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.
Is there any type medical condition or medications that will disqualify someone for having a CDL Instructor classroom ONLY license?
@Cindy
Simple answer is yes, there are meds and conditions that would be disqualifying. You would need to know what the requirements are for the position and then base your decisions on the requirements. As a CDL instructor classroom only, there will be different requirements for you that are not part of the FMCSA requirements.
I have been prescribed Effexor 75mg for Depression and Phenteramine for weight loss. What do I do if I get sent for a random drug test? My MD is also my DOT physical doctor, however is not the one that does drug screens for my company. Are these meds allowed by DOT? I have read conflicting information.
@Heather
If you are pulled for a random drug screen, then make sure you have access to your doctor’s prescription. That will cover your bases as far as the MRO will be concerned. Proper documentation will cover your situation.
I know the DOT physical does not include a drug test unless requested by employer.
Now my question is, what if a driver has been on vacation the last 10 days and has used some marijuana during the vacation. When they come back from vacation, they have to renew their DOT card.
Granted their are still some traces of THC still in the system, would that show up in the urine screening (even though the company never requested one) along with the regular things they are checking for; diabetes, kidney failure, etc.
@Rodney
Like you read and like you said, there is no drug testing done at the time of the DOT examination, unless the company ask for.
Hi i am taking Methylphendate 2X a day. Will I still be able to drive?
@mike
You will need a medical release form completed by the prescribing physician explaining the reasoning behind this particular drug use. There will be lots of questions due to the wide variety of conditions that this medication is used for, so be prepared.
Is victoza DOT approved?
@Todd
It is very similar to an injectible that has been approved by the DOT. You will need to be on this medication for a while to make sure of its effectiveness and to rule out any potential side effects. (which there are a few – including some that would be seen as a safety issue). Also, make sure you get a medical release form from your prescribing doctor explaining its usage and how you have responded to the medication. You might want to take a recent A1c with you to support your treatment results.
does the DOT physical urinalysis detect prescribed drugs. or do i tell the doctor if i am on a prescription?
@Cal
Nope, the urinalysis is looking for proper kidney function and screens for blood, sugar, and protein.
And — You are required to complete your health history in your medical form, which includes medications.
thanks !
I failed a drug test at my work awhile ago and lost my dot license, i had to see a sap to be evaluated and take a couple classes and report back to him after i was done i took my return to duty drug test passed and resumed normal operations, 3 months later i failed another drug test, does anyone know if i have to go through the same process to get my dot license back? BTW im no longer with this company.
@Aphotic
You will need to check with your local drivers license department and see what they will require for you to redo your cdl. Since the cdl comes from the state that is the place to start.
Thanks for the reply, its not a cdl just a medical card basically to drive a dot certified vehicle.
@Aphotic
That falls within your local state regulations.
I have a Class B license with P and S endorsements. I currently drive a school bus. I have a really bad case of ‘white coat syndrom’ when my blood pressure is checked. My question is: can I take a Xanax prior to my DOT physical to help calm me down for the BP check? I don’t use Xanax regularly.
@Dave
Do you plan on telling the examiner that you are taking a non-prescribed medication to overcome your white coat syndrome? Probably not the best choice.
The examiners know that this is an issue, so explain your situation and go from there. They should be willing to take a multitude of readings over time to get you calmed down. It isn’t based on a single reading.
The Xanax is a prescribed medication by my PCP. He prescribed it for when I go to blood drives and to the the dentist. I thought if I use it before going for my DOT physical and explained to the DOT doctor that I took it to calm my white coat syndrom and that I don’t need it or use it regularly. Your thoughts?
I appreciate your advice. Regards.
@Dave
Most CME’s are going to have questions about your need to take a prescribed anti-anxiety medication to pass a medical certificate examination. Even with your medical doctor filling out a medical release form explaining the situation is going to cause questions. And taking a medication that is going to cause that many questions? Not sure what will happen in this case. What do you do to get through a visit with your own medical doctor? And if that works, why not try that with the DOT examination.
I take citalipram for depression. How long must I be on it and be stable to get my CDL health card?
@Craig
You would need to be on this medication for at least 90 days or longer to determine how you will act and possibly react to the medication. After that you will want to get a medical release form from your prescribing doctor explaining your situation and how you and your condition have responded to the medication.
My husband currently holds a CDL license and has now been prescribed adderall by his doctor. How does he get this approved in order to keep his license?
@Lynn
More questions than answers here. Why was he prescribed this medication, how long has he been on the medication, is he stable with its usage? There are lots of variables here and more information would be needed. Your best bet is to have your primary prescribing doctor fill out a medical release form and take it to a local CME to see what else in the way of information would be needed before he would pass a DOT examination.
My husband was just given Depakote DR 125mg for migraines. Is this approved by DOT? Will they allow him to drive?
@Lydia
Since this drug was just prescribed, your hubby now has an invalid medical certificate due to the facts that he has a condition that has required a new medication that is used for seizures. I know that it is being given for the headaches, but no-one knows how he is going to react to the medication and it has some serious safety issues attached to it. He will need to be on the medication for at least thirty days and when he starts driving again, he will need a new medical certificate. He should also take a medical release form from his prescribing doctor explaining the effects of the medications on the driver and why he is using this medication. That will go a long ways in helping the CME to make the proper decision regarding the driver and his medical fitness for duty status.
Can I take amitriptyline while operating with a CDL license or is it a drug banned by the DOT?
I don’t see an answer to the question about taking amitriptalene. Is this a banned medication for a truck driver
@Matt
It isn’t on a banned list, yet it will cause a lot of questions because of its usages and side effects. So make sure you bring in a medical release form from your doctor explaining what and why you are taking this medication.
