Allergy, antihistamines and flying
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Allergy, antihistamines and flying
Hi all.
When reading our completely new ops manual the other day, I found a paragraph I hadn't noted before, talking about antihistamines. It says that we may not operate aircraft within 34 hours (?) after taking medication containing antihistamines.
I am moderately allergic to grass, and the last 4-5 summers I've taken antihistamines regularly (last two years the brand Cetirizin Ratiopharm 10mg, namely). I've of course mentioned this to my aviation physicians, I've seen 2 in the last 3 years, and none of them had anything to say on that.
From my own experience they do not cause any notable side effects, however if I forget to take them, I develop itching in the mouth/throat, itchy and runny nose and eyes. So from my personal standpoint I don't see that I would be fit to fly without taking antihistamines.
So what is overruling, the aviation physicians silent (implicit) acceptance, or the hard wording in our ops manual? I tend to think the latter. Would it be possible to get an explicit release from the aviation physician/aviation medicine board, or should I seek alternative treatment? I've heard it's possible to get a shot, however I've also heard it's not very effective.
When reading our completely new ops manual the other day, I found a paragraph I hadn't noted before, talking about antihistamines. It says that we may not operate aircraft within 34 hours (?) after taking medication containing antihistamines.
I am moderately allergic to grass, and the last 4-5 summers I've taken antihistamines regularly (last two years the brand Cetirizin Ratiopharm 10mg, namely). I've of course mentioned this to my aviation physicians, I've seen 2 in the last 3 years, and none of them had anything to say on that.
From my own experience they do not cause any notable side effects, however if I forget to take them, I develop itching in the mouth/throat, itchy and runny nose and eyes. So from my personal standpoint I don't see that I would be fit to fly without taking antihistamines.
So what is overruling, the aviation physicians silent (implicit) acceptance, or the hard wording in our ops manual? I tend to think the latter. Would it be possible to get an explicit release from the aviation physician/aviation medicine board, or should I seek alternative treatment? I've heard it's possible to get a shot, however I've also heard it's not very effective.
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Very interesting.
In my view there are many inconsistencies in AM and approved flight manuals. Namely they allow smokers, who are dependent on nicotine (a very dangerous and an addictive drug) to get them "through", yet ban a medicine that is designed to help.
Your question may also have opened a can of worms.
In my view there are many inconsistencies in AM and approved flight manuals. Namely they allow smokers, who are dependent on nicotine (a very dangerous and an addictive drug) to get them "through", yet ban a medicine that is designed to help.
Your question may also have opened a can of worms.
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Can has been open for years.
Older antihistamines that cause significant drowsiness (classically Piriton or Chlorphenamine (generic name for Piriton)) are incompatible with solo pilot operation.
Newer antihistamines MAY be acceptable but probably only after a period of use with a safety pilot to demonstrate that drowsiness is not an issue. I know many people who get drowsy with the so-called non-sedating antihistamines and so they would not be safe to fly solo.
At one point the RAF only approved one non-sedating antihistamine for flight use. Unfortunately it has now been withdrawn from the market due to other problems. I am out of the Occ Med loop at the moment so I don't know what the current mil advice is but I would expect the CAA advice on potentially sedative drugs to be similar.
Beware that the longer acting (once-a-day) drugs take longer to leave your system so the length of time after taking a drug that you should not fly will get commensurately longer
Hope that helps but I suspect it just stirs the already muddy water!
Bob
Older antihistamines that cause significant drowsiness (classically Piriton or Chlorphenamine (generic name for Piriton)) are incompatible with solo pilot operation.
Newer antihistamines MAY be acceptable but probably only after a period of use with a safety pilot to demonstrate that drowsiness is not an issue. I know many people who get drowsy with the so-called non-sedating antihistamines and so they would not be safe to fly solo.
