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Home » Q & A about DOT Physical Requirements » Medications

Medications

medication med

 

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Q&A

Does the DOT physical include a drug test?

What drugs are tested for, if a DOT drug test is requested?

What if the DOT drug screen tests positive?

Why do I have to have a urine test for my DOT physical?

Is protein in the urine a disqualifier?

Is sugar in the urine a disqualifier?

Is blood in the urine a disqualifier?

Can I get a medical certificate if I’m being treated for a medical condition by my doctor?

Is diabetes a disqualifier?

What if I take insulin by injection and my diabetes is under control?

What are the requirements for blood sugar limits? I just found a job driving school bus. I am a diabetic, non-insulin dependant. When I took the test my blood sugar was 350, but in the past few days I’ve gotten it down to about 170. I have never had a low or high blood sugar blackout. Will I have to get an exemption?

My doctor put me on Metformin. Can I still drive truck?

I’m a CDL driver. I had to start insulin for my diabetes. My medical card expires in a month. Will the doctor know I’m taking insulin when he does my tests?

What medications disqualify me from getting a medical card?

Can I be qualified if I have a prescription for medical marijuana?

What if I take Methadone?

What if I take nitroglycerine for angina?

Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?

Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.

I take Prozac for anxiety and I no longer have anxiety attacks. Will this be a problem for my DOT physical?

I have been diagnosed with panic attacks. I don’t have them often but I do take Lorazepam for them on a PRN basis. Can this disqualify me from driving a school bus?

I want to keep my CDL but I have anxiety and need to get on some medication. I don’t want to lose my license. What anti-anxiety medication in okay to take and still be safe to drive?

Can I still drive if I take a blood thinner?

Can I still drive while taking Provigil (Modafinil)?

Does the DOT physical include a drug test?

The DOT physical exam to get your medical card, does not include a drug test. This does not mean that any Company you want to work for, will not request a pre-employment drug test — they most likely will. But the DOT physical exam requirements do not include a drug test.

What drugs are tested for, if a DOT drug test is requested?

The 5 Panel drug test analyzes urine for the following drugs:

  • Marijuana (THC metabolite)
  • Cocaine
  • Amphetamines
  • Opiates (including heroin)
  • Phencyclidine (PCP)

What if the DOT drug screen tests positive?

The DOT drug screen is looking for illegal or non-prescription drugs. Yet, sometimes normal prescription medications can trip a positive test.

If the urinalysis is positive for one or more of the drugs on the 5 panel drug test, then the driver will be contacted in person by the Medical Review Officer. The MRO will interview the driver to determine if there is an alternative medical explanation for the drugs found in the urine specimen. If the driver provides appropriate documentation from a prescribing physician, a confirmation test with a split sample is performed for each identified drug. Confirmation ensures that over-the-counter medications or preparations are not reported as positive results. If the MRO determines that it is a legitimate medical use of the prohibited drug, the drug test result is reported as negative to the employer. Otherwise the drug test will be reported as positive.

Why do I have to have a urine test for my DOT physical?

The urine test is just a kidney screen to test for sugar and protein. It’s done to determine that there is no early onset of conditions like high blood pressure breaking down the kidneys, or early signs of diabetes, or kidney infection.

Is protein in the urine a disqualifier?

No, not necessarily. Protein in the urine may indicate kidney disease. The medical examiner will make a decision based on the amount of protein in the urine. The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you  have the condition checked by a specialist.

Is sugar in the urine a disqualifier?

Yes, it is an indicator of the onset of diabetes or already a diabetic that does not have the condition under control.  The driver would be disqualified until the condition is under control, either with medications or diet.

Is blood in the urine a disqualifier?

No, not necessarily. If the medical examiner believes that the blood in the urine may indicate a condition that affects the ability of the commercial driver to safely, the driver may be referred to a primary care physician or specialist for further evaluation.  The medical examiner may certify, time limit your certification or temporarily disqualify your medical certificate while you  have the condition checked by a specialist.

Can I get a medical certificate if I’m being treated for a medical condition by my doctor?

