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Oxymetazoline nasal spray

Other names: Upneeq, Visine, Afrin, Dristan Spray

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

Eye drops (Upneeq, Visine)

oxymetazoline (ophthalmic)

FAA guidance

Acceptable in the FAA document cited.

Source: FAA, MedGuide (FAA Office of Aerospace Medicine medication reference). FAA date 1 October 2026. Checked by Crosscheck 14 October 2026

The FAA's MedGuide lists oxymetazoline (ophthalmic) (Upneeq, Visine) as allowed, for blepharoptosis or eye redness, with no wait after the first dose, after later doses or after the final dose, used per label directions.

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More detail: oxymetazoline (ophthalmic)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.

Show the FAA's words: oxymetazoline (ophthalmic)The official FAA wording: three passages, each with its document and dateOpen
FAA, MedGuide (FAA Office of Aerospace Medicine medication reference) · FAA date 1 October 2026
Generic: oxymetazoline (ophthalmic)
Brand Name: Upneeq; Visine [OTC]
Drug Class: Vasoconstrictor
Underlying Condition: Blepharoptosis; Eye redness
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions
FAA, MedGuide (FAA Office of Aerospace Medicine medication reference) · FAA date 1 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 1 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: oxymetazoline (ophthalmic)One FAA document, with the FAA's date and when Crosscheck checked itOpen

Nasal spray (Afrin)

FAA guidance

Acceptable with conditions.

Wait

no wait after the first dose or after later doses (the FAA's MedGuide)

Two FAA documents give different waits. Both are below.

Examiner

The examiner can issue when the document's criteria are met

FAA label

ACCEPTABLE

Source: FAA, Allergy – Antihistamines & Immunotherapy Medication. FAA date 30 September 2026. Checked by Crosscheck 14 October 2026

The FAA's two documents on oxymetazoline nasal spray give different waits.

Compare FAA documents: oxymetazoline nasal sprayWhat each of the three FAA documents says, in plain wordsOpen

The FAA's documents differ. The FAA's allergy sheet requires a 48-hour ground trial after the first use of any new medication; the FAA's MedGuide, newer and written medicine by medicine, gives these no wait after the first dose. Both are current FAA documents and both name the medicine, so neither is set aside.

Wait

  • 48-hour ground trial after first use of any new medication (the FAA's allergy sheet)

The FAA's MedGuide names oxymetazoline nasal spray (Afrin, Dristan Spray) as allowed, for allergic rhinitis, with no wait after the first dose, after later doses or after the final dose, used per label directions or as prescribed.

The FAA's allergy sheet lists oxymetazoline nasal spray as an acceptable decongestant, which may be used as a single agent or in any combination product, if other certification criteria are met. Under new medications, the allergy sheet says symptoms must be controlled without adverse side effects and a mandatory 48-hour ground trial is required after initial use; for acceptable medications, it says the initial observation time is not required (see chart below); and its footnote prohibits flight/safety-related duties after initial use of a new medication until after a 48-hour ground trial and no side effects are noted. The allergy sheet also says airmen who are exhibiting symptoms, regardless of the treatment used, must not fly.

The FAA's over-the-counter guide cautions that Sudafed-like medications can speed up the heart rate, and to use caution with an underlying heart condition. 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.

Show the FAA's words: oxymetazoline nasal sprayThe official FAA wording: four passages, each with its document and dateOpen
FAA, Allergy – Antihistamines & Immunotherapy Medication · FAA date 30 September 2026
New medications:
Symptoms must be controlled without adverse side effects.
Initial observation time: Mandatory 48-hour ground trial required after initial use.
Acceptable medications:
Initial observation time: Not required for acceptable medications (see chart below).
ACCEPTABLE* (Non-Sedating) Antihistamine and Allergy Medications
May be used as a single agent or in any combination product, if other certification criteria are met.
Oral/Nasal: Decongestants
pseudoephedrine (Sudafed)
oxymetazoline (Afrin) nasal spray
* Airmen are prohibited from flight/safety-related duties after initial use of a new medication until after a 48-hour ground trial and no side effects are noted.
Generic: oxymetazoline (nasal)
Brand Name: Afrin; Dristan Spray
Drug Class: Adrenergic Agonist Agent; Decongestant
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions or as prescribed
FAA, Allergy – Antihistamines & Immunotherapy Medication · FAA date 30 September 2026
Airmen who are exhibiting symptoms, regardless of the treatment used, must not fly.
FAA, What Over-the-Counter (OTC) Medications Can I Take and Still Be Safe to Fly? · FAA date 28 August 2024
oxymetazoline (Afrin), phenylephrine (Sudafed PE), pseudoephedrine (Sudafed). CAUTION: Sudafed- like medications can speed up your heart rate; therefore, use caution if you have an underlying heart condition.
FAA, MedGuide (FAA Office of Aerospace Medicine medication reference) · FAA date 1 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.
Sources and dates: oxymetazoline nasal sprayThree FAA documents, with the FAA's date and when Crosscheck checked themOpen

See also

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.