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On the Road to Recovery: Commercial Drivers and Cold Meds

During the cold and flu season, commercial motor vehicle drivers often take medications for respiratory illnesses. However, some of these medications can cause side effects that create safety risks.

Kathy Close
Kathy CloseTransportation Editor, J.J. Keller
Read Kathy's Posts
January 10, 2024
On the Road to Recovery: Commercial Drivers and Cold Meds

If the driver’s condition or medicinal side effects call into question the ability to safely drive a CMV, the driver can’t be dispatched. 

Photo: J.J. Keller

3 min to read


It’s the season for respiratory illnesses, and many of your employees and commercial motor vehicle drivers may be coming to work under the weather. They may feel ill but not bad enough to stay home, so they medicate.

However, using some prescriptions or over-the-counter medications to relieve symptoms can create safety risks when operating a commercial vehicle or truck.

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Common Side Effects of Medications for Respiratory Illnesses

When suffering from a respiratory ailment, employees need to be aware of the potential side effects of medications. 

Depending on the specific drug, a person may experience one or more of the following:

  • Drowsiness

  • Dizziness 

  • Upset stomach 

  • Blurred vision 

  • Headache 

  • Nervousness 

  • Fast heartbeat 

  • Increased blood pressure 

  • Loss of appetite 

  • Sleep problems 

And, of course, employees should always check for interactions with any other medications they are taking.

Guidelines for Ill and Fatigued Commercial Motor Vehicle Drivers

A driver is prohibited from operating a CMV when impaired or likely to become impaired through fatigue, illness, or any other cause. 

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If the driver’s condition or medicinal side effects call into question the ability to safely drive a CMV, the driver can’t be dispatched. 

This regulation holds both the motor carrier and driver accountable, so:

  • The driver is responsible for notifying the carrier when too ill or fatigued to be safe, 

  • Motor carriers must not pressure drivers to endanger themselves and others when not feeling up to operating a vehicle, and 

  • Supervisors must be observant and identify drivers who should be pulled off the road. 

Understanding Prohibited Drugs in the Federal Motor Carrier Safety Regulations

There is no official list of prohibited drugs in the Federal Motor Carrier Safety Regulations (FMCSRs). Instead, the regulations reference the Schedules of Controlled Substances appearing in the Drug Enforcement Administration (DEA) regulations (21 CFR 1308).

DEA’s Schedule I is the only drug list prohibited in the FMCSRs, with no exceptions. Marijuana is on this list, and it is prohibited even when permitted under state law. Use of all other schedules of controlled substances is based on what the prescribing doctor said about its use. In other words, the driver is explicitly told it won’t interfere with the ability to operate a CMV safely. This stipulation appears in the general safety rules (392.4) and driver physical (391.41), both of which apply to all CMV drivers.

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Drivers operating CMVs requiring a CDL are given the same exception (382.213). 

Over-the-Counter Medications and Their Impact on Safe Driving

Over-the-counter medications are also included in 392.4 if they affect a driver’s ability to operate a CMV safely. Many cold medications have side effects that cause drowsiness.

A motor carrier must pull a driver from operating a CMV if there is a safety risk.   

The state of Oregon recently enacted a law that considers the use of over-the-counter medications, such as NyQuil, as a possible cause of DUI.

Alcohol in Medications and Its Effects on Commercial Drivers

Commercial drivers must be careful when using any medication containing alcohol. Cold-and-flu medications and cough syrups have been known to contain 10 percent alcohol to help dissolve the ingredients. This is equal to 20-proof liquor. Often, the alcohol interacts with the other active ingredients in the medications to make the user sleepy, groggy, and/or dizzy.

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The regulations are clear regarding alcohol use, whether included in cold medicine or consumed as a beverage. Drivers are prohibited from:

  • Consuming alcohol within four hours of coming on duty; 

  • Consuming alcohol or having any measurable concentration while on duty or in physical control of a CMV; and

  • Carrying any unmanifested alcohol (including medicine) on the CMV.

Closing Thoughts

During the cold and flu season, make sure your drivers understand the limitations placed on them when using medication.

A mistake in judgment is more than a violation of the FMCSRs. It may be a crash waiting to happen. 

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