Depending on the risk posed by the condition and treatment, the medical examiner may require documentation from your doctor. To assist in the preparation of the documentation, you can get more information here, courtesy of  Trucker Docs. Even though your prescribing physician may be of the opinion that your condition and treatment is safe to drive, the decision to certify still rests with the medical examiner.

Is diabetes a disqualifier?

If you have non-insulin treated diabetes the medical examiner will check that your diabetes is adequately controlled. If it is controlled, you will get a time-limited certification and most likely need to re-certify annually.

If your diabetes is treated with insulin, you will be disqualified for inter-state driving. You may be able to drive intra-state.

The DOT does have a few, very stable insulin dependent drivers testing on insulin waivers, but you would have to check with the FMCSA on this issue.

What if I take insulin by injection and my diabetes is under control?

Without a DOT Diabetes exemption waiver the answer is No, not for interstate driving, even if your condition is stable.

You may be able to drive intra-state. Each state has its own rules.

What are the requirements for blood sugar limits? I just found a job driving school bus. I am a diabetic, non-insulin dependent. When I took the test my blood sugar was 350, but in the past few days I’ve gotten it down to about 170. I have never had a low or high blood sugar blackout. Will I have to get an exemption?

The medical examiner needs to see your blood sugar levels below 120. That is the level for blood sugar spillover into the urine. The concern is not whether you have ever had a blood sugar blackout, it’s – Could you have a blood sugar blackout while driving a bus full of little people? Safety first for you, the driver, and for the public at large.

My doctor put me on Metformin. Can I still drive truck?

The Metformin is to control your blood sugar as a borderline diabetic. It will limit your DOT medical certificate to one year at a time.

I’m a CDL driver. I had to start insulin for my diabetes. My medical card expires in a month. Will the doctor know I’m taking insulin when he does my tests?

It does not matter whether he knows or not. On the DOT medical examination form that you fill out, it will ask if you are a diabetic and also how you control the condition. So you are the one who is going to tell him about the insulin.
Your examining doctor should ask quite a few questions regarding your insulin usage to help determine your options.

What medications disqualify me from getting a medical card?

Any habit forming drug; methadone; anti-seizure medication, is disqualifying.

The medical examiner will review every medication – prescription, non-prescription, and supplement to determine if its use will adversely affect the safe operation of a commercial vehicle. The medical examiner may require documentation from your prescribing physician. In this case the medical examiner may, but is not required to grant you a medical card.

Can I be qualified if I have a prescription for medical marijuana?

No. Marijuana is a disqualifier, even if you have a prescription.

What if I take Methadone?

A CMV driver cannot be qualified if on Methadone. There are exceptions to the rule regarding other drugs prescribed by a physician, but this does NOT apply to Methadone.

What if I take nitroglycerine for angina?

Nitroglycerine use is not disqualifying. The medical examiner may require an evaluation by your Cardiologist to make sure that your angina condition is stable.

Can I still drive if I take prescription Paxil, Imitrex, and Zonisamide?

These three drugs are going to be a red flag for any examiner. You should bring with you a letter from your prescribing physician, explaining the need for the medications and their possible side effects. All three are listed with side effects of drowsiness, weakness, dizziness, and should not be used while driving or using machinery. You are going to have to explain to the medical examiner why and how much if any of these medications you are taking and the basic circumstances for their needs.

Can I take Xanax and still drive truck? My doctor put me on it and I don’t want to lose my job.

One of the best ways for a driver to answer a question about whether a medication may be a disqualifier or not, is to read about the side effects of that medication.

Lets take a look at some of the side effects of Xanax which include: “Drowsiness, light-headedness, headache, tiredness, dizziness, irritability, talkativeness, difficulty concentrating, dry mouth, increased salivation, changes in sex drive or ability, nausea, constipation, changes in appetite, weight changes, difficulty urinating, and joint pain. Some other side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: shortness of breath, seizures, seeing things or hearing voices that do not exist (hallucinating), severe skin rash, yellowing of the skin or eyes, depression, memory problems, confusion, problems with speech, unusual changes in behavior or mood, thinking about harming or killing yourself or trying to do so, and problems with coordination or balance.”

