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Official Air Force Approved Aircrew Medications
Effective: 19 May, 2011
(Note: This list supersedes the medication list dated 29 Nov 2010)
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 flying class I, IA, II and III. Request for waiver of such drugs is highly unlikely.
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 aviator returning to flying 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 aviator is intolerant of or inadequately controlled by a listed medication, but is successfully treated by a non-listed drug, awaiver request for that drug may be submitted to AFMSA/SG3PF through the appropriate MAJCOM/SG (for rated officers and non-rated personnel)). Such requests are not delegatedfor initial or renewal waivers. Note that, because of the thorough review that is required, the process for approval of such drugs is much more complicated. Note: Waivers for non-FDA approved medications will not be considered. All medications and immunizations used by flying and special operational duty 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 until waiver has been granted. Verbal waivers are NOT authorized. Consult Aircrew Waiver Guide prior to waiver submission.
Ground-based Controllers, UAS Sensor Operators, and special duty personnel where AF Form 1042 applies: Use of any medication whose known actions may affect alertness,
judgment, cognition, special sensory function, mood, or coordination requires DNIC or aFor flying/special duty personnel, the following medications require ground testing, documented IAW AFI 48-123 paragraph 1.12, 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, temazepam/zolpidem/zaleplon (no-go
pills); dextroamphetamine/modafinil (go pills) if eligible. Ground testing results must also be updated in PIMR. Once successfully ground tested, the operational use of go/no-go
medications does not require DNIF. Clinical use of go/no-go medications DOES require DNIF, despite prior ground testing.
SUMMARY OF CHANGES:
Added: Potassium iodide (prophylaxis), Synvisc (intra-articular), vardenafil. Modified post-dose DNIF for sildenafil.
Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
DNIF until the underlying condition will not interfere with flying duties and there are no adverse side effects. Usage is for acute conditions, less than 4 weeks, and condition does not require waiver. Submit for waiver after potential idiosyncratic reactuion has been ruled out and Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
DNIF until the underlying condition will not interfere with flyig duties and there are no adverse side effects (minimum 72 hours). Note: For 10 recurrent episodes per
year , treat with acyclovir 400 mg b.i.d.
DNIF not required unless condition or medication interferes with life support gear DNIF not required unless condition or medication interferes with life support gear or flying duties. Adapalene Background Paper fter potential for idiosyncratic reaction has been ruled out and control is maintained. Take on non-flying days, if possible. See Alendronate For urolithiasis either alone or in combination with thiazide (hydrochlorothiazide or chlorothiazide); submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Minimum 7-day observation after last dose adjustment. Approved for FC IIA/IIU and FC III waivers.
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Chronic or Recurrent Prostatitis / Cystitis Aircrew members cannot fly for at least 8 hours after receiving a local or regional DNIF not required unless condition or medication interferes with life support gear or flying duties.
DNIF not required unless condition or medication interferes with life support gear DNIF not required unless condition or medication interferes with life support gear Single ground trial is required for members who have never previously taken aspirin; 81 mg or 325 mg once daily for prophylactic therapy as clinically indicated. Underlying disqualifying condition (when present) continue to require waiver. Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
DNIF until the underlying condition will not interfere with flying duties and there are no adverse side effects. Usage is for acute conditions, less than 4 weeks, and Submit for waiver after potential for idiosyncratic reaction has been ruled out and Limited to a FC IIA/IIU waiver initially by AFMSA/SGPA and renewals may not Waiver not required if on single approved statin medication for hyperlipidemia. Approved medications include simvastatin, pravastatin, and lovastatin up to 40mg/day and atorvastatin up to 80mg/day. Higher doses or combination of medication requires waiver. Requires at least 5 day ground trail when starting medication or for any adjustments to dosage to rule out idiosyncratic reactions. Follow up of lipids and LFTs should conform with accepted practice standardsCombination therapy with Gemfibrozil is limited to a FC IIA waiver by MAJCOM/SGPA or IIU (AFMSA) and may not be further delegated.
