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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?
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.
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My husband is a diesel mechanic and holds Class B CDL. He does not drive a truck on the highway at all. He is diabetic and medications are not controlling his levels so he going to need to go on insulin. Will he need to get an insulin exemption in order to get a new medical card? We live in Georgia, and he works in Tennessee.
@ Stefanie W
He is a class B and will fall under the states variances. So check with his local drivers license department for the best answer.
How long does it typically take for the medical examiner to contact you if you test positive for any non-prescription drugs?
@ Nick
It is not the doctors responsibility to contact you for this. He would report to the authority that request the drug screen. That usually would happen within a few days.
I’m getting ready to start a Weight loss program with a DOT approved doctor is there any known medication that I might be able to take to assist weight loss and not be disqualified from driving
@ John
Your DOT approved doctor will know what is acceptable and what isn’t.
Hello, I’m currently a Limo driver in NYC. My company has asked me to get my B CDL so I can drive the limo bus. I had a brain injury over 15 years ago and since have been on citalopram 20mg once a day for anxiety/ depression from the injury that’s now and has been controlled for many years and a very small dose (as needed) of alprazolam .5mg. I also take metoprolol 100 mg once a day to slow down my heart( I have SVT, not heart disease). I have been on all of these for 10 years plus. Do you see anything that would immediately disqualify me? Is it worth even trying or am I wasting my time?
Regards
@ Christopher G
Have medical release forms from your doctors in hand and you should do fine.
I am a certified family nurse practitioner and am working in addiction medicine. I have read many comments about Suboxone, Subutex and Methadone but did not see Vivitrol. I know that Suboxone and Subutex show as Buprenorphine in a urine screen. Since Vivitrol injection only contains the Naltroxone and does not have an opiate component would it disqualify patients from receiving a CDL license? Would it show in a CDL urine screen? Would the CME immediately disqualify the person for being on this injection? Would a medical release and 30 day usage period be enough to allow the person to receive a CDL? If the patient is in a medication assisted treatment program and receives medication at that facility do they need to list Subutex, Suboxone or Vivetrol as prescriptions? Since this is a MAT program the medications do not show on an OAARS report when it is run so does the person need to report them as prescribed? Thank you for your assistance.
@ Tracy J
First are we asking questions about a cld license or a DOT medical card. All medications are to be listed on the drivers intake for a DOT medical card. They would need releases from any prescribing doctor. And a patient or client that is in an active rehab program would not qualify to take a DOT medical certification examination.
I have been on oxycodone for the last ten years, I had my DOT physical and received my 2yr med card. I both tested for and received my class A permit. I was cleared by the company’s MRO and was subsequently medically disqualified by the company safety dept. I was attending the company driving school and had 2 days left before I could test. To make a long story and potential lawsuit short….the company decided for whatever reason that they would not work with me on prescriptions at all. I have since received spinal steroid injections and am weaning off oxycodone for the first time in 11yrs.
My question is would the rest of my pain management regime disqualify me. Once I’m off of the oxycodone in a couple more weeks I will still be on Lyrics, Robaxin, and Diclofenac. I had several med releases that clearly stated these drugs in conjunction with the oxy would not effect my driving abilities at all. So should I maintain any hope of being qualified medically to drive it while taking these meds?
@ Sean J. B
All the meds are going to raise questions, but if you have proper documentation and medical releases from your prescribing doctors, then you still may have a chance. FMCSA is looking for safety issues in its guidelines and the CMS’s are to take all the available information into consideration. Good Luck
I ran into that once with the pain med. Went tto the companies driving class. Etc then they popped a random on everyone mine came up positive for hydrocodone i had all proper release from doctors. It even showed up on initial preemployment. Nothing was said. On application it asked no where about current meds i was escorted out by security. Called attorney and was able to sue them under the Americans with disability act. After i did this many others sued them as they went threw same thing at that time had had my cdl for 15 years never even so much as a over weight ticket. Alot of these companies are getting sneaky as how they do things.
A driver at our location that has a DOT Medical Card is asking if she can take a prescribed medication of Saxenda.
@ Carol B
She would need to be on the medication for thirty days to determine if there are any adverse side effects. Once clear that there are no side effects that would influence her ability to operate a cmv safely, then she could return to driving. A new DOT physical would be required and proper documentation with a doctors release form from her prescribing doctor also.
Driving a medical card 14,000 lb truck in NH. Vt. Can I take cyclobenzaprine 5mg up to three times a day, with no side effects, neck injury, feb 18 accident.
I m looking for an answer on this and can not find out anywhere.
@ Donald B
Your DOT medical examiner will have to answer this question because you fall under your states variances and not the federal guidelines.
I do. Same dose. 3x/day. Never been brought up in drug screening.
Can I take anti-Clement inflammatory or anti-histamines ?
@ Ulrike K
A lot will depend on your dosage and their side effects. You’ll need a medical release form from your prescribing doctor explaining your situation and need for the medications.
I take one 50 mf tramafol every morning for fibromyalgia pain. When is it safe to drive
@ Elizabeth b
Tramadol?