As you can see, some of these issues can be unsafe for you and the public. It will cause any medical examiner to question your reaction to this medication. Talk with your prescribing doctor and ask questions with regards to driving while using any medication.

I take Prozac for anxiety and I no longer have anxiety attacks. Will this be a problem for my DOT physical?

If the anxiety disorder is controlled with the medication, then there is no real problem. Just make sure you inform the medical examiner about your condition and the medications you are taking for it.

I have been diagnosed with panic attacks. I don’t have them often but I do take Lorazepam for them on a PRN basis. Can this disqualify me from driving a school bus?

The side effects of the medication could be a disqualifier from driving a bus. I would bring a note from your physician stating how long and how often you use this medication.

A bus-load of kids could be stressful and may trigger your need to medicate. So the medical examiner would be concerned about the side effects of the medication. The big concern here is for your safety and the safety of the children.

I want to keep my CDL but I have anxiety and need to get on some medication. I don’t want to lose my license. What anti-anxiety medication in okay to take and still be safe to drive?

Talk with your MD and explain that you are a commercial OTR driver. That way the doctor can work out which, out of dozens of medications, will work best and not interfere with your ability to operate a commercial motor vehicle. Most of the anxiety meds do not run positive for drug testing. They usually have side-effects that cause drowsiness and that is the main problem. So give the provider as much information as possible and go from there.

You will need to get documentation from your MD stating that no side effects are present that will impact your ability to safely operate a commercial vehicle.

Can I still drive if I take a blood thinner?

Yes, you may still drive. You will need to get documentation from your treating physician as to when the condition started, what was the diagnosis, what has the treatment consisted of, what medication are you on, and is the condition stable.  All of these things are to help the medical examiner determine whether you are medically fit to operate a CMV safely.

Can I still drive while taking Provigil (Modafinil)?

The use of Provigil needs careful supervision. Drivers being prescribed Provigil should not be qualified until they have been monitored closely for at least 6 weeks while taking Provigil. The medical examiner will require documentation from your treating physician stating that the treatment is effective, and that no side effects are present that will impact your ability to safely operate a commercial vehicle.

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Comments

  1. Kevin says

    April 18, 2016 at 4:39 pm

    Is hair follicle testing going to become mandatory for DOT and do they tezt for same meds as regular 5 panal DOT test just farther back

    Reply
    • Trucker Docs™ says

      April 18, 2016 at 8:34 pm

      @Kevin
      Hair will not, at present, be part of the DOT urine testing. Yes, they look for the same things as the basic 5 panel.

      Reply
  2. Richard says

    April 12, 2016 at 1:54 pm

    Can you get your CDLs and take Suboxone?

    Reply
    • Trucker Docs™ says

      April 12, 2016 at 8:15 pm

      @Richard
      It will raise lots of questions and is difficult to substantiate. Get a medical release form from your doctor explaining your condition and the reasoning behind this particular drug usage. It may be doable, but don’t hold your breath on it.

      Reply
      • Richard says

        April 13, 2016 at 8:27 am

        Been on this medicine for 12 years and my doc would be happy to send a medical release. Hope it is okay.

        Reply
        • wannabetrucker says

          April 14, 2016 at 3:31 am

          Richard,let us know how it turns out because I’m in the same boat.

        • Jake says

          April 14, 2016 at 4:43 pm

          I got my CDL and DOT med card while on suboxone. Nobody asked me for anything other than the company for a letter from my Doctor stating that it would not affect my driving capabilities

        • Jake says

          April 14, 2016 at 4:48 pm

          Let me know how it goes for you cause mine runs out in 2 and a half months and I have to redo it so I hope I dont run into any problems this time as I am also prescribed klonopin now. But either way if w.e medication you are PRESCRIBED excluding marijuana if you have stability with the medications you should have no problems as long as your doctor is willing to write a letter for you stating again that their is no problem for (name) to drive under (medications) being prescribed ASLONG as they are taken as PRESCRIBED. Hope this helps and hope the world has not become shit because if your a good dam driver and your stopped from it because of a medication that does NOT affect your driving capabilities then the trucking industry is turning into shit cause i see people flipped over all the time crappy drivers killing people and its rarely very RARELY based on any type of medication the driver was prescribed so if they want safety they need to see a driver is truly capable of driving and thats it.

