Please read through the Q&A before posting a question. This will help everyone to not have duplicate questions. Thank you!
If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.
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?
What if I take insulin by injection and my diabetes is under control?
My doctor put me on Metformin. Can I still drive truck?
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 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.
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.
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.
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.
Can’t Find An Answer For Your Question?
If you have a question that you feel has not been answered, scroll down to the Questions and Comments box and post your question.
- Before posting, please make sure you are on the appropriate Category page, so that relevant questions and answers can be found by other drivers too.
- To save us all from zombie spammers, your question will not appear on this page until it has been approved.
- Trucker Docs™ will answer your question as soon as possible.
- Visit this page again soon to see our response.
P.S. Your email address will not be published.
Your comments are also welcome.
I used to smoke marijuana and stopped smoking marijuana a month and a half ago. I took a DOT physical exam and it came up positive on my drug test. I feel like I should have passed the drug screen. So my question is can I go somewhere else to have my DOT test and drug/alcohol screen re tested? Also is the original test reported to the DOT?
@Lynn
Not sure why you would have had a drug screen with your medical certifiacation examination, unless your boss requested it.
The DOT examination does not require a drug screen. But employment does.
If your examiner is part of the NRCME, then yes it may have been reported to the FMCSA as a disqualifier. If not, then there was no reporting to DOT. Going some where else may not change the end result.
If you have stopped using cannabis then it should be out of the system within 8 or 10 weeks.
im in the third week of a twenty two week school. I take oxycodone and tramatol. my doctor wont qualifie me because of the oxycodone .what can I do to get around this?
@Bruce
Not really anything except to get off the medication. Check with your prescribing doctor and see if he has another alternative for you and your condition.
I am a heavy drinker and I mix with hydrocodone (I know bad). I was just offered a job and need to take the DOT exam in 4 days (No drug test, just the exam), also no school bus or anything like that. Will the opiates still be checked for? Will possible damage to my liver and/or kidneys serve as a disqualifying factor?
@Ronny
I can only assume this is an April Fool’s question.
But if it isn’t, then here’s your answer — Yes the meds will show in the drug test, which you will have to take for your employer. And besides, why would anybody hire an employee that is a heavy drinker on opiates. This is a disaster waiting to happen, with you and the public. Sounds like a very bad mix. I would reconsider your choice as a commercial driver.
Thank you for the response, and I can only agree with your assessments. But just to be clear, if a drug test is not required, the physical will still test for Vicodin? I have stopped drinking however I fear an enlarged liver will be visible. Is that a dis-qualifier? Again your concerns are valid, and I am indeed reconsidering this job, I just want to know.
@Ronny
There is no drug test at the time of a DOT examination. But any DOT examiner is going to be on the lookout for anything out of the ordinary. In the physical examination, the medical examiner may discover an enlarged liver and then send you in for additional testing.
The most basic rule here is safety, for both you and the public at large around you.
Hi, I just finish my first week of three weeks CDL school and I take drug test at 03/24/2014 and recruiter told me at Friday that my test still pending but I forget to tell DOT doctor that I taking Fluoxetine 20mg so I am scared now that CDL school get rid of me because of this meds. so my question is what should I do now because this meds are show up on my drug test for sure?!
@Drazenko
You should not have any problems. If your medications trip the DOT drug exam, then the MRO doctor will touch base with you to get a copy of your prescription. This will help him make a final determination. You should not have any difficulty, unless the MRO cannot get in touch with you.
Will neurontin for restless legs and ambien for sleeping disqualify me from commercial driving?
I am a bus driver and need to know about wellbutrin (or generic thereof) and maintaining my clas be with p endorsement. I was taking it for about 3 years and it was fine, no side effect problems, but had to ween off of it last june/july do to no money. I was on it due to suicidal thoughts. I have noticed however that while those issues seem to be fine, I am a bit more nervous and irratable and was thinking about resuming. Can I lose my ability to drive if I do? I like my job, but do not like the direction my mood is going.