Single dose ground trial required; Malarone (250 mg atovaquone/100 mg proguanil) daily beginning 1-2 days prier exposure (Reminder:
last 7 days of Malarone should be taken with primaquine followed by another 7
days of primaquine alone)
; Malarone Background Paper
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic. Submit for waiver after potential for idiosyncratic reaction has been ruled out and l for idiosyncratic reaction has been ruled out and control is maintained. Doses limited to 100 gm of ointment per week.
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
Single dose ground trial required; 500 mg tablet (300 mg base) once weekly beginning 1-2 weeks prior to travel; ending 4 weeks after exposure. (Reminder:
last 2 weeks should be taken with primaquine)

For hypertension: either alone or in combination with triamterene does not require waiver. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. Symptom control = BP <140/90. See HTN Waiver Guide for treatment parameters.
____________________________________________________ *Combination therapy with ACEi, ARB, other antihypertensive requires waiver. Combo therapy requires categorical restriction for FCII – see HTN Waiver Guide.
For urolithiasis : Either alone or in combination with allopurinol or oral potassium supplements. Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
DNIF until potential for idiosyncratic reaction has been ruled out.
DNIF not required unless condition or medication interferes with life support gear BW Prophylaxis
Neurotoxicity risk precludes usage in non-BW environment; Ciprofloxacin may
be used operationally after monitored ground trial (500 mg every 12 hours for 2
NIF documented in medical records) in event of BW incident
for post-exposure treatment and prophylaxis for inhalational anthrax only;
Cipro Policy Letter.
DNIF not required unless condition or medication interferes with life support gear or flying duties.
Submit for waiver after potential for idiosyncratic reaction has been ruled out. DNIF until potential for idiosyncratic reaction has been ruled out.
Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Length of DNIF dictated by time required for adequate control of underlying *Waiverable for FCII/III (trained assets only) and based on severity as specified in the waiver guide OPERATIONAL USE ONLY: Go pill use should normally be limited to sorties over 8 hrs in a single-piloted fighter or 12 hrs in a dual-piloted bomber; Must only be used IAW applicable guidance; Check with MAJCOM/SG prior to
mg dosages, 4 hrs apart, documented in the
medical record) with mandatory DNIF required prior to operational use;
Dextroamphetamine Policy Letter.
Dextroamphetamine is not authorized for routine clinical use in flyers/special duty
personnel.
OPERATIONAL USE ONLY: Go Gel specially prepared for U-2S pilots when conducting U-2S operational sorties IAW applicable guidance; Check with
MAJCOM/SG l (two 10 mg dosages, 4 hrs apart,
documented in the medical record) with mandatory DNIF required prior to
U-2S Pilots Only
operational use; Dextroamphetamine Policy Letter.
Dextroamphetamine is not authorized for routine clinical use in flyers/special duty personnel.
Alone or in combination with dextroamphetamine for airsickness in formal
training programs only. *Not authorized for solo flight (see AETCI 48-102).
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Dietary, herbal, and nutritional supplements can only be used with the
approval of a flual
the supplement. In general, the use of nutritional supplements is not recommended. Nutritional Supplement Policy Letter; Ephedra Policy Letter; SF 600 Overprint (optional tool for convenience) DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
DNIF not required for treatment of acne, unless acne interferes with wear of life support equipment. DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
100 mg twice a day for 5 days may be used for treatment of mild infectious diarrhea; DNIF until acute infectious process is asymptomatic.
Should the individual develop an idiosyncratic reaction to Ciprofloxacin, doxycycline (100 mg, twice daily) is the recommended prophylaxis of choice (in the absence of contraindications). 100 mg daily beginning 1-2 days prior to travel; ending 4 weeks after exposure. (Reminder: last 2 weeks should be taken with primaquine.)
