FAA OFFICE OF AVIATION MEDICINE
CIVIL AEROMEDICAL INSTITUTE PUBLICATIONS
OVER-THE-COUNTER MEDICATIONS

A commonly held belief is that medicine cures all that ails.

Whether medicine is prescribed by a doctor or is an over-the-counter medication that you have selected, as a pilot you must consider the effect it will have on your performance.

When you are given a prescription, your doctor explains the possible side-effects of the medication you are about to take. Your pharmacist also outlines them when filling the prescription.

However, when you treat yourself with a non-prescription medication, you become your own doctor and pharmacist. Therefore, you must inform yourself of the possible adverse reactions that you might encounter. The following will help you understand some of the basics that you will need to successfully accomplish this task.

OTCs Defined

Over-the-counter medications (OTCs) are any legal, non-prescription substance taken for the relief of discomforting symptoms. This may include capsules, tablets, powders, or liquids.

Underlying Medical Condition

When you are not feeling well, your best action is to ground yourself and wait until you have recovered before resuming your pilot duties. There may be times, however, when you feel that you must fly and will be tempted to doctor yourself with OTCs. At these times it is good to remember that the OTCs only hide your symptoms for a while. They do not usually "cure" the condition, and you will not be at peak physical performance while you fly.

Problems With Medications

There are two main areas of concern about unwanted reactions to medications.

Possible allergy.

Allergy is a rare and unpredictable reaction to a substance. If you know that you are allergic to something, you should carefully read the list of ingredients of any OTC to assure that none of the substance is included in its formulation.

Possible unexpected side-effects.

These can take many forms, including drowsiness, impairment of judgment, upset stomach or bowels, disturbance of vision, or even itching. Any of these could cause an impairment that might lead to incapacitation while flying.

Decongestants and caffeine (contained in coffee, tea, cola, chocolate) are both strong stimulants in some individuals. Mixed together, they can make you "hyperactive." Note also that some cough syrups contain a decongestant.

Summary Advice

• READ and follow label directions for use of medication.
• If the label warns of side-effects, do not fly until twice the recommended dosing interval has passed. So, if the label says "take every 4-6 hours," then wait at least 12 hours to fly.
• Remember, the condition you are treating may be as disqualifying as the medication.
• When in doubt, ask your physician or Aviation Medical Examiner for advice.
• As a pilot, you are responsible for your own personal "pre-flight." Be wary of any illness that requires medicine to make you feel better.
• If an illness is serious enough to require medication, it is also serious enough to prevent you from flying.
• Do not fly if you have a cold - changes in atmospheric pressures with changes in altitude could cause serious ear and sinus problems.
• Avoid mixing decongestants and caffeine.
• Beware of medications that use alcohol as a base for the ingredients.

                   Medications        Side-Effects        Interactions    

PAIN RELIEF/    ASPIRIN            Ringing in ears,    Increase effect    
FEVER            Alka-Seltzer      nausea, stomach     of blood thinners  
                 Bayer Aspirin     ulceration,                            
                                   hyperventillation                      

                ACETAMINOPHEN      Liver toxicity (in                     
                 Tylenol           large doses)                           

                IBUPROFEN                              Increase effect    
                 Advil             Upset stomach;      of blood thinners  
                 Motrin            dizziness, rash,                       
                 Nuprin            itching                                

COLDS/          ANTIHISTAMINES     Sedation,           Increase sedative  
FLU             Actifed Dristan    dizziness, rash,    effects of other   
                Benadryl Dixoral   impairment of       medications        
                Cheracol-Plus      coordination,                          
                Nyquil             upset stomach,                         
                Chlortrimeton      thickening of                          
                Sinarest           bronchial                              
                Contac Sinutab     secretions,                            
                Dimetapp           blurring of vision                     

                DECONGESTANTS      Excessive           Aggravate high     
                Afrin Nasal Spray  stimulation         blood pressure,    
                Sine-Aid           dizziness,          heart disease,     
                Sudafed            difficulty with     and prostate       
                                   urination,          problems           
                                   palpitations                           

                COUGH              Drowsiness,         Increase sedative  
                SUPPRESSANTS       blurred vision,     effects of other   
                Benylin            difficulty with     medications        
                Robitussin CF/DM   urination,                             
                Vicks Formula 44   upset stomach                          


BOWEL           LAXATIVES          Unexpected bowel                       
PREPARATIONS     Correctol         activity at                            
                 Ex-Lax            altitude, rectal                       
                                   itching                                

                ANTI-DIARRHEALS    Drowsiness,                            
                 Imodium A-D       depression,                            
                 Pepto-Bismol      blurred vision                         
                                   (See Aspirin)                          

APPETITE        Acutrim            Excessive           Increased          
SUPPRESSANTS    Dexatrim           stimulation,        stimulatory        
                                   dizziness,          effects of         
                                   palpitations,       decongestants.     
                                   headaches           Interfere with     
                                                       high blood         
                                                       pressure           
                                                       medications        

SLEEPING        Nytol              (Contain            Cause excessive    
AIDS            Somined            antihistamine)      drowsiness when    
                                   Prolonged           used with alcohol  
                                   drowsiness,                            
                                   blurred vision                         

STIMULANTS      CAFFEINE           Excessive           Interfere with     
                 Coffee, tea,      stimulation,        high blood         
                 cola,             tremors,            pressure           
                 chocolate         palpitations,       medications.       
                                   headache                               

This table lists the common OTCs and outlines some of their possible side-effects that could affect your flying abilities. As with all drugs, side-effects may vary with the individual and with changes in altitude and other flight conditions.