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.

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
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.
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.
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.
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.
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.
More Safety

5 Safe Driving Tips for 4th of July
To ensure that this year’s fireworks remain in the sky and not on the roadway, follow these five easy steps to remain safe on the road this year – shared directly from a truck driver.
Read More →
NSC Marks 30 Years of National Safety Month, Includes Road Safety Focus
The Staying Safe on the Roads topic is one of four weekly focuses in June as the National Safety Council observes the 30th anniversary of National Safety Month. NSC also provides insights on the need for fleets to create a safety policy.
Read More →
Fleetworthy Integrates Lytx Video Snapshots to Improve Driver Coaching
Fleetworthy’s integration of Lytx video snapshots enables fleet managers to combine visual event evidence with Safety+ risk data, helping them make faster, more informed coaching decisions without leaving the Fleetworthy platform.
Read More →
Recalls You Need to Know About in June 2026
In June 2026, what recalls might impact your fleet? Work Truck has the answers in this comprehensive overview of recent NHTSA recalls.
Read More →
J. J. Keller Safety Professional of the Year Awards Nominations Now Open
J. J. Keller & Associates is accepting nominations for the 2026 J. J. Keller Safety Professional of the Year (SPOTY) Awards. Winners will receive prize packages valued at up to $47,200.
Read More →
ASE Aligns Automotive Service Professionals Month With Spring and Fall Vehicle Maintenance Campaigns
ASE will move Automotive Service Professionals Month to April and October beginning in 2026-2027, aligning recognition with Car Care Month events.
Read More →
Turning Connected Vehicle Data Into Decisions That Matter
Fleet leaders have more data than ever, but turning that data into clear, actionable decisions remains a challenge. This white paper shows how leading organizations are using connected vehicle data to improve safety, reduce costs, and optimize fleet performance. Learn how to turn insight into action across your fleet.
Read More →
Driver Retention: Motive Automates Driver Coaching & Driver Rewards
New automated rewards and recognition capabilities from Motive can help organizations engage drivers, reinforce positive behavior, and reduce turnover. AI Coach has also been updated to deliver personalized feedback across safety, fuel, and compliance.
Read More →
Experts Forecast Broader Impact of Wildfires in 2026
This year’s wildfire season will likely be more intense than in 2025. The 2026 wildfire forecast from AccuWeather is for fewer fires, but even more acreage will be impacted this year.
Read More →
A Walkthrough of the DataQs Process
Bad data on your carrier record can cost you. Here’s how DataQs helps fleets challenge errors before they hit CSA scores, insurance, and your bottom line.
Read More →

