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I have a CFI student who is currently using BasicMed to satisfy her FAA Medical Requirement. She is taking a drug, which the FAA in AME guidance prohibits, and is wondering if she can continue to take that drug. Going through the regulations, there is no FAR specifically naming drugs, and it appears that for BasicMed, the approval for drug use lies with the examining/issuing physician.

She has gone back to her (issuing) physician and verified that there is no concern with her taking this drug while operating a "vehicle or aircraft" and the physician has confirmed that in the physician's opinion there is no concern. In her case, her primary care physician (PCP) declined to provide a BasicMed exam, but her endocrinologist agreed to. The drug in question is one the endocrinologist is using to treat her with.

So what we have is a situation where the AME's receive guidance to "Do Not Issue" (DNI) and under BasicMed it appears that the issuing physician can decide contrary to FAA Class 1, 2 or 3 policy. The question is: Under BasicMed may a pilot be taking a drug, with the approval of their physician, which would otherwise be prohibited under a Class 1,2 or 3 FAA medical?

Addendum: The following is a AC issued shortly before this question was asked: https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC_68-1A.pdf

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  • $\begingroup$ Does your student already have an FAA medical? $\endgroup$ – TomMcW Jun 23 '17 at 1:53
  • $\begingroup$ She holds a current Class 1 medical, but does not exercise that medical due to a new diagnosis, and Rx treatment. She also holds a BasicMed medical which she intends to use while on her current treatment. $\endgroup$ – mongo Jun 23 '17 at 14:13
  • $\begingroup$ New opinion. Met with former CFI student, now MD, who reviewed BasicMed rather throughly, and also has the opinion that physician can approve meds that the FAA does not, as long as there is not a cardiac, psych or neuro disease. Another data point. $\endgroup$ – mongo Jun 27 '17 at 21:24
  • $\begingroup$ I wonder what he considers a psych disease. Do you suppose stuff like depression and ADHD count? This big streaming pile that is BasicMed helps some people, but didn't help me at all. $\endgroup$ – TomMcW Jun 27 '17 at 21:31
  • $\begingroup$ I can ask him. I would urge you to carefully read the regs, as well as the enacting legislation. ADHD is at first blush not disqualifying, but the medication could be. Just first blush. $\endgroup$ – mongo Jun 27 '17 at 23:19
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Looking at section 2307 of H.R.636, which is the congressional bill which implemented BasicMed requirements, it is clear that the physician who performs the exam, and provides care to the subject is responsible for determining what drug interactions there might be, as well as the impact of medical conditions, and whether they might be disqualifying.

Armed with this, my CFI student and I called a friend who is with FAA counsel, who does not address airmen issues, but rendered the opinion that BasicMed is separate from FAA Class 1, 2 and 3 medicals. It is separate from Sport Pilot medicals. It is unto itself. Therefore it is their opinion that it was the legislative intent to create a separate certification process.

Therefore, the examining/issuing physician makes the determination as to any medical conditions or drugs and their impact on flying. He is the subject matter expert, and therefore if full disclosure is made, the airman has operated in good faith.

Of course, we were invited to submit an interpretation request, so that we could get an official response.

When talking with attorneys, and especially FAA attorneys (in their unofficial capacity) there many disclaimers, which include neuro, psych and cardio prohibitions. And the importance of consultation with the issuing physician when there are medical changes.

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