allergy attack

[cellio]

I'm allergic to Pennsic. (Well, to dust and grass and pollen and weeds and...) So I take Allegra for about three weeks each year to deal with that, but don't take it the rest of the year. (I don't want to develop a resistance to it like I did to all previous allergy drugs save one [1].)

This year I started taking it on Saturday, and then went to Cooper's Lake Sunday for setup. I was fine yesterday, but today I've been congested all day. Mid-day I added Sudafed to the mix; I hope that wasn't bad but I really needed to treat the symptoms. (I take the Allegra once a day and had taken it this morning.) It took about four hours for the Sudafed to produce results.

I think this must have happened in the past, because there's Sudafed in with my use-only-at-Pennsic stuff. Now that I think about it, I remember once calling my doctor from Pennsic to ask if taking Sudafed while taking Allegra would kill me and he said it wouldn't.

I don't know if starting the Allegra earlier would help; how long does it have to be coursing through your veins to lay down a basic barrier against the nasty little allergens? With luck, writing this entry will help me remember next year to start earlier. (I'm sort of assuming that I should be taking allergy drugs (Allegra) and not cold drugs (Sudafed) as a baeline. I don't have a cold; I just have some of the symptoms.)

I should remember to ask my doctor if he can improve on this for me.

[1] Seldane. It worked gloriously, better than Allegra I think, so naturally the FDA eventually decided I couldn't have it.

Comments

[kayre]

You can buy Allegra-D, which is allegra plus sudafed, so adding the sudafed is absolutely fine.

Allegra is supposed to be very closely related chemically to Seldane, but I also found Seldane more effective.

I'm not sure how long it would take to be effective, but I'd try at least 3 days ahead, personally.

[cellio]

This is, in fact, Allegra-D. (I'm pretty sure, anyway.) Thanks! I didn't realize that meant it had the same stuff as Sudafed.

I think they still sell Seldane over the counter in Canada, though I haven't checked in a few years. When I had a Seldane prescription, I sometimes brought some back from trips to Canada instead of filling the prescription here. It wasn't cheaper for me (had good insurance at the time), but in Canada it came in one-a-day capsules while in the US I could only get two-a-day horse pills. So it was purely a matter of comfort. (My gag reflex is mighty, and I have trouble with large pills.) I didn't abuse it (I'd bring a box back, not a case :-) ), so I gambled that that would be ok at the border if we were ever searched (which we weren't).

[geekosaur]

I recall their recommmending taking it 1-2 weeks ahead, since the time it takes to reach full potency varies. (Of course, they'd also like you to take — and pay for — more of it....)

I also seem to recall that Allegra and Seldane both are metabolized into the same actual antihistamine, but Allegra is less effectively metabolized. (Whereas Seldane is simultaneously metabolized via another pathway to something that causes heart attacks (or was it strokes?) in some percentage of people, or something like that.) I didn't pay too much attention, since it turned out that I don't even digest it. (Oy. On the other hand, it also turned out that antihistamines don't help me, so it's all irrelevant.)

[cellio]

(Of course, they'd also like you to take — and pay for — more of it....)

Yup. And at almost 70 cents per pill just from the co-pay, I can see why that might appeal to them. :-) I think the sticker price for a month's worth of Allegra is over $100, but that was a casual comment by the clerk at the pharmacy and not a real price quote.

I had meant to start taking the Allegra Friday but forgot. I think I started Friday last year and it worked then, but last summer was wetter so maybe that helped with the dust. Next year I guess I'll just take it a week ahead and see if that makes a difference. If not, it may be time to ask Canadian friends to bring Seldane to Pennsic.

Seldane: what I understood at the time was that Seldane interacted badly with a medicine commonly used for heart conditions, but for some reason great big warning stickers saying "don't take with [whatever]!!!" were deemed insufficient. I don't recall hearing that Seldane itself posed a risk, though perhaps I just didn't hear all the problems with it.

[sethcohen.livejournal.com]

As a result of the drug-drug interactions Seldane and Hismanal exhibited, there was serious research done into what drugs also cause Q-T prolongation. Neither Seldane or Hismanal alone were risky if taken alone, but people rarely take just one pharmaceutical product...so the drugs came off the market.

[cellio]

people rarely take just one pharmaceutical product

That makes sense broadly, though I find myself wondering how many people only take allergy medicines. (Ok, technically I take more than one pharmaceutical -- but only one that's ingested. I suspect the eyedrops for glaucoma aren't relevant.)

Thanks for the information. I'd forgotten what the specific issue with Seldane was.

[sethcohen.livejournal.com]

Allegra is what Seldane is metabolized into. There are drug-drug interactions that cause Q-T prolongation (a kind of heart arrythmia) that is bad enough in some people that it can kill them. This only happens with Seldane, not Allegra.

[(Anonymous)]

how long does it have to be coursing through your veins to lay down a basic barrier against the nasty little allergens?

