Ipratroprium?

[afdgf]

Not a doctor, not going to pretend to be one, but am prone to congestion from a combination of flying/allergies/air quality. For me, the difference between a good dive trip and a bad one is going in with clear sinuses.

Not sure if you've looked into either, but for me, long term use of generic flonase (fluticasone priprionate) every evening in the weeks leading up to a dive trip and during, and short term use of generic afrin (oxymetazoline hcl) the mornings of dives up to three days in a row really makes a difference, much easier equalization, and much less congestion after the dive and no mild barotrauma. I take the fourth day off usually, let the afrin blowback run its course with a 1-2 day SI (Beer and tequila day!) And then can do 3 more days of clean diving.

Near as I can tell, both are relatively safe and not as big of a risk of wearing out on a dive causing a reverse block as oral decongestants like psuedoephedrine.

Yes, I have taken two squirts of Dymista (the pharmacy switched me to the generic) twice a day on each side for years now. I sometimes do afrin, but the package insert says "rebound inflammation" if you take too much which I have done. "Rebound inflammation" is one of the worst euphemisms ever.

 

[Duke Dive Medicine]

Yes. I did a PubMed search and came up with nothing.

Oral pseudoephedrine and ipratroprium nasal spray do different things. Pseudoephedrine is a decongestant, and ipratroprium is an anticholinergic agent that inhibits secretions. If you have congestion, ipratroprium won't relieve that. There is no research on ipratroprium and diving, but it could lead to mucosal drying and irritation which could be aggravated by dry breathing gas. If you decide to use it, I'd recommend having a conversation with the prescriber about diving.

Best regards,
DDM