Sudafed vs. Sudafed PE

[Damselfish]

So, lots of people use Sudafed when diving without issue. Now that they are trying to make it hard to buy, has anyone tried the new Sudafed PE? Any thoughts from a medical standpoint if this will be the same for diving, any concerns? Any better or worse theoretically with respect to diving Nitrox?

For those who haven't heard, the ingredient pseudoephedrine in Sudafed can be made into methamphetamine, so they're trying to cut down on supplies to drug labs by moving some versions of Sudafed and similar products behind the counter of pharmacies in many places. Which means you can't just grab it off the shelf at a drugstore (and can't get it at a place that doesn't have a pharmacy counter to move it behind like many discount stores.)

 

[crpntr133]

So, lots of people use Sudafed when diving without issue. Now that they are trying to make it hard to buy, has anyone tried the new Sudafed PE? Any thoughts from a medical standpoint if this will be the same for diving, any concerns? Any better or worse theoretically with respect to diving Nitrox?

For those who haven't heard, the ingredient pseudoephedrine in Sudafed can be made into methamphetamine, so they're trying to cut down on supplies to drug labs by moving some versions of Sudafed and similar products behind the counter of pharmacies in many places. Which means you can't just grab it off the shelf at a drugstore (and can't get it at a place that doesn't have a pharmacy counter to move it behind like many discount stores.)

If I am thinking right the PE doesn't contain pseudoephedrine. I have never used it but from what I am hearing it works the same.

 

[MoonWrasse]

So, lots of people use Sudafed when diving without issue. Now that they are trying to make it hard to buy, has anyone tried the new Sudafed PE? Any thoughts from a medical standpoint if this will be the same for diving, any concerns? Any better or worse theoretically with respect to diving Nitrox?

For those who haven't heard, the ingredient pseudoephedrine in Sudafed can be made into methamphetamine, so they're trying to cut down on supplies to drug labs by moving some versions of Sudafed and similar products behind the counter of pharmacies in many places. Which means you can't just grab it off the shelf at a drugstore (and can't get it at a place that doesn't have a pharmacy counter to move it behind like many discount stores.)

In other countries you can still buy old fashioned generic Sudaphed.
Last time I went to Siam, I took some of both - not while diving - and the new stuff works better IMO. No crazy dreams

 

[Laurence Stein DDS]

I believe that the Sudafed PE contains phenylephrine in place of pseudephredine.

Phenylephrine is related to epinephrine (adrenaline). It is a stimulant type drug that can cause vasoconstriction ( and thus acts a a decongestant by shrinking the swollen nasal membranes). It can elevate the blood pressure and cause an increase in the heart rate. Pseudoephedrine does the same which is why it is used as a decongestant.

Phenyephrine is commonly found in the nasal decongestant spray, Neo-synephrine.

Pseudephrine is being substituted with phenylephrine in Sudafed to break the supply of the precursor drug used to synsthesis of methamphetamine.

Laurence Stein, DDS

 

[debdiver]

When I first took my Nitorx class, I was told that Sudafed, or pseudoephedrine, was a central nervous system stimulant, and thus not recommended to take with oxygen enriched air. Having said that, I've known several folks that still took their sudafed while diving at 32% or 36% mixes...

Still, I'm curious, is the new Sudafed PE also a CNS stimulant?

 

[GrierHPharmD]

Here's what DAN has to say about the use of sudafed in enriched air diving:

What's the bottom line? In normal, healthy divers breathing air, occasional use of pseudoephedrine at the recommended dose is probably safe. This presumes that the drug has been taken during periods when no diving has occurred and that no undesirable reactions have occurred. However, one should avoid chronic (daily) use when diving, and it seems reasonable to avoid the drug entirely if diving while using oxygen-nitrogen mixes where the PO2 during a dive might exceed 1.4 ata, the current recommended "safe" open-circuit scuba limit. ​

Here's the whole article:
http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=51

BTW, phenylepherine (sudefed PE) is a central nervous system stimulant and would be expected to cause the same sort of side effects as pseudoephedrine (sudafed).

If you choose to use systemic (oral tablet) sudafed, you might want to use the 12-hour, extended release form. The short-acting sudafed products wear off relatively quickly and can lead to a reverse squeeze. (Use the cheaper store brands - they're just as effective and will save you a few bucks.)

Also, for pre-dive nasal congestion, you might want to consider a topical decongestant spray, used shortly before going under. Stay away from phenylephrine-containing sprays, and use the longer-acting oxymetazoline-containing sprays such as Afrin and Sinex Long Acting. (Again, I'd recommend using the store brand.)

Hope this helps,
Grier

 

[Gidds]

Not a doc or a pharmacist but I am an allergy sufferer and a diver. Have you tried Claratin i.e. lotradine? I am not sure what the chemical properties of it are but I've had some rather bad reactions to Sudafed in the past (several incidents of hallucination) and have been forced to switch. Plus like you said the sale of Sudafed and related products is being restricted so getting lotradine is easier. Anyway I find it is just as effective as Sudafed as a decongestant. Why not give it a try?

 

[mikkilj]

Pharmacist #2 here . Yeah, what Grier said...

And phenylephrine is less "specific" than pseudoephedrine, and is associated with more cardiovascular and CNS side effects. Worse still, it is generally less effective than pseudoephedrine as a decongestant.

Other manufacturers are also changing from PSE to PE, so watch those active ingredient labels!

Dr. Mikki, PharmD

 

[mikkilj]

Not a doc or a pharmacist but I am an allergy sufferer and a diver. Have you tried Claratin i.e. lotradine? I am not sure what the chemical properties of it are but I've had some rather bad reactions to Sudafed in the past (several incidents of hallucination) and have been forced to switch. Plus like you said the sale of Sudafed and related products is being restricted so getting lotradine is easier. Anyway I find it is just as effective as Sudafed as a decongestant. Why not give it a try?

Loratadine is a non-sedating antihistamine, not a decongestant. So, for someone with true nasal congestion, it's not going to help, and may in fact dry up the mucous membranes and make congestion worse. Claritin-D, on the other hand, contains both loratadine and pseudoephedrine.

If someone has chronic problems with nasal sinus congestion or allergies, a topical inhaled corticosteriod, such as Flonase or Nasacort AQ, used on a daily basis (instead of "as needed") is a better option. It works right where it's applied and very little is absorbed into the blood stream, making it a safer option for diving since it doesn't affect your other systems. The downside - they require a prescription and really need to be used every day. It can take up to two weeks for it to start working well.

Dr. Mikki, PharmD

 

[Gidds]

Good to know, thank you That explains why sometimes my nose isn't completely "unstuffed" (not that I'd dive if it were that way).