Is there any medical justification for delaying FIVE times dosing time for medication

[comanchepilot]

So AOPA sends out this missive today from ABC where the FAA has decided that one should wait five dosing intervals before operating an aircraft?

http://ftpcontent.worldnow.com/griffin/NEWSon6/PDF/1307/FAA_letter_to_pilots.pdf

and also -
[FONT=&quot]http://abcnews.go.com/US/faa-alerts-general-aviation-pilots-medication/story?id=19684010#.Ueava43CZ8E[/FONT]

Is there any science to this? Or this another 'don't fly in temps below freezing if there is high humidity' missives from the geniuses of Maryland Avenue?

Just because you and your organization is coerced to sign the letter . . . . does not make it true.

And if you read the FAA Fact Sheet and FAA materials - at NO LOCATION is five times discussed - it reads like a lawyer's risk analysis - take the absolutely longest period and double it.

You can detect benzodiazepenes in the urine for 4 days after use. Yet, the drug generally has a 4-6 hour effective period which means you can detect the drug almost twice as long as these clowns are telling you to abstain from flying. Which means even though you follow the rule of 5 times dosing, the FAA can detect it in the urine which puts you into the percentage of pilots who had detectable levels of drugs . . . .

 

[FORANE]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Sounds like a simple to remember guideline based roughly on elimination half life. In 1 half life 50% should be eliminated; after 5 half lives roughly 97% is eliminated.

 

[EdFred]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

So AOPA sends out this missive today from ABC where the FAA has decided that one should wait five dosing intervals before operating an aircraft?

http://ftpcontent.worldnow.com/griffin/NEWSon6/PDF/1307/FAA_letter_to_pilots.pdf

and also -
[FONT=&quot]http://abcnews.go.com/US/faa-alerts-general-aviation-pilots-medication/story?id=19684010#.Ueava43CZ8E[/FONT]

Is there any science to this? Or this another 'don't fly in temps below freezing if there is high humidity' missives from the geniuses of Maryland Avenue?

Just because you and your organization is coerced to sign the letter . . . . does not make it true.

And if you read the FAA Fact Sheet and FAA materials - at NO LOCATION is five times discussed - it reads like a lawyer's risk analysis - take the absolutely longest period and double it.

You can detect benzodiazepenes in the urine for 4 days after use. Yet, the drug generally has a 4-6 hour effective period which means you can detect the drug almost twice as long as these clowns are telling you to abstain from flying. Which means even though you follow the rule of 5 times dosing, the FAA can detect it in the urine which puts you into the percentage of pilots who had detectable levels of drugs . . . .

When I take HC, it says every 4-6 hours, and It was recommended I not fly for 48 hours after the last pill. That's 8 times the effective period. If it says 4-6 hours, wait 30 hours. I don't think that's out of line at all. I can feel the HC start to wear off after 4-6, but I still feel the effects of it the next day.

 

[comanchepilot]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Confirming there is no medical evidence this is a good rule of thumb. . .

 

[AggieMike88]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

I can't speak to the science, but when I take items like allergy or cold meds that cause drowsiness of "thick head slow thinking", it usually takes 2-4 days for me to return to not feeling the effects of the meds.

So I have no problem waiting as long as needed to be good to go with IM SAFE.

 

[AggieMike88]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Confirming there is no medical evidence this is a good rule of thumb. . .

oookaay... then what is it you're wanting out of the discourse of this thread?

 

[EdFred]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Confirming there is no medical evidence this is a good rule of thumb. . .

Drugs affect people in different ways. Medical evidence it going to be hard to come by to make it hard and fast. There's always going to be an outlier that feels the effects long after the vast majority do. As long as 1 person is feeling woozy 2 days later, guess what ruling we're gonna get?

 

[JeffDG]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

They do have specific guidelines for specific meds. One that I'm familiar with (I have a Letter of Eligibility for it) is Imitrex, which you can take up to two doses a day, so let's say that's 12 hours. The FAA doesn't want me flying if I've taken it within 24 hours, so nowhere near the 5 intervals.

Probably not a bad general rule-of-thumb, though.

 

[comanchepilot]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

I guess my point, Mike, is that:

a) IMSAFE is the best way for a pilot to decide. . . .not some letter signed off by a bunch of association presidents
b) its pretty clear there is no FAA support for 5 tmes
c) it is just PR BS the government is supporting that has no real scientific proof other than some lawyer somewhere thinking it is a good idea

I'm with ya - I took prometh for a bad cold / cough 3 years ago - never freaking again. It kept me fuzzy brained for 3 days from a single dose. I would have been ok in 30 hours under this rule and I couldn't remember where I parked my car for three days. And I never left the house. That's kind of what I mean . . .

 

[poadeleted20]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

I'll wait for the inputs of some of the folks with real medical expertise, but the fact that the FAA recommends 5 times dose interval as a minimum doesn't to me sound like they are saying it's a guarantee of safety. I think proper research talking with your AME or the prescribing physician (assuming aerospace physiology knowledge on the part of the latter) about the specific drug and the specific person involved is the way to do it, and the FAA "guideline" is only a last-ditch means if you can't get any better advice.

 

[steingar]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Probably a response to the graying of the pilot population. Us elderly pilots metabolize medications less rapidly than younger people. Five dosing intervals sounds like a really good idea to me. That said, I don't honestly know where they got the science, but there's more than enough pharmacology and pharmacokinetics to draw from.

 

[N801BH]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

....I'm with ya - I took prometh for a bad cold / cough 3 years ago - never freaking again. It kept me fuzzy brained for 3 days from a single dose. I would have been ok in 30 hours under this rule and I couldn't remember where I parked my car for three days. And I never left the house. That's kind of what I mean . . .

Prometh ?? is it a OTC drug ? or did ya buy it on the local street corner.

 

[EdFred]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Prometh ?? is it a OTC drug ? or did ya buy it on the local street corner.

Maybe Joe is developing a lisp, and used a margarine brand as treatment.

 

[oldbabyboomer]

Re: Is there any medical justification for delaying FIVE times dosing time for medica

Rule of thumb in biopharmaceutics/bioavailability: it takes 5 half-lives to reach plateau level in body.