Need Alternative To Sudafed 12 Hour

[kr2y5]

Sudafed doesn't seem to work for me recently, but when it did, I'd take a regular (small dosage) pill before packing my stuff and driving to the dive site, a pill right before jumping in, and a pill in-between dives. My understanding is that, the effects of the medication first increase, and then decrease over time, and by taking a few pills, spaced out in time, their effects could be maintained at a somewhat similar level throughout a 2-tank dive trip. Disclaimer: IANAD and I could be saying complete nonsense. Hopefully, someone, who knows what they're talking about will correct me. Stay away from the fake Sudafed ("PE"), it's useless.

 

[mi000ke]

I always use generic/house brand pseudoephedrine 4-6 hour tabs (go my last batch at Walgreen pharmacy). I have never had a problem when doing two dives, as we're typically talking about no more than 1 hour down, then maybe an hour surface interval at most, then another hour down. I take them usually just before getting on the boat. And for me, I find that clearing my ears on the way up is easier than on the way down, so while the pseudoephedrine has never worn off while I was diving, even if it did (and it would not completely wear off anyway) I figure it would not be a huge problem at the end of a dive.

 

[tbone1004]

oh, it should also be known that most ear problems I've seen haven't been congestion related, but inflammation related. While I don't necessarily like doing it, if I'm not feeling 100% or I know I'm going to be bouncing up and down all day *i.e. following students or new divers*, then I will take NSAIDS the morning of, and immediately following the dive to prevent any inflammation from occurring

 

[WarrenZ]

I use Claratin D 24 hour with great success. I have to be careful that I am taking psudoephedrine as I am allergic to Phenylephrine (makes my lungs fill up with fluid).

 

[Aquavelvet]

I use Claritin (loratadine) for allergy control and Flonase to keep the sinuses and Eustachian tubes open. I use both during the times when my allergies are active, whether I'm diving that day or not. I have also found that two tabs of Alleve (Naproxen Sodium) in the morning of a dive day help prevent a number of issues caused by inflammation.

 

[maj2]

Clint:
I am in Canada as well, a diver and pharmacist, so should be well positioned to try and answer. I also suffer hayfever in the summer, so am not unfamiliar with your plight!

However, please keep in mind that I am not familiar with the specifics of your case, other medical conditions that may prevent the use of certain options, etc. As such cannot recommend specifics, but offer the following as general suggestions only. Please consult further with your physician or pharmacist who will be more familiar with your specific situation.

I took a look on Health Canada's Drug Product Database, and Sudafed 12 hour looks to be discontinued. It is listed as "Cancelled Post Market," which usually means discontinued. This is not necessarily surprising with products like this that are "single entity pseudoephedrine" products. The drug can be a precursor to producing methamphetamine, so when sale of single entity pseudoephedrine products was pulled to behind the counter, sales kind of died. In any case-- it is not that your pharmacy is no longer carrying it. They simply can no longer get it.

Not sure if you are using an antihistamine already for your chronic allergy problems. If so, I would look for the decongestant-containing version of the same. Claritin Allergy & Sinus, Reactine Complete and probably some store brands would all have a 12 hour pseudoephedrine component as well as an antihistamine that will also help allergy symptoms. Just check the ingredients-- if it contains pseudoephedrine 120mg, it will have the same active ingredient as Sudafed 12 hour (in addition to the antihistamine). Both Claritin Allergy Sinus and Reactine Complete show as "Marketed" by Health Canada at the moment. These should accomplish the same thing as Sudafed 12 hour, and probably a better choice for allergy problems anyway. Just note that if you are already taking an antihistamine, do not double up. If you take Claritin, just switch to the 12 hour decongestant product for your diving days and go back to the 24 hour antihistamine on non-diving days. Similar if you are taking Reactine or a store brand. Check ingredients to be sure.

Another option would be a 12 hour nasal spray such as oxymetazoline (Drixoral spray, Long Acting Dristan and several others). Do not get in the habit of using these for extended periods. Use for a few days for rough patches is fine, and I have used them with success before diving in combination with my antihistamines when my allergies are particularly acting up. I cannot emphasize enough avoiding long term use (anything more than 3 or 4 days) of these products!