100 mg administered daily during period of exposure and for at least 2 days following exposure for prophylaxis against diarrhea in deployed personnel; total period of use not to exceed 2 weeks.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Chronic or Recurrent Prostatitis/Cystitis fter potential for idiosyncratic reaction has been ruled out and control is maintained. FC IIA/IIU waiver only. Eplerenone and Spironolactone Background Paper.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained.
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
DNIF not required unless condition or medication interferes with life support gear or flying duties.
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days) and symptom control is maintained.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Authorized under a single waiver (along with the other approved proton pump inhibitors (PPIs) esomeprazole, omeprazole, rabeprazole, lansoprazole and pantoprazole. Medication change between the approved PPIs at the base level, while still requiring a mandatory 3-day ground observation period, does not necessitate notification of the waiver authority. These changes should be documented in AIMWTS at the time of waiver renewal. Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Requires refrigeration at 36-46 degrees F. Submit for waiver afte on has been ruled out and control is maintained. FC IIC waiver by AFMOA/SGPA. Restricted Deployability, see Waiver Guide. Etanercept Psoriasis and Psoriatic Arthritis/Ankylosing Spondyltits Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Submit for waiver after potential for idiosyncratic reaction has been ruled out (minimum 3 days) and control is maintained. Submit for waiver after potential for idiosyncratic reaction has been ruled out (minimum 5 days) and control is maintained. Ezetimibe Background Paper.
d statin for hyperlipidemia is limited to FC IIA waiver by MAJCOM/SGPA or IIU (AFMSA) and may not be further delegated.
See Fenofibrate Background paper Submit for waiver after potential for idiosyncratic reaction has been ruled out.
Minimum 72 hrs ground trial at initiation of therapy and adequate control of rhinitis Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Submit for waiver after potential for idiosyncratic reaction has been ruled out on does not interfere with flying duties; DoD policyprohibits purchase of this drug for treatment hair loss using DoD funds (see below); Finasteride Background Paper.
DNIF until potential for idiosyncratic reaction has been ruled out (minimum 3 days); DoD policy prohibits purchase of this drug for treatment hair loss using DoD funds; Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Submit for waiver after potential for idiosyncratic reaction has been ruled out. *Combination therapy of Gemfibrozil with an approved statin (lovastatin, pravastatin, simvastatin, or atorvastatin) is limited to a FC FC IIA waiver by MAJCOM/SGPA or IIU (AFMSA) and may not be further delegated.
DNIF is not required once symproms relieved.
Hylan G-F 20
Synvisc,
Osteoarthritis
For intra-articular injection only. 48hrs post-injection DNIF required. Use of
Synvisc-One
this medication does not require; however, depending on severity, underlying
condition MAY require waiver.

For hypertension: either alone or in combination with triamterene does not require waiver. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. Symptom control = BP <140/90. See HTN Waiver Guide for treatment parameters.
______________________________________________________ *Combination therapy with ACEi, ARB, other antihypertensive requires waiver. Combo therapy requires categorical restriction for FCII Airmen – see HTN Waiver Guide.
For urolithiasis : Either alone or in combination with allopurinol or oral potassium supplements. Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Submit for waiver after potential for idiosyncratic reaction has been ruled out and DNIF until the underlying condition will not interfere with flying duties and there are no adverse side effects. Usage is for acute conditions, less than 4 weeks, and Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
*No initial flying class waivers. Requires 6 months symptom control prior ter Guide for use in IBD patients. Restricted deployability, see Waiver Guide. See Infliximab (Remicade) background paper.
Adverse reactions are rare. Access to medical care on the ground is recommended for a period of 4 hours for all personnel, unless operational needs dictate otherwise.
Recommend timing live immunizations such that side effects, if present, will have minimal operational impact. This guidance also applies to new H1N1 vaccine.
Due to its higher incidence of local and systemic side effects and delayed allergic reactions, grounding is requ1st / 5 days after 2nd / 3 days after 3rd injection / 3 days after booster). Grounding reduction for critical mission may be granted by MAJCOM IAWter . For IXIARO two dose JE vaccine: Side effect profile is not well established. DNIF is required for 3 days after 1st and 5 days after 2nd injection. See IXIARO Letter Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Once waiver has been granted, a 4-hour verbal DNIF is required for aircrew after each injection. (DNIF not required for ground operators). Aircrew will not deploy on immunotherapy.
