tzikeh | Three important questions, plus another question

Three important questions, plus another question

So my sinuses wanted me dead earlier today. I mean, all-out pain so much that my teeth hurt. My nose was not stuffed up, but that was because it was EVACUATING ALL MORNING LONG.

I know; you're really glad I started my post like this.

I went to Walgreens and asked the pharmacist what would be best to help -- and that I didn't know whether this was allergies (it came on very very quickly, so that was my guess), or the end of a cold I thought I'd gotten over, and was there something that would work for sinus pain and runny nose regardless of whether it was a cold or allergy?

She suggested Claritin-D / Allegra-D / Whatever-D, and told me that the generic was exactly the same. I bought the generic.

It took two hours to kick in, at which point I was able to take a nap. When I woke up, the symptoms were back (not as bad as this morning, though I can feel them slowly getting worse).

The box says "Do not exceed one dose in 24 hours." Now, with stuff like ibuprofen, I figure I can exceed "recommended dosage" every once in a while if I have a bad headache--my GP says that's fine. But this doesn't have a "recommended dosage," it has ONE DOSE. NOT TO BE EXCEEDED. 24 HOURS.

Three questions:

1) Am I going to DIE if I take another?

2) If I am going to DIE if I take another, can I take something else (like DayQuil) to try to help? (As far as I can find on the box, there's no other sinus/allergy/cold medication that is contraindicated. Only the usual MAOI / high blood pressure meds.)

3) Should I have gotten Claritin-D or Allegra-D, and not the generic?

And the other question:

Did anyone else in Chicago (or around Chicago) have sinus pain/runny nose today, when you didn't have it yesterday? I want to figure out if this is allergies, or if this is more of the cold that I had seemed to have gotten over.

ETA: I can't go out and buy anything (Neti pot, other Vick's, etc). I happen to have DayQuil and NyQuil in the house, which is why I asked. I really hope I can find some way to fix this, otherwise I don't think I'll sleep at all tonight. It hurts too much and the runny nose is... yeah.

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the generic really is the same stuff; i've never noticed that the brand name's inert ingredients have helped me more than the generics'.

the antihistamine is what's making the snot go away (loratidine in the claritin; i don't remember the drug in the generic). the decongestant is making the swelling in your sinuses go down. (pseudoephedrine if you had to sign for it; phenylephrine if you didn't.). i'd personally get them separately so if you need to take more you can just take more of the one you need, in case you just need one or the other. but you should not DIE OMG if you take 20mg of loratidine in a single day, e.g.

I am not a doctor.

I did have to sign for it, so it's the pseudoephedrine. The next commend down says taking more than one could damage my heart. This does not sound like good news.

i'd google the ingredients and look for warnings. if the "D" (for decongestant) refers to pseudofed/pseudoefedrine, then taking more than the recced dose can mess with your heart, make you speedy.

i'd try something old fashioned like vapo-rub/ peppermint or eucalyptus oil, and steam.

alas, I have neither, and now the Walgreens is closed.

Do you know if taking something like DayQuil will fuck it up too?

Some Walgreens are open 24 hours a day. Check the website.

Yes, but it's dark and I have no transport.

You need to check the ingredients of what you took against the Dayquil ones. Also, is there a pharmacy help line you can call? Wikipedia says Dayquil main ingredients are:

The active ingredients of DayQuil Cold & Flu Relief (per LiquiCap, or per 15 mL syrup):

* Acetaminophen (325 mg) (pain reliever/fever reducer)
* Dextromethorphan (10 mg) (cough suppressant)
* Phenylephrine (5 mg) (nasal decongestant)

It should not be taken by people who consume an excessive amount of alcohol, who are taking other medicines containing acetaminophen, or who are using a prescribed monoamine oxidase inhibitor. Large amounts of caffeine should also be avoided if taking this medicine.

Your best bet is a pot of steam. Get a crockpot, put it by your bed, make steam. Stick your nose over it. It will help a little, better than nothing, also better than over-medicating and creating other problems.

*end Jewish mother mode*

Have you tried Afrin spray? It's good stuff.

I have -- its actually what triggered my runny nose in the first place, or at least I thought. I try not to use it because it has that "use it more than three times and IT WORKS IN REVERSE" effect, so I'm staying away right now.

