Is it safe to take acetaminophen or a Nsaid after diving?

[Nitrox_DiverNY]

First:
Acetaminophen is not an NSAID. Ibuprofen Aspirin and Naproxen are NSAIDs.

All four of the above mentioned drugs are safe for divers. If you’re on a daily aspirin regimen though, you’re going to want to talk to your doctor about whether you have the cardiovascular health to dive safely.

Ignore comments about them being unsafe in recommended doses those are complete and utter bull crap. Stay within dosages on the label (they are actually FAR under the upper limit of the therapeutic window…). Do not drink alcohol or use another drug that metabolizes in your liver while taking a higher dose of acetaminophen. That’s where you’re going to run into problems.

With an NSAID like Aspirin, Ibuprofen or Naproxen, eat food with them or drink milk or a similar style drink to prevent ulcers and other damage to your stomach.

thanks for the help!

 

[Dr Simon Mitchell]

Just curious if taking acetaminophen or a Nsaid after diving is safe since the body is still off gassing. I only get a mild headache about one or twice a year but was curious to see if I had a headache, or other pain after a dive it would be okay to take either drug. Thanks for the help

Hello,

Just to put some perspective on this, the only published randomized double-blind trial of any intervention in decompression sickness (DCS) was an NSAID (as an adjunct to recompression). I have attached the paper. We showed that divers who received the NSAID had equivalent final outcomes to those who received the placebo, but they required fewer recompression treatments to achieve full recovery or plateau in recovery. I think you can infer from this that an NSAID is very unlikely to materially affect your risk of DCS after diving, and may actually be beneficial if you develop symptoms.

As Boulder John pointed out, NSAIDS are potentially part of the care map in first aid for DCS, and may also be employed alongside other first aid strategies like 100% oxygen breathing when treating mild DCS without recompression. Choices of therapeutic intervention should always be discussed with a diving medicine physician. I don't share DDMs concern about masking of DCS symptoms (though this was a concept that received some attention in times gone by). I feel comfortable making treatment decisions based on history (especially given that pain is essentially a subjective symptom rather than a sign), so if pain partially resolved with use of an NSAID but still had the characteristics of DCS-related pain, it would be very unlikely to influence my treatment decisions.

Simon M

 

[steinbil]

As Boulder John pointed out, NSAIDS are potentially part of the care map in first aid for DCS, and may also be employed alongside other first aid strategies like 100% oxygen breathing when treating mild DCS without recompression. Choices of therapeutic intervention should always be discussed with a diving medicine physician. I don't share DDMs concern about masking of DCS symptoms (though this was a concept that received some attention in times gone by). I feel comfortable making treatment decisions based on history (especially given that pain is essentially a subjective symptom rather than a sign), so if pain partially resolved with use of an NSAID but still had the characteristics of DCS-related pain, it would be very unlikely to influence my treatment decisions.

I guess the highlighted phrase would be key here? If the OP is asking about talking NSAIDs to remedy light head aches after diving, he's probably not going to consult a diving medicine physician. And if he doesn't, might taking the pain killer make him less likely to contact said physician because it masks symptoms?

A follow up question, since I have experienced this a few times:
- Are head aches (as the only symptom) an indication to contact a diving medicine physician for a dive profile within NDL?

 

[boulderjohn]

I'm not sure how that would happen. The Space Shuttles were pressurized to atmospheric pressure. Maybe during the extravehicular activities? Duke did a lot of work in refining and testing the O2 pre-breathe process prior to extravehicular activities so maybe before that work was complete?

It was the rapid change in altitude suring ascent. He said the same thing happens to U2 pilots.

 

[Duke Dive Medicine]

Hello,

Just to put some perspective on this, the only published randomized double-blind trial of any intervention in decompression sickness (DCS) was an NSAID (as an adjunct to recompression). I have attached the paper. We showed that divers who received the NSAID had equivalent final outcomes to those who received the placebo, but they required fewer recompression treatments to achieve full recovery or plateau in recovery. I think you can infer from this that an NSAID is very unlikely to materially affect your risk of DCS after diving, and may actually be beneficial if you develop symptoms.

As Boulder John pointed out, NSAIDS are potentially part of the care map in first aid for DCS, and may also be employed alongside other first aid strategies like 100% oxygen breathing when treating mild DCS without recompression. Choices of therapeutic intervention should always be discussed with a diving medicine physician. I don't share DDMs concern about masking of DCS symptoms (though this was a concept that received some attention in times gone by). I feel comfortable making treatment decisions based on history (especially given that pain is essentially a subjective symptom rather than a sign), so if pain partially resolved with use of an NSAID but still had the characteristics of DCS-related pain, it would be very unlikely to influence my treatment decisions.

Simon M

Simon, for clarity, I would not advocate withholding analgesia from someone with confirmed DCS pain nor do I see a scenario where a diver wouldn't be treated for DCS because the pain went away after taking medication. My concern would be a diver experiencing pain that could be related to DCS, medicating it with an OTC pain reliever, then not seeking help if the pain got better.

Best regards,
DDM

 

[OTF]

Could Aspirin's mild blood thinning/anti-clotting properties affect decompression either positively or negatively?

 

[Duke Dive Medicine]

Could Aspirin's mild blood thinning/anti-clotting properties affect decompression either positively or negatively?

Great question. The Undersea and Hyperbaric Medical Society has a position statement on their website about the use of aspirin in treatment of DCS - see "Adjunctive Therapy for Decompression Illness". Note that @Dr Simon Mitchell was one of the authors. TLDR is that there isn't much evidence to support its use in treating DCS. As far as prevention, there's no literature out there that would support its use.

Best regards,
DDM

 

[L13]

It was the rapid change in altitude suring ascent. He said the same thing happens to U2 pilots.

Still doesn't make sense. the Shuttle internal pressure was kept constant during ascent (unlike the U2).

 

[Divin'Papaw]

Providing anecdotal information from my own diving practice. I regularly take 1-2 Aleve (naproxen) a day when I'm on a diving weekend/trip. I follow the recommended instructions and take 1 every 12 hours at most, sometimes just 1 every 24 hours. I'm in pretty decent shape and regularly exercise including both cardio and strength training. But diving can be hard work and it works the body in different ways than my regular exercise routine. Maneuvering on a bouncing boat, diving in moderate to heavy current, and getting back up the ladder in heavy seas are common for the diving that I do. Aleve does a good job of managing my minor aches and pains associated with diving. I've been doing this for years. I've never had any issue with using Aleve in this way.

 

[Lorenzoid]

Aleve does a good job of managing my minor aches and pains associated with diving. I've been doing this for years.

And I thought soreness in just about every muscle of my body for two days after diving was how I was supposed to feel. Seriously, though, I have never taken a pain reliever out of the concern in the back of my mind of masking potential DCS symptoms. It is interesting that Dr. Mitchell characterized that as "a concept that received some attention in times gone by." So maybe a pain reliever after a day of diving is just fine after all.