OT (or is it?): continuous use of Pseudoephedrine

[McSleepy]

This does relate to my quality of sleep and ability to use my CPAP, but I thought I'd put the "OT" classification, just in case.

I have restrictions in my nasal passages that I'm addressing with other means (surgical), but for this topic I'd like to focus on the soft tissue, the nasal lining. Since there is so little room in there, it takes a very small amount of swelling to block the airways enough to cause arousals (RERA). I can't use vasoconstrictors (e.g., Oxymetazoline sprays or Levomethamphetamine inhalers) because of their addictive nature and menthol/camphor-based inhalers are not effective (weak and short-termed effects). What has worked great for me is OTC Pseudoephedrine pills, but I'm starting to wonder if there could be any long-term issues with that. I only take 60mg before going to bed, which is a lot less than the 240mg/24hrs maximum dose, and I have periods when I don't need it for weeks. But I do take it quite regularly, overall, and I'm wondering it there might be cumulative effects. My ENT left recently and I haven't yet seen his replacement, so I thought I'd do some research on my own. So far I haven't found any relevant literature and I was wondering whether someone here might know something on the subject. I'd appreciate any relevant input.

McSleepy

[Sir NoddinOff]

Several peer reviewed papers have recently been discussed on this forum about pseudoephedrine and various OTC decongestants, cough and sleep meds being a contributing factor in dementia and Alzheimer's, even more if there is a genetic tendency that runs in the ones family history, especially if there is a pattern of routine daily usage (see list at bottom). Here's the one study involving older people that I bookmarked... I'll look for the aforementioned thread this evening.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933398/

Here's a list of common drugs (both OTC and Rx) that have been implicated due to their anticholinergic activity. The list is very wide-ranging and combined with the several studies is worrisome, at least to me:

http://www.ncbi.nlm.nih.gov/pmc/article ... /table/T5/

[palerider]

I can't use vasoconstrictors (e.g., Oxymetazoline sprays or Levomethamphetamine inhalers) because of their addictive nature

used once a day, they're very much less addictive.

like, a month of once a day use without rebound. learned that from a sharp ENT.

[chunkyfrog]

I used to take loratadine plus pseudoephedrine, until state laws made the pills many times more expensive,
--and a super PITA to get. Kicking the PE gave me a clearer head, at the cost of a couple weeks of congestion.

[Goofproof]

I used to take loratadine plus pseudoephedrine, until state laws made the pills many times more expensive,
--and a super PITA to get. Kicking the PE gave me a clearer head, at the cost of a couple weeks of congestion.

I too used them, despite the warning for heart problems. I have kicked them to the curb, after 3 years of use. I am getting by without them. Jim

[Janknitz]

Pseudophedrine caused pretty bad tachycardia (racing heart) for me and when I gave it to my child, then about 7 years old--on a doctor's advice--she turned into a raving, agitated maniac. One child's dose. Never again! The ONLY thing we will use is saline spray, and even that in moderation because overuse can cause problems, too.

Have you tried an elimination diet to rule out a dietary source of congestion?

[tedburnsIII]

Prescription Fluticasone Propionate in the glass bottle works wonders for congestion and nips most rhinitis/sinusitis in the bud.
It is a cortico-steroid.

But when I get runny nose I turn to PE. Luckily, I don't need to use it often.

[McSleepy]

I can't use vasoconstrictors (e.g., Oxymetazoline sprays or Levomethamphetamine inhalers) because of their addictive nature

used once a day, they're very much less addictive.
like, a month of once a day use without rebound. learned that from a sharp ENT.

Didn't work that way for me. My ENT had to prescribe oral steroids to get me off of Afrin years ago. And I wasn't even spraying - I was barely dabbing my nasal lining with a cotton swab moistened with a drop of Afrin before bedtime.
McSleepy

[McSleepy]

Pseudophedrine caused pretty bad tachycardia (racing heart) for me and when I gave it to my child, then about 7 years old--on a doctor's advice--she turned into a raving, agitated maniac. One child's dose. Never again! The ONLY thing we will use is saline spray, and even that in moderation because overuse can cause problems, too.

Have you tried an elimination diet to rule out a dietary source of congestion?