Others in the thread mentioned nasal steroid sprays such as Flonase or Nasonex. These are just in the process of being made available over the counter in Canada, and some are now available without prescription here. These can also be effective for allergies, and are a far better choice for longer term use that are the nasal decongestant sprays. Do not expect rapid results though-- they take a few days of regular use to reach maximum effect.

Good luck in your search!

 

[WarrenZ]

Also read up on Psudoephedrine and the increased risk of Oxtox if you are using nitrox.

 

[DocVikingo]

Also read up on Psudoephedrine (sic) and the increased risk of Oxtox if you are using nitrox.

While there is no definitive proof of this of which I am aware, there is theoretical reason, anecdotal case report data, and diving medicine expert opinion suggesting that sympathomimetic drugs (drugs that mimic adrenalin in effect), such as pseudoephedrine, may predispose one to central nervous system oxygen toxicity when diving on enriched air.

Regards,

DocVikingo

 

[DocVikingo]

I took a look on Health Canada's Drug Product Database, and Sudafed 12 hour looks to be discontinued. It is listed as "Cancelled Post Market," which usually means discontinued. In any case-- it is not that your pharmacy is no longer carrying it. They simply can no longer get it.

In the US, Sudafed 12 Hour is still manufactured & available behind the pharmacy counter.

Another option would be a 12 hour nasal spray such as oxymetazoline (Drixoral spray, Long Acting Dristan and several others). Do not get in the habit of using these for extended periods. Use for a few days for rough patches is fine, and I have used them with success before diving in combination with my antihistamines when my allergies are particularly acting up. I cannot emphasize enough avoiding long term use (anything more than 3 or 4 days) of these products!

Indeed. See post #3 in this thread--> Afrin rebound effect?

Regards,

DocVikingo

 

[DocVikingo]

If your a DAN member, or even if you are not, give them a call. The physicians there are the medical experts in diving medicine, I'm sure they will have a better suggestion than anyone on SB.

Poppycock, SOF Diver,

If I might, I'd like to offer a few words about the "call DAN" reflex. While it often is a wise idea to inquire of DAN, a world-recognized organization, one needs to appreciate the likely limitations of doing so.

For example, when one contacts DAN they first, and often only, speak with a paraprofessional (e.g., registered nurse, diving EMT). These folks often simply thumb to DAN's medical FAQs (in this instance, most likely something along the lines of this one --> Taking medications when you dive. — DAN | Divers Alert Network — Medical Dive Article) and read or email a paraphrasing to the individual. They frequently are quite busy and give the briefest possible reply. For understandable reasons, DAN typically provides very limited direct physician access, and then only as required. As such, the answers received from one of the experts on the Diving Medicine and Ask Dr Deco forums are likely to be longer and more informative than the responses from DAN, even when both are in essence correct.

Also, these scubaboard.com forums typically afford more opportunity for rapid give and take between participants than is the case with DAN. Finally, links to previous board threads on the topic, professional magazine and journal articles on the subject, and other reference sources are often given on this forum, another nicety not usually provided in a DAN reply.

And, DAN does occasionally gives a rather shaky response. For example, their reply to an inquiry about the possible effects of massage on divers seems to be quite weak and disappointing (Pre/Post Dive Massage Therapy).

It would seem wisest to pose diving medicine inquiries to a range of sources and see how the opinions rank based on the factual and theoretical support given an opinion, the thoroughness and clarity of the response, and other relevent factors.

DAN is a very worthy and valuable organization, but it in fact is not the be all and end all of diving medicine fact and opinion. It is an excellent resource for acute diving injuries and their website has quite a few good articles on it about medical conditions and medications. But I don't think in the case of something like the present question, which is not an emergency, that there is any reason why the OP cannot expect to get safe and effective answers on this Diving Medicine forum from such professionals as the diving medicine expert and pharmacist who have already responded.

Regards,

DocVikingo