Sudafed / Pseudoephedrine & Diving (on air)

[Cacia]

The combination makes me extremely restless and paranoid almost to the point of terror on a dive as shallow as 50 feet. I don't notice these feelings on land when I combine the two though.

yes, me too. I taked it topside..its fine. I dive and at depth, I get that. Makes me wonder if the depth intensifies the drug's actions??? Or like Charlie says...the slightest adrenaline with the sudafed on board was not a good feeling. I worry when people who have never taken it get offered or encouraged to take it right before a dive...yet, many do swear by it. I had this overwhelming "air hunger" type of anxiety, I guess it was.

 

[DandyDon]

yes, me too. I taked it topside..its fine. I dive and at depth, I get that. Makes me wonder if the depth intensifies the drug's actions??? Or like Charlie says...the slightest adrenaline with the sudafed on board was not a good feeling. I worry when people who have never taken it get offered or encouraged to take it right before a dive...yet, many do swear by it. I had this overwhelming "air hunger" type of anxiety, I guess it was.

Sounds like you cope with the effects on land, but additional effects at depth aggravate it? Interesting to note that it can do so with such an experienced diver, too. We're all unique, like everyone else.

I'm no medical pro, not even a very good vet assistant, but I'd suggest trying it on land a few times, then before flying, then - on increasingly deeper dives, watching for bad effects, being prepared to abort & ascend.

 

[Scuba guy Traveller]

I have been diving since i was about 6 years old and am now 50 i have narrow eustachian tubes and require Pseudoephedrine to be able to clear properly i have dived on air and anything up to 40% nitrox i take a tab just before i gear up and have never had a problem ever.

 

[Lostdiver71]

Unfortunately the research on this is very limited. That being said some people have no problems, some have varied symptoms and there have been at least a couple of deaths that have been attributed to taking Sudafed and diving. Your experience may vary! I personally will not take it before diving due to the risk and that I have had a reverse block in the past after it wore off prematurely, a reverse block while surfacing is not fun! Fortunately I had enough gas to make an extremely slow and painful ascent!

 

[DandyDon]

A 14 year old thread revived...!!

there have been at least a couple of deaths that have been attributed to taking Sudafed and diving.

Really? Can you cite any case studies? I'm only aware of circumstantial theories.

I personally will not take it before diving due to the risk and that I have had a reverse block in the past after it wore off prematurely, a reverse block while surfacing is not fun!

I suppose that you are simply being cautious, but there are divers who cannot equalize without it. Perhaps you needed to take the extended release version.

 

[Lostdiver71]

Unfortunately I can not, most of the information that I remember came from articles that were written in the late 1990's to early 2000's. I know the DAN Alert Diver magazine and the PADI Undersea Journal both had articles that were about Sudafed and diving. They both recommended that you should not dive while on Sudafed. It was also mentioned in at least medical conference on diving back then, I used to have time to watch the videos or listen to the audio of the conferences. As I no longer work in the industry professionally, I no longer have to dive when conditions or my health is less than optimal so if I am overly congested I just do not dive. If I run across any of those articles or conferences in the future I will make sure to post them to this thread.

 

[BoundForElsewhere]

Obviously, if sudafed makes you loopy, don't take it.
Test it before you get in the water. If a 12 hour pill only works for 4 hours, don't take it.
Start with one. If that doesn't work, move up to 2. Again, test before getting in the water.
Start using flonase one week before your trip and continuously through your trip.
Generally speaking, you should always be very aware of exactly how your body reacts to different stimuli, whether that be medications or environmental. Be alert, if you feel off, don't get in the water.

There's a reason its called scubafed.

 

[victorzamora]

If I'm recalling correctly, the negative stigma some people have with Sudafed+Scuba was from a single oxtox study where two of the divers that toxed were on Sudafed, and the researchers noted it as an "unstudied variable" but made no recommendations or suggestions to stop diving with Sudafed.

Plenty of technical divers take Sudafed and push their CNS and OTUs beyond recommended limits.

 

[Duke Dive Medicine]

A 14 year old thread revived...!!

Really? Can you cite any case studies? I'm only aware of circumstantial theories.


I suppose that you are simply being cautious, but there are divers who cannot equalize without it. Perhaps you needed to take the extended release version.

Here's an article written by the late (great) Ed Thalmann in 1999 that breaks it down pretty well. This may be what @Lostdiver71 remembers.

Pseudoephedrine & Enriched-Air Diving? — DAN | Divers Alert Network — Medical Dive Article

There's some newer literature:

Systematic review on the effects of medication under hyperbaric conditions: consequences for the diver. - PubMed - NCBI

Here's one that tested high-dose (40-320 mg/kg) pseudoephedrine on unanesthetized rats. For a 70 kg/154 lb human, this equates to 2800 mg - 22,400 mg (recommended adult dose is 60 mg by mouth every 4-6 hours as needed):

High doses of pseudoephedrine hydrochloride accelerate onset of CNS oxygen toxicity seizures in unanesthetized rats. - PubMed - NCBI

Quoting the authors: "Extrapolating our findings to humans, we conclude that the recommended daily dose of PSE should not be abused prior to diving with oxygen-enriched gas mixes or pure O₂."

Best regards,
DDM

 

[mi000ke]

I take two of the 4 hour tabs every time I dive (always on EAN32) as I have cranky eustachian tubes. Have never had any observable side effects. I'm pretty cautious about staying above MOD @ 1.4. I do always feel energized after a dive, and thought that might be the nitrox talking. But maybe it's the pseudoephedrine.