About an hour. Peak blood serum concentrations are reached (on average) in 2.6 hours. FYI, the laws of steady-state metabolism means that it takes about 5 half-lives for steady-state to be reached. I recall that you've taken enough math to know what I mean, but I don't remember if you remember the math in question. In general, if the drug is supposed to last 12 hours and you take it every 12 hours, it'll take (5x12, or 60) hours for you to reach the maximum amount in your body, and thus maximum effectiveness. It works in reverse as well. If you were at maximum blood levels, and you stopped taking it, it'll all be out of your body in the same amount of time.

Be lucky that antihistamines aren't as bad as amiodarone. Amiodarone has a 51-day half-life.

D'oh!

[sethcohen.livejournal.com]

Of course, that was me. I'm responding from Karen's computer, which can be placed under a fan or air conditioning (or, in this case, both). I'm warm.

[cellio]

Thanks for the information! Ok, next year it sounds like I need to start Thursday (for a Sunday exposure). Could be Friday, but they're one-a-day pills so better 12 hours too much than 12 hours too little. :-)

I hadn't considered the flip side; I've always taken the drugs for a few days past the end of Pennsic on the theory that all that stuff bombarding my body probably has lingering effects. But, as you say, the drugs also linger. So maybe I can stop taking it the day I come home. Hmm.

Amiodarone has a 51-day half-life.

Yowsa. What is it used to treat?

[sethcohen.livejournal.com]

Whoa...remember that it's still 5 half-lives. If the drugs lasts for 24 hours, then you need to take it for 5x24 hours, or 5 days to reach maximum potency.

Amiodarone is used to treat a kind of heart arrythmia. :)

[cellio]

Oh, oops. You're right. Allegra comes in both 12-hour and 24-hour varieties, and somehow I thought you were saying that the half-life of Allegra is 12 hours rather than a particular delivery vehicle.

(I don't know if 24-hour drugs really last 24 hours. I'm torn on when in the day I should take it -- first thing in the morning for maximum effect while I'm awake, or evening so that I won't wake up with sniffles? Assume I'm running around enough to make, say, hitting 2pm consistently impractical. I'm currently taking it in the morning.)

[jerusha.livejournal.com]

According to my pocket reference, the elimination half-life of fexofenadine (the active ingredient in Allegra) is 14.4 hrs. So you would need to start your dosing 72 hours in advance of exposure. So if you'll be on site Sunday, you should start taking it on Wednesday night or Thursday morning.

[sethcohen.livejournal.com]

As your allergies are situational, I'd recommend taking it in the morning. It takes a bit for your immune system to respond to the pollen insult, so the antihistamine will already be in your blood by the time it's thinking about responding. If you had allergies related to being home (e.g. dust mite allergy) I'd recommend you take the Allegra in the afternoon or evening.

[sekhmets-song.livejournal.com]

Funny how different people react differently to the same drug: Seldane didn't do crap for me. I suspect I'd have the same issue with Allegra. I'm a Clariton girl (though I only take it one or two days a week in the summer. The winter is when I need it daily), now.
I remember when they pulled Seldane from the market. I still had half a bottle left (and something like 4 months left on the prescription) and had friends begging for my leftovers when theirs ran out.

[cellio]

There was a period of time when you couldn't get Seldane but they hadn't yet rolled out Allegra. Or there was some complication with Allegra. I don't exactly remember. It didn't affect me because I just kept taking Seldane and, since I don't take it all the time, I had enough. But for people with allergies that go all season, I can see why your leftovers were in demand.

The only reason I take a prescription allergy medicine is that every single OTC drug has a warning about a condition I have (or did the last time we surveyed them), so my doctor told me to take this instead. I don't know what makes Allegra and Seldane magically different from the OTC drugs on this front, but oh well. If I needed more than one fill-up of the prescription per year I'd look harder at it, but for $20/year I'll just do what my doctor says without complaint. (Actually, if the shelf-life is long enough I can get that down a bit by buying a three-month supply for $40. That would last me 3-4 years.)

[dagonell.livejournal.com]

If I could figure out how the quirk in my brain functioned, I would be revered throughout Pennsic... For the longest time, David suffered from hayfever while Dagonell did not. Yes, you're reading that correctly! My mundane modern identity had a prescription for hayfever which my medieval persona never needed. Camping with the family? Bring the tissues and meds. Pennsic? No problem! Nowadays, I'm more fortunate. It has to be a *very* heavy pollen day before I'm affected.

Weirdly enough, the effect is not undocumented. Sybil, the famous multiple personality, had it. Several of her personas had allergies that other personas didn't have. It's apparently a mental trick, but I don't know how I did it.
-- Dagonell

[cellio]

If you ever do figure out how to will away allergies with the power of your mind, please let me know! Yeah, I know, you could also sell the secret for a lot of money; I promise not to interfere with that. But you're my friend and you'll tell me, right? :-)

[alfiechat.livejournal.com]

Loved taking Seldane. I beleive i used to take seldane D. Allegra didn't work as well. Now i take Zyrtec D and it works much better than allegra ever did.