For tuberculin converters who do not have active TB; minimum 72 hrs ground trial.
DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days) and symptom control is maintained DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days and symptom control is maintained. Authorized under a single waiver (along with the other approved proton pump inhibitors (PPIs) esomeprazole, omeprazole, rabeprazole, lansoprazole and pantoprazole. Medication change between approved PPIs at the base level, while still requiing a mandatory 3 day ground observation period, does not necessitate notification of the waiver authority. These changes should be documented in AIMWTS at the time of waiver renewal.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Submit for waiver after potential for idiosyncratic reaction has been ruled out and Waiver not required for monotherapy. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. Symptom control = BP <140/90. See HTN Waiver Guide for treatment parameters.
*Combination therapy with HCTZ or other antihypertensive requires waiver. Combo therapy requires categorical restriction for FCII - see HTN Waiver Guide.
Minimum 72 hrs ground trial at initiation of therapy and adequate control of rhinitis is required; maximum dosage is limited to 10 mg per day.
Waiver not required for monotherapy. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. Symptom control = BP <140/90. See HTN Waiver Guide for treatment parameters.
*Combination therapy with HCTZ or other antihypertensive requires waiver. Combo therapy requires categorical restriction for FCII - see HTN Waiver Guide.
Waiver not required if on single approved statin medication for hyperlipidemia. Approved medications include simvastatin, pravastatin, and lovastatin up to 40mg/day and atorvastatin up to 80mg/day. Higher doses or combination of medication requires waiver. Requires at least 5 day ground trail when starting medication or for any adjustments to dosage to rule out idiosyncratic reactions. Follow up of lipids and LFTs should conform with accepted practice standards.
*Combination therapy with Gemfibrozil is limited to a FC IIA or IIU (AFMSA) and may not be further delegated.
Submit for waiver after symptom control and seven day ground trial on therapeutic dose to rule out idiosyncratic reaction. Submit for waiver after potential for idiosyncratic reaction has been ruled out and Submit for waiver after potential for idiosyncratic reaction has been ruled out and Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Submit for waiver after potential for idiosyncratic reaction has been ruled out and Submit for waiver after patient has been on medication for at least 30 days and the requirements for waiver submission (as defined by the Diabetes Waiver Guide) have been met.
Submit for waiver after patient has been on medication for at least 30 days and the requirements for waiver submission (as defined by the PCOS Waiver Guide) have DNIF not required unless condition or medication interferes with life support gear DNIF is not required unless condition is sy OPERATIONAL USE ONLY: Approved for use by aircrew members in dual piloted bombers (i.e., B-1, B-2, and B-52) greater than 12 hours and single/dual-seat rs as dictated by MAJCOM policy. Ground trial
(two 200 mg dosages, 8 hrs apart required. Modafinil Policy Letter.
Modafinil is not authorized for routine clinical use in flyers/special duty personnel.
*While the medication itself does not require a waiver, the condition might. If waiver is required, submit for waiver when symptom control is achieved.
DNIF until underlying condition will not interfere with flying duties and there are no adverse side effects. Usage is for acute conditions, less than 4 weeks, and condition does not require waiver.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Minimum 7-day observation after last dose adjustment.
Approved for FC IIA/IIU and FC III waivers. NOTE: NO OTHER
FORMULATIONS OF NIFEDIPINE ARE COVERED UNDER THIS
POLICY. Nifedipine Background Paper

Not waiverable for FCI. Consult WaiverGuide for FCII/III. Do ner DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days) and symptom control is maintained.
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
For unvaccinated personnel during community outbreaks or mission essential operations IAW MAJCOM policy; requires 1-day ground trial. Oseltamivir
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic. Oseltamivir Background Paper.