The good old addictive ones like Sinex are good for 2-3 days.

POLLEN

POLLEN EVERYWHERE NOT ACTUALLY COVERED BY SNOW.

IF SNOWY, MOLD.

That is my sinus icon.

Alas, I was using Afrin for my cold, and I'm at the 3-day-addicted stage.

Wow, that icon is... sinusy!

So okay, there was a high incidence of pollen today?

I'm in FLA so there's pollen like whoa. My black car is now dark green. You could take the NyQuil and know that you'll pass out. I don't think you'll die, but I am not a doctor. I'm a person with bad sinuses and a Benedryl addiction!

Incidentally, and since you seem to know about this, how does one wean oneself from Sinex addiction?

Weaning is the operative word.

I reduce to using it only at night and then stop that on a weekend - so if you do feel like shit, it doesn't affect work. Or you can transition over to a saline sinus spray which tricks your body into thinking it is Sinex.

Never underestimate the placebo effect!

NETI POT. the neti pot is your friend.

my husband likes the one that says on the box "ancient secrets. new improved design."

(ps remind me tomorrow and I will find you a choice quote from my nose book to improve your day.)

Edited 2011-03-16 03:00 (UTC)

Alas, I can't buy a neti pot at this point in the evening, and ugh I really need something to get rid of this pain and the RUNNY NOSE OMG.

You can actually use something like a water bottle similarly, anything you can put a portion of warm water and a wee bit of salt into, that has a small opening you can put against one nostril. That's what I used before I got my neti pot.

You just have to be careful with a water bottle and not put a lot of pressure, since you're supposed to let the warm water flow through your sinuses, not punch through.

I am not a doctor!!! Try a doc-in-the-box in the AM to get Real Advice!

If you look at the box, it should tell you what the amount of each drug is (e.g. 30 mg pseudophedrine, 10 mg lotrawhatever, 1 mg partridge and 2 mg pear tree).

What you want to do then is go to Web MD and / or the Merck Manual (http://www.unboundmedicine.com/merckmanual/ub/home) online, and check the toxicity levels of each ingredient. This will keep you from doing what I did at Christmas, which is come perilously close to inadvertantly ODing on acetaminophen.

On the 'stuff to try' front: 1. pull out a bowl and a towel. Put them on a table with a chair. 2. put the kettle on. 3. boil water, pour it into the bowl. 4. put your head over the bowl, put the towel over your head and the bowl. 5. Inhale. Exhale. Repeat for as long as you can stand. Works for both bugs and pollen.

If your funds will stretch for it, get a hot-water steam humidifier and put it next to your bed and sleep semi-upright.

Remember to double check with what you're already taking, and once again, I am NOT A DOCTOR!!

Apparently, the Merck Manual doesn't like people who aren't members.

Bleh.

Second the bowl-of-steam recommendation. Five or six fennel seeds added to the water will help empty your sinuses and keep them emptied.

Zyrtec, Claratin and ... That one other brand are all a LITTLE different. Claratin works best for me, zyrtec works for my partner. If you MUST use them, get the ones you have to sign for. They have better decongestants, in my exerperience.

Two years ago, I decided to go as non-pharmaceutical as I could. I bought a neti. I too, worpke up today with attack of the sinuses, so I flushed my nose out and was mildly annoyed, but fine. Did it again tonight, no problems. I totally had that exact problem, every year at this time, for years before I found that the neti works well, if you use it right. It's gross, it's weird, and it works.

Don't double up. It won't kill you, but the side effects are pretty insane. I accidentally took two (I thought they were 12 hour) and it was like overdosing on caffeine.

I wish I could go get a neti pot, but I can't. And I have to sleep tonight--so I can't double-up, but I need some kind of relief.

You could probably fake it with a funnel and some other supplies. /MacGuyver

Man, the neti. I was like 'what is this hippie crap' about it right up until I tried it in desperation, and then I was like 'where have you been all my life, weird blue plastic teapot?'

Steam. Take a shower that's as hot as you can stand it. Then boil some water, put in a bowl. If you've got anything aromatic in your spice collection (even some rosemary would be nice) add it, but it's not the medicinal part. Stick a towel over your head and breathe it. You can do this in the bathroom that's steamy from your shower.

