Consult Aerospace Medicine Waiver Guide prior to waiver submission. Only a small subset of pharmaceutical medications can be used without impacting a flyer’s ability to continue their normal duties without limitation. Note: initial waiver for the diagnosis of Diabetes still resides at AFMSA.GUMetforminGlucophagePolycystic Ovarian SyndromeXXSubmit for waiver after patient has been on medication for at least 30 days and the requirements for waiver submission (as defined by the HYPERLINK "https://kx2.afms.mil/kj/kx7/WaiverGuide/Documents/PCOS%20-%209%20Nov%2010-to%20KX.doc" PCOS Waiver Guide) have been met.DermMetronidazole (topical)FlagylRosaceaX DNIF not required unless condition or medication interferes with life support gear or flying duties.GUMetronidazole (topical)FlagylVaginitisX DNIF is not required unless condition is symptomatic. Waiver will not be considered until member is on medication with stable dose and clinically asymptomatic for at least six months. Over the Counter (OTC) Medications Aircrew Are Allowed to Take Without Flight Surgeon Approval. A large number of FDA-approved drugs are not listed under either section. If waiver is required, submit for waiver when symptom control is achieved. Rifampin was added for tuberculin converters who do not have active tuberculosis. Minimum 7-day DNIF observation period at initial treatment and subsequent dose adjustments. oz. GenHyaluronate
derivativesSynvisc, Synvisc-One, Euflexxa, Hyalgan,
OrthoviscOsteoarthritis painXFor intra-articular injection only. Effective: 25 Sep 2018 (Note: This list supersedes the medication list dated . Approved for FC IIA/IIU and FC III waivers. *Combination therapy with ACEi, ARB, or other antihypertensive requires waiver . HYPERLINK "https://kx2.afms.mil/kj/kx4/FlightMedicine/Documents/Updated_Modafinil_Policy_for_Management_of_Fatigue_Among_Aircrew_and_Special_Operational_Duty_Personnelr%5b1%5d.docx"Modafinil Policy Letter. 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.GenAtovaquone/ Proguanil (combination)MalaroneMalaria Prophylaxis XSingle 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); HYPERLINK "https://kx2.afms.mil/kj/kx4/FlightMedicine/Documents/EVAL_OF_MALARONE__00001.doc"Malarone Background PaperAntibioticAzithromycinZithromaxAcute InfectionXDNIF until potential for idiosyncratic reaction has been ruled out and acute infectious process is asymptomatic. Dose approved 125-250 mg by mouth two to three times a day (see Acetazolamide Paper). All FCII and FCIII listed (Boom Operator, Flight Engineer, Loadmaster, Aerial Gunner, Combat Control) require ACS evaluation and AFMSA waiver. Waiver will not be considered until member is on medication with stable dose and clinically asymptomatic for at least six months.
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.
HYPERLINK "https://kx2.afms.mil/kj/kx4/FlightMedicine/Documents/Humira Background Paper 2012final.docx"Adalimumab Background Paper *Consult Waiver Guide for use in IBD patients.DermAdapalene
0.1% Gel
(topical)DifferinAcne VulgarisXDNIF not required unless condition or medication interferes with life support gear or flying duties. PulmSteroids
(inhaled orally)AsthmaXXAll inhaled corticosteroids approved for use in asthma by the FDA as of 13 May 2012 may be used. For MOD, see the Approved Missile Operators Quick Reference List. New antibiotics, lipid-lowering drugs, and antihypertensive medications may be considered earlier than one year.