, this medication is available in an injectable form given every 2-4 weeks for rheumatoid arthritis and for Crohn's disease. Two to three doses are required before applying for a waiver for this medication.

Imuran (azothioprine) is an immunosuppressive medication traditionally used with transplants and some cancer chemotherapy, it recently was authorized by the FAA for flying while under treatment for rheumatoid arthritis, Crohn's disease and ulcerative colitis.  A 30 day observation period is required before applying for a waiver.

The FAA will also grant waivers for  Methotrexate, a medication used both for cancer and for inflammatory conditions such as rheumatoid arthritis, after a two week observation period without side effects. 

 The FAA does not approve for flight duty use any medications containing narcotics or codeine--Tylenol No. 3, Demerol, Darvon, Darvocet, Lortab, Percodan, Ultram (not a narcotic, but essentially viewed as one for certification purposes), etc.  Also the FAA does not allow use of medications affecting pain modulation at the nerve level such as antidepressants or Neurontin. If you use these medications, you must wait a specified amount of time--usually 72 hours--after ceasing to take the medication before returning to the flight deck. Earlier return may result in a positive DOT random drug test with some of these medications.

 

Humira (adalimumab) is an injectable medication that can slow the progression of rheumatoid arthrits in adults.  It is a recombinant antibody to human tissue necrosis factor - alpha that can be used in combination with other anti-rheumatoid medications.  Pilots on this medication must use it for at least 30 days before applying for FAA authorization to use the Humira for rheumatoid arthritis when flying.

Synvisc (hylan G-F 20) is used to inject into the knee joint in cases of severe osteoarthritis to reduce pain and use of oral medication.

Enbrel (etanercept) is a new category of injectable medication for moderately severe rheumatoid arthritis.   The FAA will consider a waiver for pilots using this medication after a 30 day ground test period, if the side effects are minimal and the degree of arthritis does not impair the ability to fly safely. 

As of 4/9/13 AMEs can certify airmen with arthritis taking oral steroids 20mg/d or less, methotrexate, Plaquenil (still requires eye eval), or NSAIDS as long as the condition is stable.  CBC and metabolic panel must be performed within last 90 days.  This policy is in flux and Humira or Enbrel are not specifically addressed.


 



Medications Within Class:

 

Please see text above as many of these medications either require a waiver or are not allowed by the FAA:

Aspirin, Tylenol, Advil, Aleve, Mediprin, Motrin IB, Motrin, Naprosyn, Voltaren, Ansaid, Indocin, Celebrex, Bextra, Vioxx, Imuran (azothioprine), Humira, Methotrexate, Tylenol No. 3, Demerol, Darvon, Darvocet, Lortab, Percodan, Ultram, Humira (adalimumab), Synvisc (hylan G-F 20), Enbrel (etanercept), Mobic (meloxicam), Remicade (infliximab), Neurontin (gabapentin), Elavil