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Class 4 medications are treated as a safety risk that cannot be accommodated in flight. They are considered disqualifying for aircrew because their effects can impair performance, judgment, or physiological function in the demanding flight environment. Therefore, aircrew on these meds are barred from flying and there’s no waiver pathway for Class 4; the status is mandatory disqualification. If you’re prescribed such a medication, you’d be grounded until the medication is stopped and you’re cleared afterward. That’s why the best answer is that they lead to mandatory disqualification.