ACCEPTABLE COMBINATIONS OF DIABETES MEDICATIONS

(Updated 08/31/2022)

The chart on the following page outlines acceptable combinations of medications for
treatment of diabetes.

Please note:

• Initial certification of all applicants with diabetes mellitus (DM) requires FAA
decision;
• Use no more than one medication from each group (A-F);
• Fixed-dose combination medications - count each component as an
individual medication. (e.g., Avandamet [rosiglitazone + metformin] is
considered 2-drug components);
• Up to 3 medications total are considered acceptable for routine treatment
according to generally accepted standards of care for diabetes (American
Diabetes Association, American Association of Clinical Endocrinologists);
• For applicants receiving complex care (e.g., 4-drug therapy), refer the case to
AMCD;
• For applicants on AASI for diabetes mellitus, follow the AASI;
• Consult with FAA for any medications not on listed on the chart;
• Observation times:
When initiating NEW diabetes therapy using monotherapy or combination medications:
Adding Medication Observation Time
Group A ONLY 14 days
Group B-D 30 days
Group E1 60 days

When ADDING a new medication to an ESTABLISHED TREATMENT regimen:

When initiating NEW or ADDING therapy for any regimen (new or established therapy):
Adding Medication Observation Time
Group F (SGLT2 inhibitors) 90 days
Group E2 (insulin):
• For agency ATCSs (non-CGM or CGM protocol) 90 days
• For Pilots / Part 67 applicants, class 3 non-CGM 90 days
protocol only: 180 days
• For Pilots / Part 67 applicants, any class CGM protocol:
 ACCEPTABLE COMBINATIONS OF DIABETES MEDICATIONS
(Updated 01/27/2021)

Biguanides
A -metformin (e.g. Glucophage, Fortamet,
Glutetza, Riomet)

Thiazolidinediones (TZD)
B - pioglitazone (Actos)
- rosiglitazone (Avandia)

GLP1 mimetics
- albiglutide (Tanzeum)
- dulaglutide (Trulicity)
- exenatide (Byetta)
- exenatide-ED (Bydureon)
- liraglutide (Victoza)

C - lixisenatide (Adlyxin)
- semaglutide (Ozempic, Rybelsus)
Group C not
allowed with
Meglitinides
DDP4
- alogliptin (Nesina)
- linagliptin (Tradjenta)
- saxagliptin (Onglyza)
USE NO MORE - sitagliptin (Januvia)
THAN 1 Alpha-glucosidase inhibitors
MEDICATION
FROM ANY
D - acarbose (Precose)
- miglitol (Glyset)
GROUP (A-F)
Meglitinides Meglitinides not
- nateglinide (Starlix) allowed with
- repaglinide (Prandin) Group C

Sulfonylureas (SFU)
- chlorpropamide (Diabenase)
E1 - glimepiride (Amaryl)
- glipizide (Glucotrol)
- glyburide (Diabeta)
- tolbutamide (Orinase)
E OR - tolazamide (Tolinase)
- gliclazide (Diamicron) - International

Insulin
E2 - All forms
- Initial certification requires FAA decision

SGLT2 Inhibitors
- canagliflozin (Invokana) SGLT2 inhibitors
F - dapagliflozin (Farxiga) not allowed with
- empagliflozin (Jardiance) Group E
- ertugliflozin (Steglatro)

Note: Amylinomimetics (e.g., pramlintide (Symlin) are NOT considered acceptable for medical certification.