I have the same question, I’m sure she meant tramadol. I have lots of knee pain and tramadol helps and doesnt affect my driving ability
What are the next steps if failed the medical examiner report for CDL renewal? The drug Tramadol is not a narcotic. The Medical Examiner failed for taking this drug. She wrote on the medical form that the standards are not met because of being prescribed a narcotic. What do I do now?
@ Patty R
According to your prescription you are taking an opium based medication. Try getting a medical release form from your prescribing doctor. That may be very helpful for the CME to make a different decision, based on more information.
Hi I had a question about seizure medication I am taking 750 mg of keppra twice a day and I have a note from my doctor saying I am fine to drive. I just need a medical card not a CDL I have not had a seizure since 2003 yet I’m still be denied by a dot examiner from getting a dot medical card. Is there anything else I can do I am not able to get a driving job without a dot medical card.
@ Tommy L
As a class A driver you will not pass the DOT certification process. But if you don’t drive class A and only need a medical card, then you fall under your states variances and should be given a medical card with the states restrictions, if any, stated on the license.
I see many questions regarding passing a DOT physical but I can’t find what a driver is supposed to do if they have a current certificate but are prescribed a new medication. My doctor prescribed me Phentermine but I don’t want to take it because it isn’t on my long-form. What do I do?
My husband is a CDL B driver. He has taken 2 hydrocodones a day for several years, due to severe arthritis of the spine. He has a prescription for this, and his doctor is aware that he is a truck driver. She knows that the pills do not affect his driving ability. Will he still be allowed to take this medicine and drive a truck?
@ Julie B
As a class A driver the answer would be no. As a class b driver, with proper documentation from the prescribing doctor, maybe. Have a medical release form from the prescribing doctor and explain the situation, length of time he has been taking the medication, and the type of driving he plans on doing.
can a truck drive take this medication and drive a truck Escitalopram tablets 10mg 1x a day
@ Shelia
The medication is prescribed for other conditions that may effect the outcome of the examination. The medication itself is not the issue the examiner will explore, it will be the condition being treated.
My husband and I are both CDL drivers. He takes Simvastin and Citalopram, cholesterol and anxiety meds.
I am a breast cancer survivor, 5 years cancer free. I tak 5mg Lisinoprol, metropolol, and letrozole. Are these meds ok?
@ Maureen B
Yes, just make sure you each have medical releases from your prescribing physicians.
I take gabapentin (neurontin) for arthritis. Is this acceptable? This medication can also be used for seizures but I do not have any seizure disorder.
I am looking for an answer to this question as well!
@ David
You are going to need plenty of medical documentation before you go for your medical certification examination. Check with your local DOT/CME to get the proper forms and paper work before setting an appointment for the medical card exam.
I live in Washington state and I take 800mg Gabepentin twice a day. thei DOT doctor just told me that they wouldn’t pass me because of the doseage today they said that I have to be all the way off of it to get my pass.Does anyone know of a medication that will do the same job I take it for pain not sesures.
Yes. Cymbalta. Doesn’t cause drowsiness in most people
@ Lyndia
You need to check with your primary doctor and explain to him why you are being denied a medical card. A medical release form from your prescribing doctor may be sufficient.
is suboxone a disqualifying medication for class a cdl drivers if prescribed for pain management NOT opiate addiction? thank you.
@ Mike
in most cases it is an instant disqualifier.
I have I know someone who has a CDL with the same company for four years was hired taking Subutex and has passed every year the DOT physical, and now this year. A doctors field him said he don’t pass people on this medication he went to his second DOT doctor they passed them now they have to get a third-party specialist involved why is that
@ A
The medication should require a medical release form from the prescribing doctor. With proper documentation there should be limited issues.
This reply is for the Truck Doc please ! You say Suboxone is an instant disqualifier for a (CDL Class-A) driver attempting to get their DOT medical exam, when I’ve read a couple of your other answers to other Suboxone questions who asked you the same question, and you said that they should get a supporting letter from the prescribing Dr. stating that the applicant has no impairment effects from the suboxone, therefore giving the cdl applicant a chance at being accepted by the Medical Examiner for the DOT Physical !
Please explain why are you so inconsistent w/your experience & advise surrounding attempting to obtain a DOT medical exam to get a CDL Class A license !?? Your answers surrounding Suboxone & the DOT examiner were giving hope, and then this answer here in perticular, SHUTS ANY OF THAT HOPE RIGHT DOWN ! WHY !??