@ e.r.
In most cases you should not have any major issues. Make sure that you have a note from your doctor stating your general need and the effects, both positive and negative, of your medications. It does not appear that you are an interstate driver, so your state laws may allow you to take the meds with nothing more that your doctors recommendations.
I am prescribed Suboxone …. can I get a CDL ?
@ joeNY
Your medication would provoke more questions regarding its need. I am not sure you would be able to pass a drug screen while using this medication. I suspect that once you are clean and no longer have a need for Suboxone, that you would have no real problems. Just be aware that your present medication can be just as habit forming as what you are getting away from.
Can I take Gabapentin if it is prescribed for nerve pain, or are all anti-seizure medicines prohibited no matter what the reason it is being prescribed?
Is ropinarole accepted by DOT
@John
It isn’t so much the medication that would be the main question. It is what condition the drug is used to correct.
If it is being used for Parkinson’s, that will have to be judged by your DOT examiner. Parkinson’s is a progressive condition. If in the very early stages and no real limitations, then you may get away with it for a while. If the condition is showing signs of progression, then your driving days are going to be limited.
Safety is the key for both you and the public at large.
My husband had a heart attack three days ago and the doctor put in a stent. They have prescribed a blood thinner, his doctor said he could go back to work in about 7 days, but the medical dept. where he works said that he would have to be off work for 2 months (DOT regulations) and that he would have to be released by the company doctor. Can u comment of this. Thank U……
@Gloria
Please see the FAQ for cardiovascular for a more complete answer to the regulations regarding stent surgery.
Your husband will first need to be cleared by his cardiologist, and then it is still up to the certified medical examiner to make the qualifying determination for a medical card.
Companies have the right to enforce stricter regulations than those required by FMCSA.
prescription medication can be detected in a drug screen.
The MRO (medical review officer) do they use a percentage as pass or fail on a drug screen?
For exsample: trace levels or 1%. Fail? or
1% is a fail.
At what point do medications wear off and residue toxins not be detected in the screening?
Are there home remedies help clean your system faster? For example: apple cider vinegar or white vinagar?
@Michael
When you do the drug test, if there are are any positives in prescription drugs the MRO will contact you for a copy of the script. Then the MRO will determine positive or negative.
My husband is type 2 diabetic and has been on oral meds for years. He is also an interstate truck driver. Recently, the oral meds have been losing their effectiveness and his doctor has suggested Victoza. I understand that this is a once-a-day injection but it isn’t insulin. If he takes this medication (injection) can he keep his CDL and drive interstate? I know that he can’t use insulin without the exemption, which takes a month of non-driving to get. We can’t afford for him to be off the road that long, as he is the primary bread-winner and there is also a loan on the truck. The doctor thinks this new medication will work very well for Hubby, but we don’t want (CAN’T) risk him losing his CDL. We have a couple weeks to make this decision but need all the correct information to make the best decision for him.
Thank you for your prompt response.
P.S. His GP, who is prescribing this new med, is also his medical examiner.
@Jammie
If your primary diabetes doctor is doing your DOT medical examination, then he should know whether Victoza is an acceptable medication via the DOT, FMCSA. I would ask him first.
I take a small dose of Requip for ressless leg syndrome. Is that approved to be taking?
@Martha
The medical examiner would want to know how long you have been on this medication. Due to its potential side effects, you will want to bring a note from your primary healthcare provider explaining your medication’s use and length of time being used. This should answer most of the questions for the DOT examiner.
I have been on pain medication for about 7 yr now for back pain and I have no side effects it’s like taking Advil with no sleepiness or side effects because of the long time I have been on them but that won’t matter will it ?
@Bobby
Considering you have given no information as to what the medications are that you take, we have no way to truly answer this question. If you could be more specific, then we may be able to answer your question.
can i go to take another physical if i failed before due to medication (methadone) that i am no longer taking?