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
May be used as a “get me down” for unexpected ear/sinus blocks during flight or while in a critical phase of decompressive dive duties; not for treatment of DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days) and symptom control is maintained.
DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days)and symptom control is maintained. Authorized under a single waiver (along with the other approved proton pump inhibitors (PPIs) esomeprazole, omeprazole, rabeprazole, lansoprazole and pantoprazole. Medication change between the approved PPIs at the base level, while still requiring a mandatory 3-day ground observation period, does not necessitate notification of the waiver authority. These changes should be doc of waiver renewal. DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
May be used as a “get me down” for unexpected ear/sinus blocks during flight or while in a critical phase of decompressive dive duties; not for treatment of Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Pimecrolimus Background Paper.
DNIF not required unless condition or medication interferes with life support gear Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained.
Waiver not required if on single approved statin medication for hyperlipidemia. Approved medications include simvastatin, pravastatin, and lovastatin up to 40mg/day and atorvastatin up to 80mg/day. Higher doses or combination of medication requires waiver. Requires at least 5 day ground trail when starting medication or for any adjustments to dosage to rule out idiosyncratic reactions. Follow up of lipids and LFTs should conform with accepted practice standardsCombination therapy with Gemfibrozil is limited to a FC IIA waiver by MAJCOM/SGPA or IIU (AFMSA) and may not be further delegated.
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Single dose ground trial required; 30 mg (base) daily (recommendation for increase from 15 mg to 30 mg by CDC) for terminal 14 days of post-exposure prophylaxis. Contraindication: G-6-PD deficiency, pregnancy, and possibly lactation (if
infant has G-6-PD deficiency).

Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained.
8 hour ground trial prior to first expected use (as operations allow). Do not prescribe for Airmen with known iodine sensitivity, thyroiditis, goiter, hyperkalemia, or pregnancy. Do not ground test unless use is anticipated/directed by MAJCOM or COCOM. .
Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Single dose ground trial required; Malarone (250 mg atovaquone/100 mg proguanil) daily beginning 1-2 days prior to travel; ending 7 days after exposure. (Reminder:
last 7 days of Malarone should be taken with primaquine followed by another 7
days of primaquine alone).
Malarone Background Paper.
DNIF until potential idiosyncratic reactions has been ruled out. Use IAW with
operational guidance
; single dose ground trial advised.
DNIF until potential for idiosyncratic reaction has been ruked out (minmum 3 days) and symptom control is maintained.
DNIF untilr potential for idiosyncratic reaction has been ruled out (minmum 3 days) and symptom control is maintained. Authorized under a single waiver (along with the other approved proton pump inhibitors (PPIs) esomeprazole, omeprazole, rabeprazole, lansoprazole and pantoprazole. Medication change between the approved PPIs at the base level, while still requiring a mandatory 3-day ground t necessitate notification of the waiver authority. These changes should be documented in AIMWTS at the time of waiver renewal. Waiver not required for monotherapy. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. Symptom control = BP <140/90. See HTN Waiver Guide for treatment parameters. Dosage restriction: 5 to 20 mg. Ramipril Background Paper.
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
*Combination therapy with ACEi, ARB, other antihypertensive requires waiver. Combo therapy requires categorical restriction for FCII - see HTN Waiver Guide.
DNIF until potential for idiosyncratic reaction has been ruled out (minmum 3 days) and symptom control is maintained,.
DNIF until potential for idiosyncratic reaction has been ruled out.
Alone or in combination with dextroamphetamine for airsickness in formal
training programs
. *Not authorized for solo fl
tion with dextroamphetamine for airsickness in formal
training programs. *Not authorized for solo flight (see AETCI 48-102).