Sir, I have had my CDL since 1981. I took my DOT physical last Tuesday 11/3/15. I passed everything with flying colors until I was asked what meds I was on. I have taken Ambien since 2004 so that I can get good sleep. I have been on a 25mg pain patch for 8 yrs for some nerve pain in back and leg. Dr gave me Percocet to take as need up to twice a day. I take 1/2 pill in morning to help get out of bed and one after supper before bed. I drive 2 to 3 times a week on 150-200 mile trips with my own equipment. The lady who was a nurse practitioner said I showed now abnormal behavior and looked to be in great shape. She got my medical report from my regular doc. She said it looked fine but I still have not got my card. She told me yesterday that the DOT DOC said she needed to do more research on the meds. I’m a responsible person and know I can not be impaired in anyway. I never take Ambien less than 8 hours prior to having to get up and drive. I guess my question is if I fail how long do I have to wait to take it again and will I have to do the driving test to get them back if I fail. I was grandfathered in. My last accident was in 1985 on ice. I have no tickets. Can I get a 2nd opinion? Or should I go directly to the DOC who has me in question and set down and speak to him directly. I am very concerned, I’ve been driving for years with same meds and no issue. I have a piece of equipment that will set and I will not put anyone else behind the wheel. To find others who will care for my equipment and maintain it the way I do are almost impossible to find. Its not worth the risk to me.
@Charlie
A medical release form from your prescribing doctor explaining your situation and the medications that you take will be a huge help. Also let the the CME know how much you drive and if you only travel within your state or not. That helps answer any questions that the CME will have. Right now all you need to do is pass the medical physical, and does not effect your drivers license, even if you were to fail at this time and you could re-take your physical in a day or so if you are having issues with the present examiner.
I have a driver in Texas who is taking tylenol 4 with codiene for pain. Can he be disqualified on a dot physical drug test?
@Ricky
If it is prescribed by a doctor and he is taking it as directed, then the MRO will want to see the script to confirm that your driver is doing as directed. He could be disqualified until he can provide the needed information to the MRO, because he will test positive. Once the MRO has what he needs and confirms proper usage, then he will change the test to negative.
I was having trouble sleeping at night so doctor prescribed me diazepam to help my mind settle and let me fall asleep can this prescription cause me to lose my medical card
@Henry
This medication is going to cause a lot of questions. You will need a medical release form from your doctor and he will need to have had you on this medication for a while before allowing you to return to driving. This one is a safety issue due to its known side effects. Your doctor needs you on this medication for a bit so he can support or deny that you are not having any difficulty with its effects.
Trucker docs my doctor has had me on the diazepam for at least a month now is that long enough?
@Henry
This will really depend on why you were prescribed the medications. This med is used for some things that would have you disqualified and some things that thirty days may be enough.
I have been one carbamazepine, and lomotrogine for at least 10 years. I had surgery in 2010 to cure my seizures. I have not had a seizure in 7 years. My doctor gave me a letter stating this. I will only be driving interstate. Can I get my dot card? I’m nervous about listing these meds
@Jimmy
If you are going to be driving interstate, then there will be tons of questions and medical support will be an absolute necessity.
If you are going to be driving intra-state, then there will still be questions and medical support will be needed. You should check with your local drivers license department and see what they have to say. It will depend on what you drive, where you drive and what your status is regarding your medical condition. Your medications will also raise questions, but if supported by your prescribing doctor on a medical release form, then you may be OK.
can i be on mirtazapine 30mg for sleep. i have ben on this medication going on 10 years with no side affects,.my dot doctor wants me to get off medication?my primary doctor says ok to use actually it is good for me to use, allows me to sleep great.
@Mark
The DOT examiner is not in a position to request that you get off of any medication that is properly prescribed by another doctor. The DOT examiner is only supposed to find any supportive information regarding whatever medications you are taking and request additional information from the prescribing physician. Go somewhere else if this is an issue, but make sure you take a medical release form from your prescribing doctor to answer any questions that may arise due to the meds you are taking.
I’m on cumedin do I need a Dr release to go back to driving a cdl job had a dvt
@David
That will be a big help to the DOT examiner. He is looking for supportive information so that he can make the best decision.
I have had my cdl almost 18yrs. About 5-6 yrs ago I had a really bad case of mono after recovering I still felt like I could never get enought sleep, after several sleep test I was diagnosed with hypersomnia, which was caused by damaged the mono did to my brain. I have been successfully diagnosed Provigil for 4-5 yrs. I went to get my new DOT physical ( at the same office I have been going to 12 yrs) well I had a new doctor who refuses to renew my forms, because of the provigil. Is there anything I can do or should I try for disability?
@Ronda
At this point your CME will need a medical release form from your prescribing doctor explaining that you have been on this medication and driving for the past 4 or 5 years and that you are not having any issues with its usage. The CME is only trying to CYA before signing a new medical card. He may also limit your medical card to one year at the time, so be prepared. But the medical release with a good explanation from the prescribing doctor should help.
I take prescription hydrocodone for tailbone pain. Will this fail me on a DOT drug screen?
@Doug
Yes and no. Yes will test positive and no if you can provide the MRO with a copy of your prescription from your prescribing doctor, then the MRO can make the same test negative.
I’ve been taking since 1999 @ different times different narcotic pain pills. I have chronic pain in my back and have had multiple surgeries and procedures. I’ve took legally with script Vicodin , morphine, OxyContin and lord knows what else. I have took dozens of random tests and hire drug test. I have never had an issue with an Mro calling me about these, I have always passed these test. I don’t understand why they have never once called. I have usually quite a bit in my system also. I always took these by the prescribed amount . I guess I’m so used to them they just have never affected my driving. Thanks everyone be safe out there!