Like I said yesterday to you Dr, in response to one of your answers to another Suboxone patient inquiring your advise about Suboxone, that I myself have been on Suboxone now for over 10-years, and I have absolutely NO driving impairment whatsoever, and I’m seeking my Class-A CDL this week. And I will be asking the Prescribing Dr for a supporting letter from him to the DOT medical-examiner that I’ll be going to for my Physical exam. Because I will go to any & all lengths to get my CDL Class-A. license (Minus dishonesty & illegal behavior of course) This is how crucial & important getting my CDL is to me & my life. And I will NOT STOP fighting for my CDL Classs-A license either, if I run into any resistance. Also, I read that there have been legitimate Medical-studies & tests w/Buprenorphine (Supporting Suboxone as a SAFE medication to drive with) and the fact that it DOES NOT EFFECT one’s driving & reaction time, therefore not effecting their ability to operate a motor-vehicle safely, resulting in NO impairment ! Also, over the past 10+ years that I’ve been taking Suboxone, on a daily basis, I’ve been stopped by local & state police for a few traffic violations, like speeding, defective equipment, illegal-helmet (which I beat in a Court hearing !) and NOT ONCE did one of those “Trained” Police-officers ever have ANY REASON and/or “Probable-cause”, and/or ANY “Red-flags” that I might be impaired, even in the slightest amount ! Even after calling their dispatch for my past driving record that includes MANY-DWI’s !!! So, w/that said, I have literally driven into & through several Law-Enforcement impairment tests….EVERY TIME I GOT PULLED OVER for a routinely less-severe traffic violation ! So those Traffic-stops ALONE should be PROOF ENOIGH that my Suboxone Rx (That I take daily) DOES NOT EFFECT MY DRIVING ABILITY AT ALL !!! So, I’ve been stopped by Cops in my car, my truck & my Harley over the last 10+ years, while under the influence of Suboxone, and passed w/flying colors. And EVERY SINGLE TIME, the second the Cop approaches me, he is TRAINED to immediately look for ANY SIGNS of DUI of alcohol AND drugs….and/or ANY “Impairment” ! And EVERY TIME I have passed w/flying colors ! And these are cops who KNEW they were stopping a Multiple DWI Offender ! So, their senses were heightened, and were on High-alert ! And they still couldn’t find ANY impairment whatsoever. Even after following me, while I was driving, before turning on their Blue-lights & pulling me over for the traffic violation of speeding or defective-equipment. Also let me add. That I’ve been pulled over for the most redicilous reasons ! Once was for no mudflats. It was a Friday night, after midnight ! The time Cops are making DWI stops. And in reality the Cop was pulling me over just to see if I was still Sober & not under the influence of alcohol or drugs ! Because, once Cops KNOW who you are, and your past, they will make up reasons to pull you over just to make sure you’re STILL SOBER & NOT IMPAIRED ! Also, You see, my drivers-license has a Reatriction on it, because of my past DWI’s. That restriction is that I have ZERO ALCOHOL in my system while driving ! It’s not like most states laws @ .04%. My restriction states ZERO ALCOHOL in my blood when I drive ! ZERO TOLERANCE ! So, that makes me even more of a safe driver than MOST, because I won’t even have 1 or 2 drinks before I drive ! I’m in Recovery. And have been Sober now for just over 14-years. And I truly desperately need to get my CDL, so I can start a new, and “Last” chapter in my life, in order to support myself for the next 15 or so years, til my life ends. So, I’m PRAYING that my prescribing Dr will fully support me, and advocate for me to the Medical-examiner. And I’m PRAYING the Medical-examiner will “see” & “understand” the mountain sized life-changing obstacles that I’ve had to overcome over the last 20-years. And the rigorous honesty I put forth, in order to move forward & BETTER my life, ALL IN HOPES the Medical examiner will pass me w/my DOT physical, so I can get my Class-A CDL learners-permit.
Please respond w/your thoughts to my situation, and why your answers surrounding Suboxone have been so inconsistant.
Thank you so very much !
@ Richard
Suboxone is always a tricky question. As examiners, we need way more information then space on this site offers. Suboxone, in some cases, would pass a medical examination, supported by proper documentation. Some cases, not so.
Why are you on Suboxone???
I’m on Suboxone as part of treatment program can I get my dot medical card to drive 3/4 ton pick up n dual axle trailer in ky
@ MJ
You need to check with your states drivers license department for the best answer. Suboxone is going to raise questions at the time of the physical so be prepared with medical documentation and also explain to the examiner that you are not a class A OTR driver.
I was told by my medical examiner that I need a evaluation and clearance from a psychiatrist for the meds I am taking ( trileptal ) but psychiatrists are not qualified enough to say whether or not someone is stable to operate a DOT motor vehicle, I am from Connecticut can anyone help with a psychiatrist that has DOT knowledge in my area or surrounding states. Thank you
P.S. the doctor who prescribed the meds is not qualified to give me clearance as well.
@ Chris
The medical release form from the psychiatrist has to do with the meds that you take, not to evaluate your driving ability. Have the psychiatrist explain your medications and the dosage, along with any ongoing side effect, if any. Then take the release form to the CME so that he can make a well informed decision for you. It’s the CME’s job to make the final decision, but he needs the release form from your other doctor.
I am temporarily taking Dramamine to help with dizziness from the flu. Is it ok to drive? Is Dramamine on the restricted medication list?
@ Larry
If you suffered fro dizziness and were placed on a medication for it, then your medical card was invalidated and you need to do a new medical certificate. Once you stop taking the Dramamine, then go for the retest.