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Cetirizine

Old 5th Jul 2007, 15:07
  #1 (permalink)  
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Cetirizine

This from a letter I received from the CAA today:

Dear Mr Morris,

We have received the forms from your most recent revalidation medical examination via your AME...

I note from the form that you declare that you are taking the medication Cetirizine for hay fever symptoms.

For your information, this medication is disqualifying for aviator's (sic). Acceptable medication to take if you suffer from hay fever are (sic) Loratadine and Telfast. Please cease taking Cetirizine if you wish to maintain the validity of your medical certificate.
This made me very cross. First, that my AME didn't know that - why do they cost so much, if it isn't for their specialist knowledge? - and second, that this should be a blanket ban. For me, Cetirizine cures my hay fever symptoms with no side effects. Loratadine doesn't work (not tried Telfast - obviously will have to now!). Would they really rather I flew with streaming nose and eyes than control the symptoms with a medication which I know works?

Grrrrrrr. Yet another piece of evidence-free regulation...

Tim
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Old 5th Jul 2007, 15:28
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Why don't you call up their chief medic, and find out what their concerns are before dismissing them? Perhaps after having a FRIENDLY conversation with them about their concerns, you could polietly explain your experience on the drugs and ask for if an exception can be made?

Publishing their letter and getting cross with them on the internet, is not likely to help your case. Would you respond well to such actions, if you were in their situation?

dp
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Old 5th Jul 2007, 15:41
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Does seem a little strange, it sounds like someone, somewhere has had a bad experience with ceterizine.

Loratadines been around a little longer, so (???) may have a better established, and safer profile.

Both are meant to be "non drowsy", but experience tells us otherwise.

It's a bit off the point, but have you tried the topical/inhaled stuff. They tend to work well for someone with your symptoms, aklthough you have to persist with the treatment.
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Old 5th Jul 2007, 16:37
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I have always used cetrizine,however I don't remember telling them that I did(I also don't remember them saying I couldn't)
How would they police such a thing anyway? Apart from a post mortem,in which case I doubt I would be bothered about the loss of a medical
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Old 5th Jul 2007, 17:33
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A quick Google revealed a likely reason for the CAA ban on Citirizine!

What side effects can this medication cause? Return to top


Cetirizine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • drowsiness
  • excessive tiredness
  • dry mouth
  • headache
  • sore throat
  • stomach pain
  • diarrhea
  • vomiting

Some side effects can be serious. The following symptom is uncommon, but if you experience it, call your doctor immediately:
  • difficulty breathing or swallowing
Cetirizine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

This was taken from this URL http://www.nlm.nih.gov/medlineplus/d...r/a698026.html

Obviously you dont feel you have suffered any of these side effects, but the CAA must act to cover alll eventualities. Hence the ban.
pumper_bob is offline  
Old 5th Jul 2007, 17:36
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I use levo-ceterezine, slightly newer mix. But had to fight to get this from my previous doctor (as with anything that costs more than the £ 6-85 they get back).
Escpecially during hot weather I find it doesn't last a full day and when it does wear off late afternoon I get very tired and often fall asleep in my chair at my desk for an hour or so. Not very helpful.
I was clearly told several years ago that very few hayfever remedies are accecpted for a class 1 medical, but i thought class 2 didn't count ?. Is it a new euro thing.
Since then I gave up commercial flying (flying an A330 across the pond and back week in week out was just sapping my will to live) and even PPL flying due to work commitments

Question for anyone that know. Is there another remedy I could try / that my doctor could give me, but costs are preventing them from mentioning. Something that will last longer and perhaps no drowzy spells (all high street stuff just gives me a bad headache)
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Old 5th Jul 2007, 18:39
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I'm sorry, Dublinpilot, but the letter didn't say 'Please contact us if you wish to discuss it.' It was quite clear that they wouldn't accept use of cetirizine by pilots at all. I am aware of the list of possible side-effects - but having not experienced any, I know it works for me.

I'm cross because from what I have previously heard, the CAA is not flexible on this sort of thing. Perhaps if I spoke to them they would be - but that wasn't the import of the letter. I'll certainly give it a go.

I'm definitely taking it seriously - it's not just a question of a post-mortem. If I crashed but survived, I could imagine they might prosecute, especially if I killed passengers. So clearly I can't carry on taking it having received this letter.

No-one's mentioned the fact that my AME didn't pick this up...

