DPP-4 Inhibitor (Type 2 Diabetes)Conditionally Approved

Alogliptin

Brand names: Nesina|Last verified: 2026-09-12

FAA Pathway: Special Issuance (Diabetes Mellitus — medication controlled); AME must defer initial certification

Alogliptin is a DPP-4 inhibitor on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

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Related Resources

Pilot Tip

Always report all medications on your FAA medical application (Form 8500-8, Item 17a), even OTC medications. Failure to disclose is a far bigger issue than the medication itself.

Certification Details

Initial Certification

FAA decision — the AME must defer

Observation Time

30 days after starting (Group D); 14 days if added to an established regimen; 48 hours after a dose or formulation change

Required Documents

Diabetes or Hyperglycemia on Medications Status Report (or detailed clinical progress note no more than 90 days old) plus an A1C within 90 days

Initial Target

A1C below 9.0 on an acceptable medication combination

Combinations

Up to 3 non-insulin medications, only one per group; DPP-4 inhibitors are Group D and are not allowed with meglitinides

Certificate Classes

1st, 2nd, and 3rd class via Special Issuance

Sources

FAA AME Guide — Pharmaceuticals: Diabetes Type II (faa.gov/ame_guide/pharm/oral_diabetes)
FAA AME Guide — Pharmaceuticals: Acceptable Combinations of Diabetes Medications (faa.gov/ame_guide/media/diabetesmeds_acceptablecomb.pdf)

Last verified: 2026-09-12

Frequently Asked Questions

Is Alogliptin allowed for pilots?

The FAA considers Alogliptin (Nesina) to be "Conditionally Approved" for medical certification purposes. Alogliptin is a DPP-4 inhibitor on the FAA's list of acceptable diabetes medications, but diabetes treated with any medication requires an Authorization for Special Issuance. The FAA makes the initial decision and the AME must defer. After approval, an AME may issue subsequent certificates under the terms of the Authorization.

What is the FAA status of Alogliptin?

Alogliptin has a status of "Conditionally Approved" under FAA medical certification policy. The certification pathway is: Special Issuance (Diabetes Mellitus — medication controlled); AME must defer initial certification.

Can I fly while taking Alogliptin?

Flying while taking Alogliptin may be possible through the FAA's Special Issuance process. You will need to meet specific requirements and obtain approval before exercising pilot privileges. Consult an experienced AME for guidance.

Important Notice

The FAA does not publish a comprehensive list of “approved” medications. The information on this page represents our interpretation of publicly available FAA guidance and is provided for informational and educational purposes only. It does not constitute medical advice, legal advice, or a guarantee of certification outcome.

The primary issue with the FAA is always whether the underlying medical condition — not just the medication — is compatible with safe flight. You should only start, stop, or change medications after consulting your treating physician. Always consult with a qualified Aviation Medical Examiner (AME) for guidance specific to your situation. FAA policies are subject to change. ClearedMed is not affiliated with or endorsed by the FAA.