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SESK: Stuff Everyone Should Know · sesk.info/pilot-antihistamine-side-effects

Which side effects make common over-the-counter cold pills risky for pilots?

Drowsiness and slower thinking from antihistamines and decongestants.

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Why: The PHAK says antihistamines and decongestants, some of the most common OTC drugs, can cause drowsiness and cognitive deficits. The cold itself may also be a good reason to stay on the ground.

Huh, didn't know that: The PHAK says aspirin, acetaminophen and ibuprofen usually do not restrict flying at correct doses.

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Why did the pilot skip the cold medicine? He wanted to stay on top of things, not under the weather.
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References

Answer: Drowsiness and slower thinking. The PHAK says antihistamines and decongestants, some of the most common OTC drugs, can cause drowsiness and cognitive deficits. The cold itself may also be a good reason to stay on the ground.

  1. PHAK FAA-H-8083-25C Chapter 17, Aeromedical Factors www.faa.gov/sites/faa.gov/files/regulations_policies/handbooks_manuals/aviation/phak/19_phak_ch17.pdf
    antihistamines and decongestants, have the potential to cause noticeable adverse side effects, including drowsiness and cognitive deficits
    Checked 2026-10-09.

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