Try using a pyrex measuring cup (or similar) as a sub for a neti pot. It will be messy, but you're desperate ;->. Here's a recipe for the solution.

These things make not work for long, but hopefully will help you get some sleep. Prop yourself up on several pillows to sleep tonight -- being as vertical as possible helps with not clogging quite so easily.

Hope this helps -- feel better!

the barometric pressure changes have been making me dizzy for a week and my ears have tickled all day long.

the 24 hour ones really shouldn't be exceeded because they're time released in some way I think.

I take plain 24 hour claritin and then take pseudophed separately so I can take more pseudophed if I need it, but I take it at a very low dose because it's a stimulant and can make your heart race if you take too much. I had a library school classmate who had an irregular heart beat and she couldn't have caffeine or pseudophed. If you don't have a problem like that you can take more than the normal dose a couple of times, but eventually you get a kickback where it stops working, like with afrin, so you don't want to do it too often.

I had a library school classmate who had an irregular heart beat and she couldn't have caffeine or pseudophed. If you don't have a problem like that you can take more than the normal dose a couple of times

I have no irregularities in my heart beat or blood pressure, but I'm still a little leery of going against something with such strident warnings. MEH, I really want to take another.

the issues is more that if you take more of it you're getting more of the loratadine (the antihistimine - that's the generic name for Claritin and there's absolutely no difference between the name and generic) too, which you don't need.

Have you tried taking advil ? When I have a sinus headache advil works because it's an anti-inflammatory and helps reduce the swelling that is causing the pain.

If the stuff's got pseudoephedrine, it is likely to keep you awake just as much as your sinus pain will.

Normally I'd say Afrin for a crisis situation, but you're already past the optimum point for it. So to get to sleep, I recommend steam + ibuprofen. The ibuprofen is perfectly safe, will reduce inflammation, and should relieve your pain enough to help you sleep. The steam will unclog you as much as you can be unclogged without additional drugs. If you have a sleep-aid, you might want to use that, too.

If you are prone to sinus ick like I am, do get your hands on a neti pot (IMO the western-style sinus rinse bottle is easier to use, but the basic neti pot concept is the same). I don't think I've had a single cold since I started using mine three years ago.

I've never seen a sinus rinse bottle vs. a neti pot -- what's the difference?

I've got the sinus rinse version of the Neti Pot - basically they both use warm saline, but with the Neti pot you have to tilt your head back and with the squeeze bottle you just squeeze it up into one nostril and it comes out the other. Easier on beginners. You can get one at Merz - they'll recommend the beginner version.

I don't think we have Merz in Chicago -- is that a general store like a Walgreens?

I live in Chicago. We definitely have Merz.

http://www.merzapothecary.com/

AHAHAHAH OMG I knew that you lived here.

And I think I've walked past that Merz every week when I go to The Book Cellar for grilled cheese and Riesling (and books). Unobservant beyond belief. Or maybe I just didn't recognize the name.

Either way:

>.

:)

Go in there.

Ask for "beginner neti pot thing."

YOu will be happy.

You can get a sinus rinse bottle at Walgreens, too! It's called a "NeilMed Sinus Rinse" and they should be in the section with the decongestants. I use mine twice a day, because I never could figure out how to use the Neti pot without feeling like I was drowning.
Also, my sinuses have been KILLING ME. Pressure change, I think.

A neti pot is shaped like a miniature teapot, and you basically just use gravity to pour the rinse through your sinuses. You have to be at a particular angle and it's hard to control the flow.

Neil Med makes a squeeze-bottle that I use instead. It allows a more natural head angle and it means you control the flow more directly via the pressure you put on the squeeze bottle. Having used both, I like this method better. The pre-measured sodium packets, while more expensive than just using kitchen salt, ensure you will get the right mix, too.

Yep, NeilMed is what I have too.

shrift pointed me here. I am not a doctor, nor am I a pharmacist, but I have been an editor for 16 years for a pharmacotherapy journal, and that has made me my friends' and families' de facto shaman. Basically, I know where to look stuff up and how to interpret it.

