Is it safe to take acetaminophen or a Nsaid after diving?

[tursiops]

Acetaminophen also has some psychological affects, including increasing risk-taking behavior:

Effects of acetaminophen on risk taking

From my layman's perspective, it looks like this is probably not a significant impact when taken within recommended dosages -- especially for someone like @Nitrox_DiverNY who's describing use only a few times a year.

This seems like an obvious and somewhat trivial study and result. If I think a risk might cause some pain, and I take some pill that will mask the pain, then my risk analysis changes. It is kind of like avoiding a really high-calorie dessert, but I'm less likely to avoid it if I'm told the calories will not be absorbed by me if I take this little pill first.

 

[tursiops]

Simon, for clarity, I would not advocate withholding analgesia from someone with confirmed DCS pain nor do I see a scenario where a diver wouldn't be treated for DCS because the pain went away after taking medication. My concern would be a diver experiencing pain that could be related to DCS, medicating it with an OTC pain reliever, then not seeking help if the pain got better.

Best regards,
DDM

This might be a lesser effect than just plain stubborness as a cause of not seeking help.

 

[Seaweed Doc]

It seems the conclusion on DCS and pain relievers is that risk isn't increased, though masking pain and not seeking help could be an issue.

However, there's been a lot of "stuff" said about which pain reliever to take. As an, ahem, "older adult" my own docs say acetominophen only, no ibuprofen. And I'm sad about that because vitamin I was my go to for pain relief. I'm also a rule follower when it comes to meds and don't take a few extra for added pain relief beyond recommended doses. But I am not you. Talk to your doctor about what's right for you to take for pain relief. Don't trust the ads, and don't trust random people.

 

[Duke Dive Medicine]

This might be a lesser effect than just plain stubborness as a cause of not seeking help.

Maybe a bit of that, along with machismo and the unfortunately pervasive culture of judging someone who has DCS as somehow inferior or having done something wrong.

Best regards,
DDM

 

[Nitrox_DiverNY]

Hello,

Just to put some perspective on this, the only published randomized double-blind trial of any intervention in decompression sickness (DCS) was an NSAID (as an adjunct to recompression). I have attached the paper. We showed that divers who received the NSAID had equivalent final outcomes to those who received the placebo, but they required fewer recompression treatments to achieve full recovery or plateau in recovery. I think you can infer from this that an NSAID is very unlikely to materially affect your risk of DCS after diving, and may actually be beneficial if you develop symptoms.

As Boulder John pointed out, NSAIDS are potentially part of the care map in first aid for DCS, and may also be employed alongside other first aid strategies like 100% oxygen breathing when treating mild DCS without recompression. Choices of therapeutic intervention should always be discussed with a diving medicine physician. I don't share DDMs concern about masking of DCS symptoms (though this was a concept that received some attention in times gone by). I feel comfortable making treatment decisions based on history (especially given that pain is essentially a subjective symptom rather than a sign), so if pain partially resolved with use of an NSAID but still had the characteristics of DCS-related pain, it would be very unlikely to influence my treatment decisions.

Simon M

very interesting, thanks for sharing!

 

[Nitrox_DiverNY]

Providing anecdotal information from my own diving practice. I regularly take 1-2 Aleve (naproxen) a day when I'm on a diving weekend/trip. I follow the recommended instructions and take 1 every 12 hours at most, sometimes just 1 every 24 hours. I'm in pretty decent shape and regularly exercise including both cardio and strength training. But diving can be hard work and it works the body in different ways than my regular exercise routine. Maneuvering on a bouncing boat, diving in moderate to heavy current, and getting back up the ladder in heavy seas are common for the diving that I do. Aleve does a good job of managing my minor aches and pains associated with diving. I've been doing this for years. I've never had any issue with using Aleve in this way.

thanks for providing your own experienced taking this medication while diving

 

[Koalaroo]

My own two cents and experience part of my osteo-arthritis management is up to 1000mg of Paracetamol (acetamenophen) per day, as needed. I cleared with my GP that this poses no danger to, after, before, or around Scuba Diving.
I also take 60mg Duloxetine (Cymbalta) for my Fibromyalgia treatment, and same here: No adverse advice to scuba diving

So I would assume, the normal headache treatment dose of an occasional 500mg of Tylenol/Panadol/Paracetamol/Acetamenophen should not pose any risk, unless you are inherently allergic to the drug. But that's then nothing to do with diving

 

[Germie]

As far as I know there is no risk about diving with ibuprofen, aspirin, naproxen, diclofenac and paracetamol. These painkillers are used quite a lot.

It seems that if you want to use a painkiller to prevent dcs, you can take aspirin. But also that is not completely known, and some people state it is a bloodthinner, that increases risk of bleeding. I met a diver in 2012 who took for every day decompressiondiving 2 aspirins to prevent dcs, he absolutly believed in this. I never tried.

 

[Duke Dive Medicine]

As far as I know there is no risk about diving with ibuprofen, aspirin, naproxen, diclofenac and paracetamol. These painkillers are used quite a lot.

It seems that if you want to use a painkiller to prevent dcs, you can take aspirin. But also that is not completely known, and some people state it is a bloodthinner, that increases risk of bleeding. I met a diver in 2012 who took for every day decompressiondiving 2 aspirins to prevent dcs, he absolutly believed in this. I never tried.

Please see post #27 above. There's no evidence that aspirin is effective in preventing DCS, and it does have anticoagulant effects that may increase the risk of bleeding.

Best regards,
DDM

 

[Nitrox_DiverNY]

My own two cents and experience part of my osteo-arthritis management is up to 1000mg of Paracetamol (acetamenophen) per day, as needed. I cleared with my GP that this poses no danger to, after, before, or around Scuba Diving.
I also take 60mg Duloxetine (Cymbalta) for my Fibromyalgia treatment, and same here: No adverse advice to scuba diving

So I would assume, the normal headache treatment dose of an occasional 500mg of Tylenol/Panadol/Paracetamol/Acetamenophen should not pose any risk, unless you are inherently allergic to the drug. But that's then nothing to do with diving

thanks!