The FMCSA recently reiterated it's policy that there is no specific list of prohibited medications. They didn't list varenicline by name, but that appears to be the medication they are using as an example to indicate that it is ultimately the medical examiner's responsibility to determine if the use of a medication represents an unacceptable safety risk. They also republished the medication use form, an optional form that medical examiners may use to obtain recommendations from medical treatment providers of CMV drivers. Medical examiners are not required to use the FMCSA form, and can create and use their own forms if desired.
Interestingly, the FMCSA did not appear to refer to methadone as a prohibited medication, even though methadone is the one and only medication that has been specifically listed in some FMCSA guidance materials as a disqualifying medication. There also is no reference to the use of medical marijuana, although elsewhere the FMCSA has made it clear that use of marijuana in any form is disqualifying as it remains a DEA Schedule I drug.
Clarification notification from the FMCSA:
My doctor wants me to begin a smoking cessation program that includes a medicine to help stop smoking, is it okay to start the medicine and drive?
The Federal Motor Carrier Safety Regulations (FMCSRs) does not include a list of prohibited medications.
The Agency relies on the certifying medical examiner to evaluate and determine whether an underlying medical condition, medication, or combination of medications and substances used by an individual driver will impair his or her ability to safely operate a commercial motor vehicle (CMV). Medical Examiners may disqualify a driver who takes any medication or combination of medications and substances that may impair or interfere with safe driving practices. All medications must be assessed to determine the potential risk of adverse side effects, which include but are not limited to: dizziness, drowsiness, and sleepiness, and the direct impact the potential side effects have on CMV driving and operation safety.
The medical examiner may confer with the treating medical specialist(s) who is familiar with the driver’s health history. The final decision to certify the driver rests with the certifying medical examiner.
The certifying medical examiner may consider utilizing the optional medication form when communicating with the treating prescribing clinician.
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