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Doctors' Answers to "Frequently Asked Questions" - Seldane

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Seldane-D Substitute [posted 8/14/98]
Question: I am a 46 year old diabetic and thyroid patient. My diabetes is controlled with Glucophage and Glucotrol. When I fly, I occasionally have an ear canal that won't pop. After years of trying OTC decongestants and antihistamines, I finally found (with the help of my endocrinologist) that I could take Seldane-D as a prescription without reacting to it. I react to all OTC medications tried (greatly increased heart rate). Now that I finally found it, the FDA is removing Seldane-D. What can I use instead? Claritin is too slow to build up in the system to become effective. I need something that will help keep my ears clear when taken 1-2 hours before flying. Plus, it's nice to have something I can take for a cold.

Answer: Allegra is the metabolically active part of Seldane and comes in an Allegra-D format as well. I'd try this first.

Question: I am a cardiac patient for whom Procardia has been prescribed. I have been reading that Seldane and grapefruit could be a deadly combination. Do you have any information of this?

Answer: Didn't used to think so, but recent information shows a major change in many drugs while taking grapefruit juice, particularly some calcium channel blockers. However, Seldane is no longer available so this is probably a mute point.

Seldane Prescription Instructions
Question: I have been taking the medication Seldane for about five years for allergies. My most recent renewal had a caution on the label saying that this medication should not be taken with grapefruit or grapefruit juice. I have never seen this warning before. Can you explain why this should be avoided?

Answer: Seldane is getting ready to be pulled from the market. I would use Claritin or Allegra in place of Seldane.

Question: Do you have any information on the drug Seldane and also its side effects and reactions to other drugs?

Answer: Side effects include Ventricular Tachycardia, Ventricular Fibrillation, Cardiac arrest, low blood pressure, palpitations, syncope, dizziness, drowsiness, headache, fatigue, nervousness, weakness, increase appetite, nausea, vomiting , change in bowel habits and dry mouth. Interactions with other drugs include Itraconazole, Ketoconazole, Erythromycin, Clarithromycin and Azithromycin. Any of these drugs are given with Seldane can cause serious cardiovascular side effects.

Question: I heard that Seldane-D is a discontinued product. If not, is it safe to use? If yes, can you recommend me something other than Afrin? My nasal congestion is very chronic.

Answer: Seldane and Seldane-D will soon be off the market. This is due to buildup of the drug when taken with certain other drugs, especially macrolides (erythromycin, Biaxin, Zithromax, etc.) and/or ketoconazole (an anti-fungal drug). This drug is relatively non-sedating compared to traditional antihistamines like Benadryl, etc. Consequently was used a lot for allergic symptoms. Other drugs that act in a similar manner, but don't have the interaction with the above drugs, are Claritin, Claritin-D, Allegra, etc. Afrin is mainly pseudo-effedrine (similar to the D part of Seldane-D or Claritin-D). You shouldn't use this more than one or two days in a row or you can develop the exact runny nose you are trying to avoid. This is called rhinitis medicosium. Other drugs (not antihistamines) that work on allergic symptoms are nasal steroid inhalers and cromlyn sulfate nasal inhalers. These will not help the itching eyes, ears, etc., but will generally help allergic rhinitis.

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