Sudafed / Pseudoephedrine & Diving (on air)

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I have used Afrin and Sudafed on a regular basis to keep my clearing ability intact and have had no trouble in the past 25 years. It has save a few dives for me and caused no problems. What little side effects there are, are compensated by increased underwater enjoyment. Your results may vary.
 
I used to have to take Sudafed before dives to prevent sinus squeeze. Now I use neilmed sinus rinse twice a day starting a few weeks before a dive trip and I don’t need the Sudafed anymore!
 
Halls Mentholyptus. Clears the sinuses without side effects.
 
There are now "HBP" versions of many of these meds for people with hypertension. They may or may not have the same issues as they are sometimes completely different drug families.
 
I have done 1 dive while using Sudafed. I had a bad cold and some fever, but was on holiday. I can clear my ears, but it was a little bit hard, so I took pseudoefedrine just in case. No problems during my 76m deep solocavedive on 6/72 trimixdiluent on ccr. Just I felt some pain between my eyes, but no problems with my ears (I could clear my ears before the dive). Setpoint was 1.3 and during deco 1.6. Divetime 182minutes. Profile was: surface then drop to 29m, then back slowly to 2m, than a drop to 76m with 20 minutes bottomtime. So deco in the cave at 900m from exit, then swim back, and again over 29m to exit.
Enough bailout. It was the only time I used pseudoefedrine, as even with colds I normally can clear my ears, I just get some pain between my eyes then, but can dive, takes some more time to go down. But I always have some pseudoefedrine with me on holiday, you never know, part of safe a dive kit. But I did not feel any side effect (and no effect that it helped).
 
FWIW - If I do 10 dives, I’ll take just 1 regular Sudafed before the first dive of the day on 5 of the dives... depends on how I feel each day. Never a problem
 
I will often take Sudafed, particularly while using full face masks, since continuous equalization with them -- even if one is only slightly congested -- can pose a bit of a challenge. A "valsava nose block," as musical and appealing as that may sound, is no substitute for open access to one's nose.

I haven't experienced any CNS related issues with the medication of which I am aware, regardless of the studies and claims that I have read, over the years; nor experienced anything at any given depth or air mixture, for that matter; but I do sorely miss those bygone days, when one could buy bottles of five-hundred capsules of pseudoephedrine at Sam's Club or Costco, before the ascendency of crack.

Timing dosages of Sudafed, though, like most things in life, is everything. I once experienced a terrible reverse block, when I delayed getting into the water; and that produced the most excruciating pain and the most impressive "Hollywood" bloody nose that I have ever experienced, one that I could "taste / smell" for two days.

Now I regularly receive the stink eye from the pharmacist at Walgreen's when I buy two packages of eighteen -- and have to dig through the wallet for my license, and assure them that my teeth aren't the color and texture of candy corn . . .
 
Packages of 18? We can only get packages of 6. I have used only 2 pills from my 3 packages of 6.
 
https://www.shearwater.com/products/swift/

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