ENT Recommended Sudafed

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waterdogs

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charlotte north carolin
Folks, returned from my ENT yesterday to get checked out before beginning our OWC classes and explained that I've had trouble in the past equalizing. He recommended, and wrote a perscription for Sudafed.

Question: Does this really work? Secondly, which i forgot to ask, when do you take it? Night before morning dive? A few hours before?

He's a DAN recommended ENT so I believe his advice, just wanted to hear from the folks out here.

Anyone taking it and when?

waterdogs.
 
I personally can't take Sudafed 'cause I'm one of the few who has an adverse reaction to it. If you've never taken it before, I'd recommend you take it on a non-diving day to make sure you don't have any adverse reactions... you wouldn't want to discover one under water.
Rick
 
Waterdogs,
Take Rick's advise and try it on a non diving day. For me, taking a Sudafed is like taking a sleeping pill, knocks me right out. Check it out before you dive. :tree:Bob
 
Hey, thanks, I will try it this weekend, cold outside and not much to do so if it does make me drouzy ill take that much needed nap.

I read a post on here sometime ago on this, couldn't find it, hence the question.

waterdogs'
 
Hi waterdogs:

The advice that you got from Rick and Bob to try (any) medicine ahead of time when you will be taking it with diving is excellent advice. Any medicine that is supposed to have an effect can also have side-effects- even if it's over-the-counter (OTC) or "all natural". Rick's rapid heartbeat reaction to Sudafed is much more common than Bob's sleepiness, but even rare reactions occur in some people. You'll want to know how a medicine sets with you before you dive on it.

About "Sudafed". I have counted no less than 11 different formulations sold under the "Sudafed" name. When you discuss medicine, it's important to know exactly what you're talking about since different medicines have different effects and side-effects. For example, "Sudafed Cold and Allergy Tablets" contain pseudoephedrine (the medicine most commonly associated with the "Sudafed" name-see below) and chlorpheniramine maleate- an antihistamine that causes drowsiness in some people. I have a personal bias against combination medicines unless it is clear that you will always need all of the different medicines in the combo pill. I'd much rather just take what I need when I need it and leave out any "extras" that I could do without. I think it interesting that your physician wrote a prescription for "Sudafed" since all of the "Sudafeds" that I'm aware of are available OTC in the US without a prescription. You should find out exactly what you have.

Now, about pseudoephedrine. When most divers talk about "Sudafed" they usually mean the active ingredient that I think is common to all of the "Sudafed" formulations- pseudoephedrine. Pseudoephedrine is a sympathomimetic amine in the same general family as epinephrine (adrenaline). It can cause dizziness, insomnia, agitation/nervousness, headache, palpitations, rapid heartbeat, and other side-effects. It works by constricting blood vessels- particularly those of the upper respiratory tract- reducing swelling of the linings of the nose, sinuses, etc. Pseudoephedrine is absorbed rapidly and easily through the intestinal tract and goes to work quickly. The "half-life" of a typical non-extended release 30mg dose in most people (the time it takes for half the drug to be eliminated) is about 4 hours, but that rate of elimination can be variable between divers.

Let's talk about some of the specific formulations of the "Sudafed" brand commonly used by divers and their differences.

"Sudafed Nasal Decongestant Tablets" have 30mg of non-extended release pseudoephedrine. It takes effect quickly (I'd guess within the hour in most people- but that's just a guess) and typically continues to have the desired effect for 4-6 hours. If you take it the night before a morning dive and don't take it again before the dive, it will no longer be working and you might even have some "rebound" from the effect of the drug wearing off and be more congested than before. For most people it would probably work best to take it an hour or so before the dive, and I would personally plan to be finished diving 3-4 hours later when the effects of the drug will possibly be waning.

"Sudafed 12 Hour Tablets" contain 120mg of pseudoephedrine. It looks to me like all of the pseudoephedrine in this formulation is in the time-release form. That would suggest to me that it would take longer to take effect than the "Sudafed Nasal Decongestant Tablets", but since it is released continuously during its course of action, the time it would begin to wear off should be more predictable. "Sudafed 12 Hour Tablets" (or their generic equivalent) are my personal decongestant of choice on those occasions when I take pseudoephedrine and dive. They don't usually cause me to have insomnia, so I generally start it the night before a morning dive, and take it again in the morning the day of the dive- about 12 hours after the first dose. The effects of the drug should last my whole morning of diving and into the afternoon (or even evening).

"Sudafed 24 Hour Tablets" contain 240mg of pseudoephedrine. 60mg of the pseudoephedrine is in an immediate-release coating and 180mg is in a time-release form. It should take effect quickly when taken the morning of a dive (like the "Sudafed Nasal Decongestant Tablets" above), yet reliably last for a full day of diving with its time-release throughout the day- perhaps even including a night dive.

Again, drugs affect different people differently, and any drug can have untoward side effects. It's a good idea to try any new medicine before diving. You should be fully aware of what you're taking, the medicine's planned effects, and its potential side-effects before taking it when diving.

HTH,

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual. All questions concerning medicines and/or medical conditions and diving should be discussed between the diver and their personal physician and/or DAN before diving.
 
Haven't filled the perscription yet and just like any other doctor, can't read the darn thing, but it looks as though the drug may be called "duratuss", form of sudafed.

Once I get it filled, i will again call the ENT to determine exact time and longevity of effects, etc. I will try it out first then decide if it's best for me based on any side effects.

thanks, lots of info to asimulate.

waterdogs.
 
Cool. Drug makers have found that marketing multiple medicines under a common name is good for business. There are at least 5 different formulations sold under the "Duratuss" name. I don't know what you have, but plain old "Duratuss Tablets" contain 120mg of pseudoephedrine and 600mg of guaifenesin.

Guaifenesin is an expectorant that is supposed to loosen phlegm and make it easier to, uhm, get rid of it. My pharmacy professors oh-so-long-ago told me that guaifenesin doesn't work, but it's unlikely to hurt anything.

I don't know specifically about Duratuss, but the 120mg dose of pseudoephedrine would suggest that it's in a time-release form similar to "Sudafed 12 Hour Tablets". If you go to the pharmacy when they're not busy, the pharmacist can probably look it up and tell you specifically.

HTH,

Bill
 
<completely off topic post/>
Waterdog-

You're from Charlotte? I live in Charlotte (Huntersville to be precise). We're fairly new to the area. Drop me a line and fill me in on where you dive and what shop you frequent.

I'm still getting my bearings on the local dive scene.

Scott Beach
scott_beach@beachcreative.com
</completely off topic post>
 

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