@Rio
Yes, you can take another physical. Just make sure you get a note from your primary healthcare provider explaining your past and present condition. And if you are on new medications, make sure the new medications are explained in the note. Take this note from your primary provider to your physical exam appointment, for the medical examiner.
has tramadol been classified as a controlled substance??thnx
@Jeff
If the medication is being properly prescribed and used as prescribed, then there is no real problem.
Under the influence of this drug and operating a CMV should be out of the question though. Too many potential side effects that place you and the public at large in danger.
As far as a controlled substance, it is classified a controlled substance, that’s why you have to have a prescription to get it.
I to am concerned about Tramadol I have been on it for 7 years and up until now have had no problem getting a cdl and driving while taking it what has changed
@Howard
Tramadol’s known adverse side effects commonly include dizziness, nausea, vertigo, vomiting, and somnolence which would be disqualifiers for a driver. The potential side effects of the medication put both you and the public at risk.
Get a medical release form completed by your primary care physician explaining your usage and if your condition is stable. This will be a huge help to the DOT examiner to make a qualifying decision.
Does Dot restrict the use of Pseudoephedrine for sinuses for any line of Commercial drivers.
@Rodger
As you know this medication is usually given for sinus congestion. The biggest concern will be the side effects of the medication. Any medication has side effects, but one that may interfere with the safe operation of a commercial motor vehicle is of major concern.
I would get a note from your prescribing doctor indicating the need, use and side effects of the medication you are taking, as well as the length of time and whether your condition is ongoing or is going to resolve anytime in the near future. This will go a long way in helping the DOT examiner make a safe decision regarding your medication usage and the operation of a CMV.
If my employer wont allow me to drive my CDL job because Im on paxil and Xanax then can I file workmans comp claim here in California.How am I to support my family.I am the only one working.I have no other skills.I am 47 years old.I have a mortgage. please help God Help me please. The doctor wont give me anything that does not cause drowsiness and the Xanax REALLY works.I have PTSD
@Tony
The best thing you could do with this situation is to get a note from your primary healthcare doctor stating that your conditions are stable and that the use of these medications have you stable and safe, and that you have been this way for a good long period of time [try to get a date in the years].
Both of these medications are either for depression or thoughts of suicide. DOT and FMCSA have very strict rules regarding these types of conditions with long-haul drivers. The rules are mostly for keeping you and the public around you safe.
As for filing a workers-comp case, we cannot comment as this is not our field of expertise.
But the doctor’s note will go a long ways in helping the DOT medical examiner discern you situation.
Thanks for the question. Trucker Docs
Can I drive Legally using my C.D.L.’s while on suboxone prescribed by my DR. ?
@Ron
I do not believe you would be able to legally drive a CMV while using even a small dose of suboxone, even if it is prescribed by your doctor. This is still classed as a habit forming drug and is usually used with patients that are cleaning up from an opiate dependence situation.
Thanks for the question. Trucker Docs
is there a list of OTC medications that would give a positive drug screen? We are getting questions regarding this.
@Rhonda
According to one of our drug testing labs, MedTox, there is no OTC medication that causes a positive drug test – so there is no list.
That being said, this is how a ‘positive’ works.
Driver has a drug test, these results go to lab and then reported to the medical review officer (MRO). If there is any finding that is positive, then the MRO calls the driver and ask questions about any medications being taken by the driver. Once information is supplied to the MRO, then the split sample is tested for dosage and usage of that particular medication. That is when a ‘positive’ test can be reduced to a ‘negative’ test result.
Now, there are OTC medications that a driver should not use while driving, but these are usually medications that cause drowsiness or dizziness, which makes perfect sense within the driving community.
Thanks for the question. Trucker Docs
Taking lorazapam 0.5 twice a day for driving anxiety. I drive a school bus is this OK.
@Mary Ann
If you have been doing this for any period of time and the state DLD is OK with it, then it will not be a problem.
Most of these new changes effect the Class A drivers, not the other classes.