  3. Michele says

    April 12, 2016 at 10:52 am

    If a driver is taking Addrell, does this disqualify him for a CDL ?

    Reply
    • Trucker Docs™ says

      April 12, 2016 at 8:00 pm

      @Michele
      It would depend on the reasoning and the length of time that the driver has been on these medications.
      It would mostly test positive on a DOT drug screen, so make sure you have the prescription available for the MRO.

      Reply
  4. Kelsey says

    April 9, 2016 at 1:55 pm

    My husband wants to begin taking adipex (a prescribed weight loss medicine). It is a phentamine. Will this affect him having his CDLs?

    Reply
    • Trucker Docs™ says

      April 9, 2016 at 3:34 pm

      @Kelsey
      Unknown. It needs to be used for a period of thirty days to determine its effect and side effects, if any. He should not be driving until this information is known. If it is prescribed, make sure you keep copy of the prescription on hand in case he is drug tested and it comes up positive.

      Reply
  5. Stephen S says

    April 5, 2016 at 6:53 am

    Can I get a DOT medical card to drive a vehicle (10,000 to 26,000 lb) if I use insulin for diabetes even though the vehicle does not require a CDL? I am not sure I am asking the right question.

    Reply
    • Trucker Docs™ says

      April 6, 2016 at 11:50 am

      @Stephen
      If you are going to be an intra-state only driver, you should need the correct information from your state drivers license department. Their rules are a bit different from the FMCSA.
      You may not need a CDL, but each state is different with insulin dependent drivers, so check with them for sure.

      Reply
  6. Lloyd C says

    April 1, 2016 at 9:57 am

    I take Pioglitazone, will that keep me from getting my dot med card?

    Reply
    • Trucker Docs™ says

      April 3, 2016 at 7:22 pm

      @lloyd
      If you have been on the medication for any length of time, then make sure you have a medical release form from your doctor and a copy of your last A1c. That should provide the information that the CME is going to be looking for.

      Reply
  7. Bob H says

    March 30, 2016 at 9:26 pm

    Can a person taking muscle relaxers for a back issue and having a weight restriction of only being able to lift 20lbs be able to drive Semi in Michigan and still be safe for themselves and the other people on the road according to DOT standards??..

    Reply
    • Trucker Docs™ says

      April 1, 2016 at 5:00 pm

      @Bob
      No, you could not qualify as medically fit for duty. And at present your medical card should be invalid, until you can pass the DOT medical certification examination.

      Reply
  8. Jenn says

    March 29, 2016 at 11:35 am

    Looking into getting my CDL but I take a high dose of Gabapentin (Neurontin) for some nerve pain in my legs & to level out my mental illness. It’s working great but I’m concerned I’ll have to overhaul my meds routine if I start driving. Can you drive while taking Gabapentin?

    Reply
    • Trucker Docs™ says

      March 29, 2016 at 1:16 pm

      @Jenn
      This medication is going to cause a ton of questions before you ever get started.
      Best bet is to get a medical release from your doctor explaining why you take these medications and how you have responded to them. With that information in hand you have answered many of the questions that the CME is going to have. But it is not a guarantee that he will see fit to pass you on the medical certification examination without further information.

      Reply
      • Sophia says

        June 10, 2016 at 7:44 pm

        Will victoza show up in a random drug test.

        Reply
        • Trucker Docs™ says

          June 10, 2016 at 8:54 pm

          @Sophia
          This medication is for diabetes, so why are you worried about it in a drug test. The short answer is no and they are not looking for it.

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