With any 24-hour [drug]-D version, the concern about taking more than one dose in 24 hours is ODing on pseudoephedrine, which can be bad. My personal choices, in the privacy of my bathroom? I probably take a second dose as soon as 20 hours after the first one. But everyone's body chemistry is different, and you don't know how you might react.

So my advice (for what it's worth, from a stranger on the internet who edits pharmacy but is in no way qualified to dispense it) is to take the DayQuil, *IF* it's been at least 12 hours since you took the [drug]-D. The longer time span between them, the less chance for an interaction. If you're really concerned, take half a dose of theDayQuil (if it's liquid; if it's the pill, then you have to take the whole thing).

You should be fine -- you might have jitters, like you got overcaffeinated. But you should be fine, because the [whatever]-D and the DayQuil have different types of decongestants, so you won't be doubling up on the exact same one.

Wow - thanks for dropping by!

I will probably wait another hour or two and take the DayQuil--can I also take ibuprofen for the sinus pain?

You can definitely take ibuprofen, since the DayQuil has acetaminophen, and they're too different to have an OD effect.

Also - why would something that says it lasts for 24 hours only work for five hours?

I completely missed this last night!

The simple answer -- which is not meant to be glib -- is that the human body is weird. Some people metabolize drugs (certain drugs, not all drugs) much, much faster than the average person. Some formulations of drugs, like the generic, "dump" too much of the active drug too early, even when they claim to be time-release. (I always try the generic version of stuff first, because I am a cheap-ass, and then if it doesn't seem to work, I'll switch to the brand name.)

Finally, it might just be that the drug you bought (I was re-reading your post, and I'm not sure if it was Claritin-D or Allegra-D or Zyrtec-D, or the generic of same) might not work well for you. I regularly have to cycle through Claritin and Zyrtec (6 months of one, then it stops working, so I switch to the other for about 6 months). It's possible that you just picked one that doesn't want to work well for you.

It's not *only* the decongestant part that helps with the sinus badness; the antihistamine part helps by preventing histamine from overreacting, which causes inflammation. In little teeny sinuses, inflammation is enough to stuff you up horribly.

I hope the DayQuil helped last night, and that you get some decent relief today!

I'm an allergic asthmatic, and yeah, it's been bad the past few days. I'm going to say maybe allergies (but you might have a sinus infection that's augmenting yours).

I have terrible allergies and did not notice anything unusual yesterday.

(I can't answer the other questions. I would suggest steam, however, which you can do with a pot on the stove...)

It looks like everyone and their dog has given you their $.02 on this, but since when has that stopped me. :)

I've taken Allegra-D as a prescription every day of my life for about 5 years now. Maybe longer. It's AWESOME! BUT it needs to be the kind of thing you take All The Time. If I get away from it for a few days, it needs to build back up when I finally get off my ass to get my 'script refilled. (And if your doctor will write you 'script for it, I find that the generic prescription is cheaper than the OTC 'real' stuff that's out now. It's the same drug, just less money.)

My doctor tells me to take Sudafed or something over that if I find myself still stuffy, so yes, you can take an OTC with it.

And as I said on Twitter, I'm *waiting* for my head to explode with OMG!ALL THE SPRING EVER now that we seem to have turned a corner, but so far I'm fine.

1) Don't take another. It won't due any good as it will last only as long as the first dosage. From the length of time I would say your body processes the active ingredients of the decongestant and antihistamine quickly.

2)You can take the DayQuil. If you still have a headache take some ibuprofen. DayQuil has actimenophen.

3) Worst comes to worst hop in a hot shower. The steam will help.

If you are young (under 40), don't have high blood pressure, and have a healthy heart, you can probably get away with taking a little extra pseudofed. (Like 3 tablets instead of 2)

Note that key word: Probably. You are gambling that you don't have an undiscovered heart condition or a weak blood vessel in your head.

(I once took 3 tablets of plain pseudofed when I had a severe flu. I was very jittery, ground my teeth so much my jaw hurt, and my pulse raced for 2 hours. I got no sleep, but at least I could breathe.)

But.

A 24-hour extended release pill has several tablets worth of pseudofed in it and would be dangerous to anybody who took another dose less than 22 hours later.

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Three important questions, plus another question

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Nasal Spray

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Pollen

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how does one wean oneself from Sinex addiction

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As a fellow sinus sufferer...

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