*24 hours DNIF required after each dosage. (Verbal DNIF acceptable). Not Waiver not required if on single approved statin medication for hyperlipidemia. Approved medications include simvastatin, pravastatin, and lovastatin up to 40mg/day and atorvastatin up to 80mg/day. Higher doses or combination of medication requires waiver. Requires at least 5 day ground trail when starting medication or for any adjustments to dosage to rule out idiosyncratic reactions. Follow up of lipids and LFTs should conform with accepted practice standardsCombination therapy with Gemfibrozil is limited to a FC IIA/IIU waiver by MAJCOM/AFMSA and may not be further delegated.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. FC IIA/IIU waiver only. Eplerenone and Spironolactone Length of DNIF dictated by time required for adequate control of underlying DNIF until potential for idiosyncratic reaction has been ruled out and condition does not interfere with flying duties. Usage is for acute conditions, less than 4 weeks, and condition does not require waiver.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Submit for waiver after potential for idiosyncratic reaction has been ruled out and Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
1 gram once daily. Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Only authorized for RA cases that show no progression of disease (only 10% of cases). Mesalamine is better choice for inflammatory bowel disease control.
DNIF not required unless condition or medication interferes with life support gear or flying duties. Tazarotene Background Paper Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained. Tazarotene Background Paper Waiver not required for monotherapy. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. Symptom control = BP <140/90. See HTN Waiver Guide for treatment parameters.
*Combination therapy with HCTZ or other antihypertensive requires waiver. Combo therapy requires categorical restriction for FCII – see HTN Waiver Guide OPERATIONAL USE: For the safe performance of mission IAW AF and
MAJCOM policy.
Requires ground trial (DNIF for 12 hrs after a single dose up to
30 mg) documented in medical records prior to operational use. Furthermore,
verbal DNIF for 12 hrs before resumption of duties is required after each dosage;
max 7 consecutive days, not to exceed 20 days/60 day period. No-Go Pill Policy
Letter.
CLINICAL USE: Requires DNIF for treatment period.
For treatment of fungal culture or formal histopathologically confirmed fungal infections only (positive KOH is not acceptable). DNIF for 72 hrs ground trial and obtain baseline LFTs; for pedal onchomycosis 250 mg daily for 12 weeks. Terbinafine Background Paper.
Minimum of 7-days ground trial is required; changes of dosages and/or preparation requires an additional 7-day observation period.
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Appropriate urological work-up is required prior to starting medication. Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained (minimum 7-day observation after last dose adjustment). A change of
dosages and/or preparation requires an additional 7-day observation period. (Note:
Testosterone has been classified as a Schedule 3 Controlled Drug
).
Appropriate urological work-up is required prior to starting medication. Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained (minimum 7-day observation after last dose adjustment). A change of
dosages and/or preparation requires an additional 7-day observation period.
(Note: Testosterone has been classified as a Schedule 3 Controlled Drug).
Submit for waiver after potential for idiosyncratic reaction has been ruled out and control is maintained.
DNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic.
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Chronic or RecurrentProstatitis / Cystitis Submit for waiver after potential for idiosyncratic reaction has been ruled out and DNIF not required unless condition or medication interferes with life support gear Monotherapy, or in combination with thiazide diuretic no longer requires waiver. Minimum 7 – day DNIF observation period at initial treatment and subsequent dose adjustments. Symptonm control = BP<140/90. See HTN Waiver Guide for treatment parameters.
*Combination therapy with ACEi, ARB, or other antihypertensive requires waiver . Combo therapy requires categorical restriction for FCII – see HTN Waiver Guide.
DNIF until potential for idiosyncratic reaction has been ruled out and acute Submit for waiver after potential for idiosyncratic reaction has b Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Medication
(No Waiver Required)
(Waiver Required)
Category
Diagnosis
Symptoms
Generic Name (Oral
Trade Name
Utilization
Controlled
Preparation Unless
Specified Otherwise)
Inclusive)
Submit for waiver after potential for idiosyncratic reaction has been ruled out and Chronic or Recurrent Prostatitis / Cystitis DNIF is not required for occasional OTC use to provide relief from minor self- limiting conditions unless underlying condition is symptomatic.
DNIF until the underlying condition will not interfere with flyig duties and there are no adverse side effects (minimum 72 hours). For suppression of HSV recurrence following regimens recommended: 1. For <10 recurrent episodes per year –valacylcovir 500 mg q.d. 2. For 10 recurrent episodes per year valcyclovir 250 mg bid.
