Beta Blockers Because the maximum heart rate is limited, pilots on this medication may have difficulty achieving their maximal predicted heart rate on treadmill stress tests. These medications are usually well tolerated but a small number of people will experience fatigue and decreased sexual function.

In 2026, the FAA and most global aviation authorities generally permit pilots to use certain beta blockers, but with strict oversight. While the FAA does not maintain a "yes/no" list of medications, beta blockers like Atenolol, Metoprolol, and Propranolol are commonly "waived" for pilots who need them to treat hypertension or stable coronary artery disease. However, the pilot cannot simply start the medication and fly; they must undergo a mandatory observation period (usually 7 days) to ensure there are no side effects like dizziness, fatigue, or a dangerously low heart rate that could impair flight safety. The underlying medical condition—such as high blood pressure—must be well-controlled and documented by an Aviation Medical Examiner (AME). If a beta blocker is being used for "off-label" reasons like performance anxiety or tremors, the FAA may be more restrictive, as the medication's primary intent must be to treat a stable, disqualifying physical condition under a "Special Issuance" authorization.