Sudafed and diving

[driftwood]

I remember in my OW class that we were told to not use Sudafed.

Yesterday, my wife saw the most highly recommended ENT in our area. She often has trouble equalizing on the first dive and it takes her a bit to get to depth. Dr. Shepard, who also dives, said he never understood the reason recreational divers shouldn't take Sudafed.

Personally, we are going to take the doctor's advise over PADI's.

 

[BRT]

There may be lots of reasons to not use Psudoephidrine while diving but without it I couldn't dive so I use it and have for 30 years.

 

[DevonDiver]

When I was a novice diver, I attempted to dive with Sudafed. It gave me palpitations and trembling at depth. I would never use it again for diving.

Taking the word of one doctor over the recommendations of the scuba agencies is short-sighted. Where do you think the scuba agencies get the information from which to make their recommendations?

Your doctor may not "understand the reason recreational divers shouldn't take Sudafed", but they are looking at it from a medical perspective, not a diving perspective. I take it that the doctor isn't practiced in diving medicine or an active/experienced diver themselves?

My partner is an ENT MD. Her awareness of specific diving issues is virtually non-existent.

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

This thread should be in the Diving Medicine forum, where qualified medical advice would likely be contributed.

 

[drrich2]

I use 24 hour Sudafed; I've used 12 hour Sudafed before. I have chronic 'allergies,' and equalizing can be tough at times for me. The medicine makes it easier. I have around 190 dives or so, I've had a reverse block twice, and it hurts and is frightening. There's no guarantee you'll work through it, and you eventually have to go up or drown. I don't know what water rushing through a ruptured ear drum into the middle ear feels like, and I'd rather not find out experientially.

The reasoning I've heard put forth in the past is that if you need a decongestant to prevent squeeze or reverse block, and take it, there is a chance it'll let you descend, then wear off, so you can't equalize and thus put you in reverse block. The temptation to use Sudafed to dive despite an unusual event such as a cold causing unusual congestion is, well, substantial. A lot of people travel to dive. Spend money on plane tickets, etc..., for a trip they might get once per year. So you see the dilemma.

For those of us with modest difficulty equalizing at times, as a long-term 'baseline' issue rather than transient acquired illness, some use Sudafed. I go for the long-acting versions. If I never get a reverse block again it will be too soon!

Some of us can use Sudafed often with no discernible physical symptoms. Some, such as DevonDiver made clear, have a very different experience.

So the question isn't just 'What about Sudafed?' It's also 'What about you?'

Richard.

P.S.: I'm not advocating or opposing you or anybody else using Sudafed. And I use the one with Pseudoephedrine as the active ingredient; my comments and opinions only involve that. Beware, as you may see the brand name used on medicines with another active ingredient.

 

[James Robertson]

my ENT told me to always use 12 hour sudafed and afrin before i go diving. And before flying. But i had serious eustachion tube issues caused by TMJ.

 

[pasley]

Not a Doctor or otherwise qualified expert. The below is not advice but only my opinion.

All agencies teach that if you need medication to dive, don't dive. Base reason is as follows:
1. Drugs are not evaluated at multiple atmospheres of pressure. The effects of the drug at depth are not known of a certainty. The drug could be absorbed more slowly, or more rapidly or in some other manner behave in the body differently from the way it did in clinical trials at one atmosphere.
2. IF the drug wears off during the dive, that could create challenges for the diver. See item number 1.

When discussing any medical question you need to talk to a Dive Medicine Doctor....That is a doctor who has taken additional training in this area of expertise. It is NOT an MD that SCUBA dives. There are Dive Medicine Doctors for various subareas such as ENT, Heart, etc.

Two quick stories:
A. This is friend of friend story. Friend knows someone who started new medication. On land, it was fine no ill effects, at depth, they dozed off.\
B. Personal story. When I started diving, as a person with allergies and a long history of sinus infections my doctor at the VA prescribed SUDAFED for me. Short story I started having absolutely freezing hands and feet on land. I mean my wife would say an ice cube was warmer than my hand. Eventually I called the VA Hospital and was told to get to the Emergency Room immediately. HUH? For cold hands and feet? Really? But I went. Diagnosed with a condition called Renaud's, that in extreme circumstances can result in amputation of the hands and/or feet as it cuts off the circulation at the wrist and ankles. They told me to stop taking the SUDAFED as it is a vassal constrictor and exasperated the problem. Did Sudafed cause the problem? No it did not, but it made it worse. I stopped taking it and have had only mild and sporadic attacks since.

 

[driftwood]

He also recommended the 12h sudafed.

About the responses I expected from the thread.

 

[thanksforallthefish]

Have been using sudafed for 25 years and no adverse affects and know quite a few other divers who also use sudafed.

We were told in our OW course that sudafed was one of the few medicines that were known to be safe to use when diving.

 

[theskull]

Sudafed is generically known among divers as SCUBA Candy. Many have more comfortable dives because of it, and a few could not dive without it. But it is a drug, and PADI and your Instructor are not your doctor and are therefore best advised to not recommend it to you. There are a few individuals who for medical reasons should not combine Sudafed with diving, and fewer who should not take it at all, and that is why it must be universally poo-poohed, with exceptions prescribed for you individually by a doctor.

theskull

 

[AfterDark]

I've only used Sudafed and similar drugs when diving for money other than that the risk of reverse block is IMO too high. Maybe for people with physical defects in their sinus /ears or chronic allergies who dive on vacation it's worth the risk? I'm sure if I found myself in that situation I'd be popping the pills.

Some of the sea sickness meds have made me a bit more loopy than I am normally so I avoid them. Drugs / alcohol and diving aren't a very good mix under the best of conditions (youth, health, physical condition) and should be avoided whenever possible IMO.