OTC allergy medication PSA - latest article from the FAA Safety Briefing

[Rick Junkin]

I just read this article and discovered I had not properly researched my over the counter allergy medication of choice - it is no longer my choice! This is required reading for anyone not already in the know regarding the FAA OTC approval list.

Beware the sedating antihistamine.

https://medium.com/faa/allergies-and-allergy-medication-7715c91c3736

Cheers,
Rick

[ilovecornfields]

I’m not sure why people take systemic antihistamines when nasal corticosteroids are more effective and have a better side effect profile. I can understand taking both in the case of severe symptoms (in which case you shouldn’t be flying anyway) but it seems most people taking systemic H1 blockers (or their doctors) just don’t know any better. 

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/649601

[EricJ]

I had to quit Zyrtec, which I thought was a little better, and switch to Claritin, actually the generic Costco Allerclear, due to the FAA concerns.   My doc says the issue is whether something is expected to cross the blood-brain barrier or not, and whether something does or doesn't is actually a bit of a crapshoot for their individual situation.   That said, I take Allerclear daily and have no issues and very few allergy symptoms any more.   Seems to be working for me, but ymmv.

 

[carusoam]

Claritin is best known for not causing drowsiness…

it’s challenge… is it takes 24hours to become fully effective… as it gets converted to different chemistry in the body before it can start working…

Schering Plough, Its manufacturer, knew this and timed their next product to coincide with the patent expiration…

So… believe it or not… Clarinex is the follow-on product…. Works great, no drowsiness… No waiting 24hrs for conversion… 

Then the Patent office didn’t agree with the claims… that any bio-chemist couldn’t see the next step… nothing to patent…

Since then…. Schering Plough got purchased by Merck…

Like anything else… allergies and their meds can be really individual experiences…. Some people really like Claritin… some people don’t…

If you use Claritin… read the label info on the box… check the AOPA meds list allowed for flying…

Sleepiness is probably correlated with altitude as well…

Also check the side affects for high blood pressure…

Expect to take it every day during allergy season…

Some labels make it easier like… “don’t operate heavy equipment”

Label laws and their results… have come a long way over the years. 

PP thoughts only, not a medical person at all…

Best regards,

-a-

[bonal]

Ok, breaking radio silence.  Important subject for me as a kid I suffered from the worst hay fever you can imagine.  I could tell you when the first acacia tree would bloom in the Bay Area even if it was fifty miles away.  Took everything including prescriptions, shots OTC you name it.  One particularly bad year when I was in my early 20’s a customer at a store I was working noticed how much I was suffering and suggested I try acupuncture.  Yeah sure, OK. But in truth I was more sick of the side affects from the meds I thought I’d give it a try.  Pulled out the yellow pages (pre internet) found someone and made a visit.  Let me sum it up by saying it cured me with only four visits.  Zero problems for about three years then had a little relapse went back for another round, three visits once a week.  I have NEVER had an issue with allergies since.  I won’t go into why it works, it was explained to me and it made total sense.  For those of you that suffer from this you might give it a try.

Edited May 1, 2022 by bonal

[PT20J]

I believe that long term use of first generation anticholinergic antihistamines have been linked to an increased risk of dementia.

Also, I believe that nasal corticosteroids are contraindicated if you have glaucoma as they can increase intraocular pressure.

I'm an engineer not a doctor, so all I know is what I read.

[ilovecornfields]

28 minutes ago, PT20J said:

I believe that long term use of first generation anticholinergic antihistamines have been linked to an increased risk of dementia.

Also, I believe that nasal corticosteroids are contraindicated if you have glaucoma as they can increase intraocular pressure.

I'm an engineer not a doctor, so all I know is what I read.

If you have glaucoma, talk to your ophthalmologist before using nasal steroids. If you don’t have glaucoma, then don’t worry about it.

Nasal steroids were shown to increase intraocular pressure on average by 1 mm Hg with no clinical difference in disc:cup ratio or any other clinically relevant endpoint.

Not an engineer…

[Eight8Victor]

@Junkman Rick, you may want to ask your doctor about Kenalog. 
 

[Rick Junkin]

3 hours ago, Eight8Victor said:

@Junkman Rick, you may want to ask your doctor about Kenalog. 
 