Vardenafil
(Levitra®)
Erectile
*24 hour DNIF after each dosage (verbal DNIF acceptable). * Not authorized
Dysfunction
OPERATIONAL USE: For the safe performance of mission IAW AF and
MAJCOM policy.
Requires ground trial (DNIF for 4 hrs after a single dose up to
10 mg) documented in medical records prior to operational use. Furthermore,
verbal DNIF for 4 hrs before resumption of duties is required after each dosage;
max 10 consecutive days, not to exceed 28 days/60 day period. No-Go Pill Policy
Letter.
CLINICAL USE: Requires DNIF for treatment period.
OPERATIONAL USE: For the safe performance of mission IAW MAJCOM and
AF policy
. Requires ground trial (DNIF for 6 hrs after a single dose up to 10 mg)
documented in medical records prior to operational use. Furthermore, verbal DNIF
for 6 hrs before resumption of duties is required after each dosage; max 7
consecutive days, not to exceed 20 days/60 day period. Not authorized for use
during routine training missions. No-Go Pill Policy Letter.
CLINICAL USE: Requires DNIF for treatment period.
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209 Botulinum
When used for facial cosmetic purposes, side effects may include visual blurring, ptosis, corneal ulceration, diplopia. For treatment of non-cosmetic issues, ACS eval is required.
Discussed in Jan 04 AMCB meeting; board members were concerned using antidepressants among aviators; opted to review Army’s experience before considering it for AF aviators.
Unacceptable CNS excitability. DNIF durinphylaxis against inhalational anthrax authorized only (risk/benefit compared with CNS excitability Not Waiverable
must be considered at the operational level). Cipro Policy Letter Condition requiring injectable steroid is reasons for grounding.
Anxiety, irritability, anger, and/or depression.
Negative ionotropic effects; aviators using this fungistatic medication must be grounded for the duration of therapy plus 1 week for the wash out period due to its long half live; pulse therapy requires 2 week grounding per pulse (1 week during Not Waiverable
Adverse effects include but not limited to: optic neuritis, cataracts, decreased night vision, blurred vision and photosensitivity, seudotumor cerebri, depression, psychosis, and suicide.
Nightmares, headaches, morning groginess, and mild depression.
Unacceptable (up to 70%) incidence of vestibular side-effects.
Not Waiverable
Dizziness, headache, shortness of breath.
DNIF for duration of therapy – any regimen in excess of three weeks requires documentation of intact adrenal axis; see waiver guide.
While primarily thought to be a nicotine agonist, also has dopaminergic activity; Not Waiverable
FDA issued and Early Communication (Nov 2007) about an ongoing safety review after receiving reports of suicidal thoughts and aggressive and erratic behavior in patients who had taken Chantix.
Non-Waiverable Medications On This Page
Note: (1) Members pending waiver action must remain DNIF until waiver has been granted
(2) Medications not on this list, singly or in combination, require review by AFMSA/SG3PF (rated officers) and MAJCOM/SG (non-rated personnel)
(3) Verbal waivers are NOT authorized
(4) Waivers for non-FDA approved medications will not be considered
Approved by AF/SG3P on 18 May 20111500 Wilson Boulevard, Suite 1200, Arlington, VA 22209

Source: http://hprc-online.org/dietary-supplements/files/ctb_140148.pdf

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SAFETY DATA SHEET PYNOSECT POWDER 1. IDENTIFICATION OF THE SUBSTANCE AND OF THE COMPANY Identification of substance: Pynosect Powder Company Identification: Mitchell Cotts Chemicals, P O Box 6, Steanard Lane, Mirfield, West Yorkshire, England, WF14 8QB Tel: +44 (0)1924 493861 (24 hours) 2. COMPOSITION/INFORMATION ON INGREDIENTS Chemical Composition: Contains 5 g/kg

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