At one point the RAF only approved one non-sedating antihistamine for flight use. Unfortunately it has now been withdrawn from the market due to other problems. I am out of the Occ Med loop at the moment so I don't know what the current mil advice is but I would expect the CAA advice on potentially sedative drugs to be similar.
Beware that the longer acting (once-a-day) drugs take longer to leave your system so the length of time after taking a drug that you should not fly will get commensurately longer
Hope that helps but I suspect it just stirs the already muddy water!
Bob
Alternative measures may include rinsing the palate with cold water frequently, (the pollen is harmless in the tummy), splashing cold water into the eyes frequently, vaseline around the nostrils, (to trap the pollen), and taking sensible measures such as showering and changing clothes following exposure to pollen. Shutting windows at night may also help.
A stage up maybe to consider topical treatment (nasal spray and eye drops seem to work well)-ask your AME.
Antihistamine treatment has been debated at length previously-(try a search). Second generation treatments claim not to cause drowsiness, but some users beg to differ.
The "shot" I think you may be referring to is kenalog. You'd be hard pushed to find a prescriber in the UK insured to offer it, as it can rot your bones. (Although it does work very well for hay fever).
Safe flying
A stage up maybe to consider topical treatment (nasal spray and eye drops seem to work well)-ask your AME.
Antihistamine treatment has been debated at length previously-(try a search). Second generation treatments claim not to cause drowsiness, but some users beg to differ.
The "shot" I think you may be referring to is kenalog. You'd be hard pushed to find a prescriber in the UK insured to offer it, as it can rot your bones. (Although it does work very well for hay fever).
Safe flying
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Hi all, thanks for the answers so far.
I called my aviation physician and explained to him the case. He also told me that "old" antihistamines used the be an issue, not so much with the newer ones.
We discussed the details; I've been taking this specific brand for two years with no negative side effects. I feel fine both driving and flying (flew with it last season unaware it was against out ops manual). However he was unsure of how the legalities are working out (I asked if there was, or needed to be some kind of medical release), so I sent him an email for him to forward to his superiors at the regulator, so we'll see what they say.
I also directed the question to my company, they replied that the text has been unchanged for years. It also include a vaguely worded sentance about red warning triangles on the affected drugs, however that, as I see, does not void or limit the first sentance in the paragraph, saying explicitly that flying on antihistamines is prohibited. (Not "antihistamines marked with red triangle").
So for me it's not really a practical problem as it is a legal issue. Personally I know that said medication works fine for me, but I don't want to knowingly disregard the ops manual every time i fly, I want to do things right (ie get any liability off my back). Right now, not a problem, as I'm off it, but I need to start taking it within a month, max two.
Furthermore, this is applicable to multi pilot operations, and watering palate is not practical as we do not have a toilet onboard. I also did a search on these forums for "antihistamine" but there were no results.
I called my aviation physician and explained to him the case. He also told me that "old" antihistamines used the be an issue, not so much with the newer ones.
We discussed the details; I've been taking this specific brand for two years with no negative side effects. I feel fine both driving and flying (flew with it last season unaware it was against out ops manual). However he was unsure of how the legalities are working out (I asked if there was, or needed to be some kind of medical release), so I sent him an email for him to forward to his superiors at the regulator, so we'll see what they say.
I also directed the question to my company, they replied that the text has been unchanged for years. It also include a vaguely worded sentance about red warning triangles on the affected drugs, however that, as I see, does not void or limit the first sentance in the paragraph, saying explicitly that flying on antihistamines is prohibited. (Not "antihistamines marked with red triangle").
So for me it's not really a practical problem as it is a legal issue. Personally I know that said medication works fine for me, but I don't want to knowingly disregard the ops manual every time i fly, I want to do things right (ie get any liability off my back). Right now, not a problem, as I'm off it, but I need to start taking it within a month, max two.
Furthermore, this is applicable to multi pilot operations, and watering palate is not practical as we do not have a toilet onboard. I also did a search on these forums for "antihistamine" but there were no results.
