Sudafed prior to diving--is it safe?

[Marie13]

The reason we are taking the meds is because we already had a problem on a dive and figured out the issue.

Haha. I’ve been taking allergy meds for constant congestion - at doctor’s instructions - since the early 80s, at least. Clearing my ears the very occasional times I’ve flown was not instantaneous.

 

[Duke Dive Medicine]

The Diving Medicine Q&A forum is in a learning zone and is flame-free. Kindly keep the discussion civil and relevant to the original post.

Best regards,
DDM

 

[NW Dive Dawg]

Not sure where this thread might have gone sideways. The OP stated a concern of O2 toxicity as a result of a friend who takes Sudafed in order to "help him equalize". I personally don't believe that there is an additional 02 ox risk......but admit that I don't know. My intention was simply to point out that there may be additional risk of a reverse squeeze if using a decongestant....like Sudafed, to circumvent any congestion condition...... and then that drug for whatever reason wears off or otherwise stops working during a dive.

 

[drrich2]

My intention was simply to point out that there may be additional risk of a reverse squeeze if using a decongestant....like Sudafed, to circumvent any congestion condition...... and then that drug for whatever reason wears off or otherwise stops working during a dive.

True. On the other hand, someone with some chronic congestion issues may not take decongestants or other assistive medication, dive (perhaps with some mild difficulty equalizing going down), then encounter a reverse squeeze on ascent. That reverse squeeze might not've happened had that person taken long-acting Sudafed, etc...

Which path offers the lesser risk isn't always an easy call. I think for some of us, long acting oral agents have a good personal/anecdotal track records and seem to help.

And people will push the envelope. Typical advice to call the dive if you're not feeling fully functional across the board may fall flat when on a multi-thousand dollar dive trip using precious vacation time for the 1 or 2 weeks that year you'll get to do this thing you love. My nose is a little stuffy, who cares about seeing a manta?

I've had reverse squeeze to a substantial degree twice over the years, both times on quarry dives, and it was painful and alarming. It's a risk worthy of concern.

 

[Colliam7]

FWIW: I have reverse block, in one ear only. Started years ago, and is intermittent. It manifests itself as discomfort appearing at depth of ~ 7-8 feet on ascent. I usually hang out at that depth for a minute or two until it clears. However, when I am instructing, and am with a group of students, that situation is 'inconvenient'.

I therefore take Sudafed before diving, on advice of my ENT physician (also a diver). It works. If I don't / forget to take it, I have a 50-50 chance of RB. When I do take it, I have not had any episodes of RB.

(Also, FWIW, I take pseudoephedrine, NOT Sudafed PE (phenylephrine). PE is pharmacologically weak, bordering on functionally inert.

 

[MrVegas]

I just tell people what I do . . . but for your own situation, talk to your doctor, do your own research, etc. I have taken Sudafed or Claritin-D pretty often for diving. It helps me -- probably more with sinus squeeze than ear problems. Usually the 12 hour version to make sure it doesn't wear off while I'm underwater. I think Duke Diving Medicine posted to the oxygen toxicity studies; theoretically it could be an issue, but the dosages in the rat studies were absolutely enormous. I've taken Sudafed diving nitrox.

 

[Rkelleyj]

A friend of mine takes Sudafed (Pseudoephedrine) prior to diving--he says that it helps him equalize. I’d like to recommend him something like Pro Plugs or EarShield, especially since some experienced divers have told me about the potential concern of oxygen toxicity when taking it just prior to diving. Should I advise him to steer clear of Sudafed? Cheers.

FWIW - I have been using it sparingly for @15yrs in combination with my daily HBP medications. Let me explain..

My use has been occasional - I would guess 3 out of every 20 dives. I’ve never taken more than 1 tablet, simply because I don’t have a need for severe congestion relief and I have treated HBP.

It’s common knowledge that pseudoephedrine is systemic, meaning simply that the mechanism of action it takes on the soft tissue within the nasal cavity is also effected throughout your entire body (for most part) and it constructs or you could say restricts blood flow.. usually translating to negative effect for folks with cardiovascular issues, but positive for divers wanting to equalize easier.

I have spoken with countless long time divers, shop owners, instructors, technical guys and what I gathered from all these conversations and my own reading (including DAN and SB) is this that it’s a personal and circumstantial decision, and you are at your own risk but there is no known acute issue with pressures at recreational depth and pseudoephedrine.. other than example described above,

Curious to hear others’ latest opinions and experiences.

HTH

 

[Colliam7]

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