Thanks for the suggestion. My wife uses Flonase (fluticasone) so Im going to try that for a few weeks. If I don't have good results from that I'll try Nasacort (triamcinolone, same as Kenalog) next. I have regular appointments with my ophthalmologist and will be able to keep an eye on any intraocular pressure changes (very bad pun intended). Both fluticasone and triamcinolone are on the FAA "go" list.

Cheers,
Rick

[jaylw314]

From https://www.faa.gov/licenses_certificates/medical_certification/media/OTCMedicationsforPilots.pdf

The FAA generally suggests waiting 5 half-life intervals before flying.  For most medications, one half-life is typically 12-24 hours, so figure 3-5 days.

Edit: Huh, I was little surprised to see Coricidin, I thought that was dextromethorphan? 

Edited May 2, 2022 by jaylw314

[ilovecornfields]

1 hour ago, jaylw314 said:

From https://www.faa.gov/licenses_certificates/medical_certification/media/OTCMedicationsforPilots.pdf

The FAA generally suggests waiting 5 half-life intervals before flying.  For most medications, one half-life is typically 12-24 hours, so figure 3-5 days.

Edit: Huh, I was little surprised to see Coricidin, I thought that was dextromethorphan? 

I think CoricidinHBP does have dextromethorphan. Only time I ever think about it is when the kids (young adults) OD on it. There was a series of fatal Benadryl overdoses a few years ago as well. Apparently the anticholinergic effect produces some pretty impressive hallucinations.

I miss the time when kids just got drunk, smoked weed and occasionally ate mushrooms. Kids these days scare me with their “skittles parties” and polysubstance abuse. 

https://pubmed.ncbi.nlm.nih.gov/14574654/

[David M20J]

another quick reference for a lot of different medications for different things can be found here https://www.leftseat.com/faa-accepted-medications/ , use as a reference, ultimately consult your AME, they would have better advice and the ability to get or help get approvals for meds

[jaylw314]

2 hours ago, ilovecornfields said:

I think CoricidinHBP does have dextromethorphan. Only time I ever think about it is when the kids (young adults) OD on it. There was a series of fatal Benadryl overdoses a few years ago as well. Apparently the anticholinergic effect produces some pretty impressive hallucinations.

I miss the time when kids just got drunk, smoked weed and occasionally ate mushrooms. Kids these days scare me with their “skittles parties” and polysubstance abuse. 

https://pubmed.ncbi.nlm.nih.gov/14574654/

It's confusing because CoricidinHBP has dextromethorphan (which is listed as not allowed), and Coricidin (the original version) has chlorpheniramine, AFAIK, which is also not allowed.  So I'm not actually sure what they're referring to when they list Coricidin as "allowed".

Not that any of this is terribly important, and you're right, the only reason I've ever heard of Coricidin brands is because of kids overdosing on it.  

[A64Pilot]

I have found that rinsing my nose out twice a day with saline works better than any drug.

Use to before I found the sinus rinse the inhaled steroids worked, any antihistamine makes it somI can’t sleep, I’m tired but can’t sleep

[carusoam]

Pharma labeling has added an extra level about a decade ago…

Today’s kids are pretty good at being amateur chemists as well…

OTC- Over the Counter was the stuff we can read the labels of ourselves… To OD accidentally, usually requires eating a really unusual amount… hard to do accidentally…

Now, there is a slew of products that are accessible, similar to OTC, but they are behind the counter…. But no prescription required still…

So… if you like Claritin… there is decongestant version called Claritin-D… the -D is behind the counter… and you have to ask for it…

 

Whatever the -D active ingredient is can easily be easily converted to something more fun…

So… while the pharmacists are watching for people buying more than one box at a time… the organized crime lords have been known for stealing trailers right from the manufacturing site…

 

Each box has two names on it…

1) Brand name… Pure marketing skill…. Fancy memorable name…

2) Active ingredient chemical name (sort of)… the people that patent the chemistry stuff, first apply some Latin logic to somehow get a near fancy name for it…

3) Review the active ingredient names… these are the important ones… check them all against the FAA’s list of go/NoGo products… this is really helpful when finding competing, off patent, products… for less… 

4) CB rules for Medications… When the patent has run out, the competition runs in… on both prescription and non-prescription meds… comparing the active ingredients list of competing products is interesting…

PP thoughts only, I know more about the label, than the products inside…

Hope this gives some insight of some questions to ask your doctor…

Best regards,

-a-