Tim
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Old 5th Jul 2007, 18:45
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pumper_bob
same can be said for pretty much anything - eg
What side effects may I notice from taking aspirin?
Serious side effects with aspirin include:
black, tarry stools
confusion
difficulty breathing, wheezing
dizziness, drowsiness
ringing in the ears
seizures (convulsions)
skin rash
stomach pain
unusual bleeding or bruising, red or purple spots on the skin
vomiting up blood, or what looks like coffee grounds
Call your doctor as soon as you can if you get any of these side effects.
Minor side effects with aspirin include:
diarrhea
nausea, vomiting
reduced amount of urine passed
stomach gas, heartburn
The "sedative anti histamine" (spelling?) group are a bit worrying due to the drowsy factor. However a large range of drugs can be acceptable if taken for a period on the ground with no side effects. Some I guess will never be acceptable, shame the CAA don't make the info more accessible.
So said AIC 99/2004 (pink 72) is worth a read for general info.
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Old 5th Jul 2007, 19:00
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I find this slightly odd - there are two forms of "ceterezine" - ceterezine hydrochloride, and ceterezine dihydrochloride (there are probably others, but I only know these two). I wonder if the warning is a blanket covering all forms but I would have expected clearer wording.

Personal experience is that I'm ok with the hydrochloride form after the first couple of days of being grouchy & irritable (so nothing new there!) but that the dihydrochloride knocks me for six. In fact I was originally prescribed the hydrochloride variant to stop all of those side effects. The rest of my family all react the opposite way around.
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Old 5th Jul 2007, 23:40
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tm, I think the CAA did ok, they could have said, Licence revoked immediately, informing you, as they did, saved you a whole lot of hassel, think of it that way.
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Old 6th Jul 2007, 00:21
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Daysleeper, just for the sake of impartiality i googled Telfast. This is the result:-
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Headache
  • Nausea
  • Dizziness
  • Fatigue
  • Drowsiness (rare)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

The URL is here:-http://www.netdoctor.co.uk/medicines/100002541.html

All i would note at this stage is the bracketed "rare" next to drowsiness. Surely that is the reason the CAA allow it and not the other medication?
I would like to say that i am only talking from a theoretical perspective as i am not a sufferer(Well not including the demands made by my wife and my addiction to anything aviation, which usually costs more than my wifes credit card bill for a month)
Who mentioned wine and restaurants? OK i am guilty, but dont tell my wife!
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Old 6th Jul 2007, 08:00
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Two golden rules of medicine:

Never say never.

Never say always.


Cheers and have a safe flying weekend, Ginge
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Old 6th Jul 2007, 15:45
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I note this on the CAA website (http://www.caa.co.uk/default.aspx?ca...08&faqid=359):
Summary
If you need medication the underlying medical condition will often make you unfit to fly
If you need medication to ‘make you feel better’ you should not be flying unless your authorised medical examiner or medical adviser (who knows you are a pilot) has approved its use. Professional pilots should take advice from a doctor experienced in aviation medicine.
If you have been taking a medication that can affect judgement, especially those with drowsiness or dizziness listed as potential side effects, a suitable period should elapse after the last dose to enable any effects to dissipate. If the dosage regime is ‘every 4-6 hours’ do not fly until 12 hours has elapsed after the last dose. If dosage is ‘every 10-12 hours’ do not fly for 24 hours
You might argue - I would - that in declaring to my AME that I was using cetirizine at the medical, I was asking my 'authorised medical examiner' to 'approve its use.' Indeed, we discussed it - briefly - and he didn't raise any concerns. I could ring him up to discuss it, but that letter from the CAA effectively closes that door.
On the other hand, the last paragraph basically rules out any drugs on a once-per-24-hours basis, such as the one I was taking (Boots own brand).
Off to find Telfast, anyway.
Tim
(PS edited to add: I talked about side-effects to a medical researcher once who said that basically, anything that happens to any of the test subjects during the drug trial becomes listed as a side-effect. So every drug causes headaches, because at some point during the trial, someone's bound to have one..!)
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Old 6th Jul 2007, 15:54
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I just say a "non drowsy making, non prescription, over the counter medicine for hay fever symptoms"...in fact my AME coached me to put that on my form....
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Old 10th Jul 2007, 11:27
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Im sure I listed Cetirizine Dihydrochloride as a medicine i regularly take on my class 2 medical form and havent heard anything from the CAA

should i expect one or are these letters sent out when one renews?

GW
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Old 10th Jul 2007, 22:54
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Telfast is prescription only.
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