I actually have very little congestion: a small amount and not often. But the tolerance is very small: the tiniest amount is enough to cause the restriction. In fact, I never have rhinorrhea, sore throat, barely ever have fever - haven't missed a day of work in years. It's just that my nasal passages are so tight and my airflow need - so large (I have nearly 7 liters of vital capacity) that RERAs are easily caused.
McSleepy

[McSleepy]

Prescription Fluticasone Propionate in the glass bottle works wonders for congestion and nips most rhinitis/sinusitis in the bud.
It is a cortico-steroid.

But when I get runny nose I turn to PE. Luckily, I don't need to use it often.

I was on corticosteroid sprays for years - didn't make any difference. I regularly use nasal washes and that helps a lot, but occasionally I'll have periods of congestion. It is not seasonal - I was on antihistamines for years - didn't help either. I thought I had made a connection to climate, but I've lived in humid and dry climates since, and it can go either way.
McSleepy

[McSleepy]

Thank you for all the input, I appreciate it! The part about the connection of drugs to dementia is scary, I hope it is overstated - even though I'm quite medicine-free (I don't take anything truly regularly, other than proton-pump inhibitors), one can't really avoid them for too long. I'll read the referenced articles and research the leads posted here, and I'll also ask the new ENT when I see her next. Thanks, again!
McSleepy

[chunkyfrog]

Most drug discussion on the Internet will inevitably lead to the bad, and then the very bad.
In the face of everything else, it is best to follow your doctor's advice, but to be mindful of any
unique side-effects you might experience. Be assertive if you feel something is wrong.

[tedburnsIII]

Prescription Fluticasone Propionate in the glass bottle works wonders for congestion and nips most rhinitis/sinusitis in the bud.
It is a cortico-steroid.

But when I get runny nose I turn to PE. Luckily, I don't need to use it often.

I was on corticosteroid sprays for years - didn't make any difference. I regularly use nasal washes and that helps a lot, but occasionally I'll have periods of congestion. It is not seasonal - I was on antihistamines for years - didn't help either. I thought I had made a connection to climate, but I've lived in humid and dry climates since, and it can go either way.
McSleepy

If you refer to neti-pot/ready wash there is an interesting YT video advising against using it as a preventative, IOW, use for acute outbreaks only and for a few days. Control group scientific study by allergy specialist. I don't know yet if permitted here to post a link to that informative video.

[McSleepy]

Prescription Fluticasone Propionate in the glass bottle works wonders for congestion and nips most rhinitis/sinusitis in the bud.
It is a cortico-steroid.

But when I get runny nose I turn to PE. Luckily, I don't need to use it often.

I was on corticosteroid sprays for years - didn't make any difference. I regularly use nasal washes and that helps a lot, but occasionally I'll have periods of congestion. It is not seasonal - I was on antihistamines for years - didn't help either. I thought I had made a connection to climate, but I've lived in humid and dry climates since, and it can go either way.
McSleepy

If you refer to neti-pot/ready wash there is an interesting YT video advising against using it as a preventative, IOW, use for acute outbreaks only and for a few days. Control group scientific study by allergy specialist. I don't know yet if permitted here to post a link to that informative video.

I don't see a reason why it wouldn't be permitted; go ahead (you may just post the YT video ID number).
McSleepy

[tedburnsIII]

Prescription Fluticasone Propionate in the glass bottle works wonders for congestion and nips most rhinitis/sinusitis in the bud.
It is a cortico-steroid.

But when I get runny nose I turn to PE. Luckily, I don't need to use it often.

I was on corticosteroid sprays for years - didn't make any difference. I regularly use nasal washes and that helps a lot, but occasionally I'll have periods of congestion. It is not seasonal - I was on antihistamines for years - didn't help either. I thought I had made a connection to climate, but I've lived in humid and dry climates since, and it can go either way.
McSleepy

If you refer to neti-pot/ready wash there is an interesting YT video advising against using it as a preventative, IOW, use for acute outbreaks only and for a few days. Control group scientific study by allergy specialist. I don't know yet if permitted here to post a link to that informative video.

I don't see a reason why it wouldn't be permitted; go ahead (you may just post the YT video ID number).
McSleepy

Now I am having a problem locating the video. It may have been removed, but I watched it only a few days ago. However, it is not showing up in my YT History or Favorites. I am tired of searching for it after half an hour. May try later- sorry.