Allergies and diving

[lord1234]

So right now in New England, it is the height of allergy season. I take Allegra D and sometimes FloNase(when I forget the allegraD) to combat my nasal symptoms(those are all that I exhibit). Is this ok while diving? I find that the pills tend to last 12 hours with a 1 hour lag time between when I take them and when they activate. Same with the flonase.

 

[BillP]

Allegra D is fexofenadine- a "non-drowsy" anithistamine plus pseudoephedrine- a decongestant. Antihistamines reduce the effects of histamine- a chemical released by the body that adds to the swelling/stuffiness and drainage associated with allergies. Pseudoephedrine (eg Sudafed) reduces swelling of the mucosa linings of the nose and sinuses. Some people are made sleepy by fexofenadine, which could affect fitness to dive, but otherwise "non-drowsy" antihistamines are generally considered safe to use when diving. You can read a lot about pseudoephedrine and diving by doing a search on the board. You can read specifically about Allegra D (including side-effects, etc.) at:

http://www.aventis-us.com/PIs/allegra_d_TXT.html

Flonase is a nasal steroid. It reduces the inflammation associated with allergies. It works better for most people when used regularly rather than just occasionally. Nasal steroid sprays are generally considered safe to use when diving. You can read more about Flonase at:

http://us.gsk.com/products/assets/us_flonase.pdf

For many divers with allergies, the risk of not treating the allergies and diving with congestion is greater than the risk of taking the medications while diving. But no medication is without risk.

HTH,

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.

 

[DandyDon]

Very Good Answer Bill! :35:

Now from a stumbling diver with no medical training: I take antihistamines the night before and an hour before any boat ride to help prevent motion sickness, and if I am not diving Nitrox - include pseudoephedrine to help with equalizing. But then, I take both twice a day every day year 'round for allergies anyway, so I am not risking the reactions occasionally encountered by those who are not accustomed to the two OTC drugs.

 

[lord1234]

aah, then I guess I will be sticking with the flonase and discontinuing use of Allegra D...

Planning on taking Nitrox class soon...and have read enough about it to be concerned about the side affects of psuedoephedrine.

 

[Lightning Fish]

Very Good Answer Bill! :35:

Now from a stumbling diver with no medical training: I take antihistamines the night before and an hour before any boat ride to help prevent motion sickness, and if I am not diving Nitrox - include pseudoephedrine to help with equalizing. But then, I take both twice a day every day year 'round for allergies anyway, so I am not risking the reactions occasionally encountered by those who are not accustomed to the two OTC drugs.

Don:

You may already be aware of this, but... pseudoephedrine has a rebound effect. It helps to clear up the sinuses, but later, if used too often, the sinuses will be even more plugged due to the rebound. Some people then take more pseudoephedrine to clear up, then when it wears off they get the rebound, then they take more.... A friend of my wife's used a nasal spray for 10 years before he stopped using it. Everyday he would be plugged up and not knowing about the rebound effect, he just took more.

So, my question to you is: do you really need to take pseudoephedrine everyday? Not trying to throw a wrench into your life, but...

Cheers,
Bill.

 

[BillP]

pseudoephedrine has a rebound effect.....

A friend of my wife's used a nasal spray for 10 years before he stopped using it. Everyday he would be plugged up and not knowing about the rebound effect, he just took more.

Howdy Lightning Fish:

I think that you might be comparing apples and oranges here. You're right that decongestant nasal sprays (like Afrin/oxymetazoline) have a very marked "rebound" effect in many people when used for just a few days. When you stop taking decongestant nasal sprays you can be just as congested- or more- just from stopping the spray. But pseudoephedrine is generally taken orally, and has much less of a "rebound" effect. Scubadoc goes so far as to say that he believes that pseudoephedrine (eg Sudafed) doesn't have a rebound effect at all (see http://www.scubaboard.com/showthread.php?t=2567).

Do you have evidence to the contrary, or is this just what you've heard?

Bill

 

[BillP]

aah, then I guess I will be sticking with the flonase and discontinuing use of Allegra D...

Planning on taking Nitrox class soon...and have read enough about it to be concerned about the side affects of psuedoephedrine.

It's certainly fine to avoid pseudoephedrine if you're concerned about it. Keep in mind, though, that they do make a formulation of Allegra without pseudoephedrine (just plain "Allegra" without the "D")

HTH,

Bill

 

[DandyDon]

So, my question to you is: do you really need to take pseudoephedrine everyday? Not trying to throw a wrench into your life, but...

Cheers,
Bill.

I just take it orally as indicated by symptoms, very seldom as a prophylactic. And I've been taking OTC decongestants of one type or another for 40+ years.

I guess I could explore other avenues with a physician, but the suggestion has always been scheduled shots, and I really prefer a PRN pill. Every now and then, tho, I have an acute attack - and nothing helps, nothing gets done in my life for a day. My brother is still farming, so he gets those, too

It's certainly fine to avoid pseudoephedrine if you're concerned about it. Keep in mind, though, that they do make a formulation of Allegra without pseudoephedrine (just plain "Allegra" without the "D")

HTH,

Bill

That would simply be the antihistamine without the decongestant, right. AllergraD incldues the decongestant, as I understand. Put on the reading glasses (sold in the same department) and read the ingredtiants.

Let me offer cautions here to anyone who maybe be reading this but has never taken PSE (pseudoephedrine) and/or antihistamines...

PSE is chemically similar to "speed" and some people get that effect, elevated pulse, excitability, etc. Be careful the first time.

Many antihistamines claim to be non-drowsy, but I have seen them knock people out for many hours. It unlawful in some states to take them and drive.

 

[markfm]

The shots can be interesting -- I started getting them after I broke out in welts from my allergies. Five years later, about to end the shots, I still take antihistamines every so often, but at least no more blotches

On the down side, I'm a lard-butt desk jockey by trade, and the darned air system bites. The air tests negative, but it's a mix that's just right to generate allergy-like reactions, from myself and multiple colleagues. Drowsy, sneezing, but nothing nominally "bad" about the air.

 

[Lightning Fish]

Howdy Lightning Fish:

I think that you might be comparing apples and oranges here. You're right that decongestant nasal sprays (like Afrin/oxymetazoline) have a very marked "rebound" effect in many people when used for just a few days. When you stop taking decongestant nasal sprays you can be just as congested- or more- just from stopping the spray. But pseudoephedrine is generally taken orally, and has much less of a "rebound" effect. Scubadoc goes so far as to say that he believes that pseudoephedrine (eg Sudafed) doesn't have a rebound effect at all (see http://www.scubaboard.com/showthread.php?t=2567).

Do you have evidence to the contrary, or is this just what you've heard?

Bill

Hey Bill,

My information is from what I've read and from my doctors. When I take pseudoephedrine orally, it clears me up but later I am really congested. Is it rebound or is the congestion just accentuated because I spent the last several hours clear and able to breath?

In the thread you quoted, Scubadoc says "Sudafed does not cause rebound congestion when taken by mouth.", which is interesting. I will have to talk to my doctor about it next time I see him. Very interesting actually. A drug is a drug is a drug ... How is the method of ingestion important in this case?

Bill, what is your expertise?

Thanks, I may have learned something today.

Cheers,
Bill.