The FAA’s MedGuide shows which medications it allows and the waits that apply. It does not decide whether you are fit to fly. Here is how to use it without misreading it.
The FAA’s Office of Aerospace Medicine has introduced MedGuide, a reference for airman medical certification that shows which medications the agency classes as allowed and how long to wait before flying. The FAA’s own mental health rulemaking committee flagged this information gap in its April 2024 report, so it is a real step. It is also easy to misread, so start with what it actually says.
What version 1.0 shows
MedGuide, version 1.0, lists only medications the FAA classifies as allowed. The FAA’s condition is that the underlying condition is stable and no adverse side effects are present. Each entry gives dosing guidance (within label directions or as prescribed) and three waiting periods: after the first dose, after a later dose, and after you stop the medication.
When you start a new medication, the FAA says that in most cases a 48-hour wait is required before you return to safety-related duties. Each medication’s entry can differ, and the three waiting periods are listed separately. The FAA says longer waits can apply to higher-risk medications and shorter ones to medications with minimal systemic effects. According to the FAA, the waiting period lets the medication take effect and shows whether any side effects develop.
You can search by generic or brand name. The medication list itself sits in an interactive dashboard linked from the FAA page. NBAA reports that the FAA plans to add more conditions and medications over the next several months, so the list will change. Version 1.0 currently includes only some allowed medications.
What a missing medication does not mean
Version 1.0 shows only allowed medications. Conditional and unacceptable categories are planned for later versions. If a drug is not in the tool today, you cannot conclude that it is prohibited, and you cannot conclude that it is fine. The tool is silent on it.
What MedGuide cannot decide
Appearing on the list does not make you fit to fly. The FAA’s own disclaimer says the guide should not be the sole basis for aeromedical decisions, which must include an individualized assessment, and that it is not clinical advice. Three things stay with you and your clinicians:
- The condition behind the prescription. A medication can be allowed while the condition it treats is not stable enough to fly with.
- How you respond. The FAA’s guidance is to cease flying or safety-related duties immediately if any aeromedically concerning adverse side effects develop prior to duty, and it says pilots should notify their treating physician and/or the FAA prior to flight (14 CFR 61.53 is the pilot reference).
- The whole picture. A search result is about one medication. Your doctor and your AME look at you, your condition and everything else you take.
Appearing on the list does not make you fit to fly.
One practical exercise from Shannon.
Before returning to flight or other safety-related duties on a medication, write down:
- The applicable wait. Use the entry for the initial dose, a subsequent dose, or discontinuation, as relevant.
- Your dose timing. The clock time of your last dose.
- The wait’s end. The earliest clock time the listed wait is satisfied.
- Your response. Any side effect that could affect safe performance.
If the wait has not elapsed, or you have aeromedically concerning side effects, do not fly. Contact your treating physician and/or the FAA as the FAA guidance directs. If the medication is not listed, do not assume it is either prohibited or acceptable. Ask your AME or another aeromedical resource before you rely on it, and do it before the day you need to fly.
Meeting a listed wait is necessary but not enough. The underlying condition must also be stable and aeromedically acceptable.
Where the fear fits in
MedGuide answers a narrow question: is this medication one the FAA allows, and what is the wait. It does not answer the question many pilots are really carrying, which is what happens to my medical if I ask. This tool does not change your reporting obligations. Follow the instructions on the medical application, and if you are unsure what applies to you, ask your AME or an aviation medical attorney before you decide what to disclose.
Congress is working on the same gap. On September 24 the Senate passed the Aviation Medication Transparency Act (S. 3258) by unanimous consent. It would require the FAA to publish a public, user-friendly list of medications pilots can use, updated at least once a year. The House version, H.R. 2592, cleared the House Transportation and Infrastructure Committee on September 15 by voice vote and also calls for listing medications classed as Do Not Issue or Do Not Fly. As of October 19, the full House had not voted and the bill had not become law. MedGuide is a separate FAA product.
What to watch
This is version 1.0, so expect it to change. Check the FAA page before relying on anything you saved, and look at the “last updated” date. The version at the time of writing shows October 1, 2026.
- FAA Office of Aerospace Medicine. MedGuide. Last updated October 1, 2026.
- FLYING Magazine. “Unsure If You’re Fit to Fly? FAA’s MedGuide Can Help.” October 15, 2026.
- AeroTime. “FAA launches medication guide for pilots and controllers.” October 2026.
- NBAA. “FAA Unveils New Tool to Gauge Fitness to Fly.” October 15, 2026.
- AOPA. “Senate unanimously approves mental health, medication bills.” September 30, 2026.
- AVweb. “House Panel Advances FAA Medication Transparency Bill.” September 18, 2026.
- 14 CFR 61.53, Prohibition on operations during medical deficiency.
This post is a plain-language summary of publicly available FAA guidance as of October 2026. It isn’t medical, legal, or aviation regulatory advice, and every case is fact-specific, so bring your situation to your AME or an aviation medical attorney before you decide anything.
Last checked: October 19, 2026.
- Two Pilot Mental Health Bills Just Passed the Senate: 4 Things Every Pilot Should KnowThe Aviation Medication Transparency Act mentioned above, and what it would change.
- A PATHway Opened. You Still Have to Walk Through It.Another FAA medical change, and what it takes to actually use it.
Carrying a question about your medical? Take the clinical question to your AME. If the worry around it is what feels heavy, the first call is free and confidential.
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