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Direct vasodilators and your FAA medical

Other names: hydralazine, Apresoline, oral minoxidil, minoxidil, Gainextra, Rogaine

The FAA's guidance for direct vasodilators depends on how it is taken. Each way is below, with its own FAA source and date.

Tablets for blood pressure (minoxidil, hydralazine)

FAA guidance

Acceptable with conditions.

Wait

7 days

no-fly ground trial when starting a new blood pressure medication

Examiner

CACI: the examiner can issue when the condition's worksheet criteria are met. Applicants for first- or second-class must provide the worksheet's information annually; applicants for third-class with each required exam

FAA label

ACCEPTABLE

Source: FAA, Antihypertensive (HTN, blood pressure medication). FAA date 30 September 2026. Checked by Crosscheck 11 November 2026

The FAA lists direct vasodilators as acceptable blood pressure medication when the certification criteria are met, with a seven-day ground trial when starting, and says the examiner should issue, if the pilot is otherwise qualified, when the pilot is on three or fewer medications.

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Compare FAA documents: Direct vasodilatorsWhat each of the three FAA documents says, in plain wordsOpen

The Guide's hypertension table says the number of medications counts each component (for example, lisinopril/HCTZ is 2 medications), and that with 4 or more acceptable medications the examiner should defer.

  • 7 days after starting: no flying

FAA rule for blood pressure medication: The FAA's hypertension worksheet (CACI) refers to the antihypertensive sheet for acceptable medications, and allows combinations of up to 3 of the classes it lists -- alpha blockers, beta-blockers, calcium channel blockers, diuretics, ACE inhibitors, ARBs, direct renin inhibitors and direct vasodilators -- and lists centrally acting antihypertensives, such as clonidine, as not acceptable. The Guide's hypertension table says the number of medications counts each component (for example, lisinopril/HCTZ is 2 medications), and that with 4 or more acceptable medications the examiner should defer. FAA, CACI – Hypertension Worksheet

Show the FAA's words: Direct vasodilatorsThe official FAA wording: two passages, each with its document and dateOpen
FAA, Antihypertensive (HTN, blood pressure medication) · FAA date 30 September 2026
Seven-day (7) no fly/ground trial is required when starting a new hypertension (HTN) medication to verify no side effects.
AME should issue (if otherwise qualified) if the airman is on 3 or fewer medications
ACCEPTABLE HTN Medications (when certification criteria are met)
Direct vasodilators
FAA, Guide for Aviation Medical Examiners – Item 36. Heart – Hypertension · FAA date 23 March 2023
B . Treated with 3 or fewer* acceptable medications .
Follow the CACI – Hypertension Worksheet .
C . Any of the following:
Treated with 4 or more* acceptable medications;
DEFER
Notes: *Number of medications counts each component. (Example: lisinopril/HCTZ is 2 medications.)
Sources and dates: Direct vasodilatorsThree FAA documents, with the FAA's date and when Crosscheck checked themOpen

On the scalp, for hair loss (Rogaine)

minoxidil (topical)

FAA guidance

Acceptable with conditions.

Wait

24 hours

after the first dose

Source: FAA, MedGuide (FAA Office of Aerospace Medicine medication reference). FAA date 27 October 2026. Checked by Crosscheck 11 November 2026

The FAA's MedGuide lists minoxidil (topical) (Gainextra, Rogaine) as allowed, for alopecia (Hair loss), with a wait of 24 hours after the first dose and none after later doses or after the final dose, used as prescribed.

More detail: minoxidil (topical)The rest of Crosscheck's reading, in plain wordsOpen

The MedGuide defines allowed as acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present, and says wait times are not determined solely by the medication: an extended observation period may be required to verify clinical stability of the condition.

  • 24 hours after the first dose: ground observation
Show the FAA's words: minoxidil (topical)The official FAA wording: three passages, each with its document and dateOpen
FAA, MedGuide (FAA Office of Aerospace Medicine medication reference) · FAA date 27 October 2026
Generic: minoxidil (topical)
Brand Name: Gainextra; Rogaine
Drug Class: Topical Skin Product
Underlying Condition: Alopecia (Hair loss)
Use: ALLOW
INITIAL Wait Time (after first dose): 24 hours
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: As prescribed
FAA, MedGuide (FAA Office of Aerospace Medicine medication reference) · FAA date 27 October 2026
ALLOWED: The medication is acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.
FAA, MedGuide (FAA Office of Aerospace Medicine medication reference) · FAA date 27 October 2026
Underlying Condition: Evaluating medication use requires considering the impact of safety of flight from both the medication and underlying condition. Wait times are not determined solely by the medication; an extended observation period may be required to verify clinical stability of the condition.
Sources and dates: minoxidil (topical)One FAA document, with the FAA's date and when Crosscheck checked itOpen

Questions pilots ask

Each answer is built from the FAA guidance on this page. Its sources and dates are in the page.

What does the FAA say about direct vasodilators for pilots?

The FAA's guidance for direct vasodilators depends on how it is taken. Tablets for blood pressure (minoxidil, hydralazine): acceptable with conditions. On the scalp, for hair loss (Rogaine): acceptable with conditions. Crosscheck does not predict the FAA's decision.

How long is the FAA's wait for direct vasodilators?

Tablets for blood pressure (minoxidil, hydralazine): 7-day no-fly ground trial when starting a new blood pressure medication. On the scalp, for hair loss (Rogaine): 24 hours after the first dose.

What does the FAA say about direct vasodilators tablets for blood pressure?

The FAA lists direct vasodilators as acceptable blood pressure medication when the certification criteria are met, with a seven-day ground trial when starting, and says the examiner should issue, if the pilot is otherwise qualified, when the pilot is on three or fewer medications. Crosscheck does not predict the FAA's decision.

What does the FAA say about direct vasodilators on the scalp, for hair loss?

The FAA's MedGuide lists minoxidil (topical) (Gainextra, Rogaine) as allowed, for alopecia (Hair loss), with a wait of 24 hours after the first dose and none after later doses or after the final dose, used as prescribed.

Related pages

Medication guidance alone does not determine whether a pilot is medically qualified to fly. The underlying condition, dosage, side effects, medication combinations, and certification history may affect FAA eligibility.

For informational purposes only. Not legal or medical advice.