Work Truck Logo
MenuMENU
SearchSEARCH

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.

Ad Loading...

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. 

Ad Loading...

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.

Ad Loading...

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.

Ad Loading...

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. 

Subscribe to Our Newsletter

More Safety

Graphic featuring fireworks on a blue background with the headline "Stay Safe on the Road This July 4th" and the subheading "Tips From a Former Truck Driver." The image promotes road safety during holiday travel and accompanies advice on avoiding truck blind spots, passing safely, leaving adequate space around trucks, and planning travel during busy traffic periods.
Safetyby StaffJune 18, 2026

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 →
Graphic for NSC National Safety Month featuring warehouse, trucking, and transportation workers. Text highlights safety priorities including moving safety forward, road safety, worker health, and preventing slips, trips, and falls.
Safetyby StaffJune 16, 2026

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 →
Person using a laptop to view a fleet management dashboard displaying weather alerts, vehicle speed data, maps, and road-condition images. The screen highlights a snowy roadway and a lake-effect snow warning for a fleet vehicle.
Safetyby News/Media ReleaseJune 12, 2026

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 →
Ad Loading...
Graphic showing the word “RECALL” painted in large yellow letters across a road surface with double yellow center lines. “June” appears at top left, and the Work Truck logo appears at bottom right.
Safetyby Wayne ParhamJune 10, 2026

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 & Associates, Inc. Safety Professional of the Year award logo, featuring the company name, stylized “K” emblem, and bold “SPOTY” acronym above the title “Safety Professional of the Year.”
Safetyby News/Media ReleaseJune 8, 2026

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 →
A wide promotional graphic announcing changes to Automotive Service Professionals Month. The ASE Automotive Service Professionals Month logo appears above text announcing that beginning in 2026-2027, Automotive Service Professionals Month will move to April and October to align with Spring and Fall Car Care Months.
Safetyby Lauren FletcherJune 2, 2026

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 →
Ad Loading...
wheel geotab image
SponsoredJune 1, 2026

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 →
Presenter onstage at Motive Vision 26 conference beside a large smartphone display showing a driver rewards app, highlighting a first-place achievement in a Q1 Excellence Program with points, rankings, and Google Pay integration.
Safetyby Wayne ParhamMay 29, 2026

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 →
Graphic for Work Truck’s 2026 Wildfire Outlook featuring bold white text over an active forest wildfire scene, with flames spreading across wooded terrain against a red-orange sky.
Disaster Responseby Wayne ParhamMay 27, 2026

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 →
Ad Loading...
Graphic featuring a speech bubble with the text “DataQs?” centered between two white semi-trucks on a textured brown background, with the Work Truck logo in the upper left corner.
Safetyby Kathy CloseMay 26, 2026

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 →