What Is Aspirin Sensitivity?

Some people are truly allergic to aspirin. Others have what doctors call a non-allergic sensitivity to it. That means when they take the drug, they have symptoms -- sometimes dangerous ones -- but they don’t have an allergy.

People with this condition sometimes have problems with other similar meds for pain. These common medications are part of a group called nonsteroidal anti-inflammatory drugs, or NSAIDs. Common examples include:

What Are the Symptoms?

When you take one of the drugs listed above, you might notice:

What Is Samter's Triad?

This combination of problems might also be referred to as aspirin triad, and aspirin-sensitive asthma. It includes:

  • Reactions to aspirin and NSAIDs
  • Asthma or bronchospasm triggered by taking aspirin or a NSAID.
  • Growths in your nasal passages, called polyps, that can cause problems with your sinuses

Experts aren't sure why these problems show up together. About 3% to 5% of people with asthma have aspirin sensitivity. Samter's triad is more common in women. Symptoms often start when you’re in your 30s.

Along with lasting stuffiness, you’ll notice watery eyes, a cough, and other problems. You might lose your sense of smell. Some people have sudden, severe asthma attacks that can be triggered by alcohol consumption and require emergency treatment.

How to Manage Aspirin Problems

Get help for emergencies. If you have sudden symptoms -- like swelling, trouble breathing, or wheezing -- call 911 or go to the emergency room. These reactions can be life-threatening.

Don’t take it or other NSAIDs. If you have asthma and nasal polyps, your doctor will tell you to avoid specific NSAIDs. Acetaminophen (Tylenol) is a safe alternative. 

Keep an eye out for aspirin. Look for it in unexpected places. Lots of remedies for colds, the flu, coughs, stomach problems, and other conditions contain it or another NSAID. You may even find it in cosmetics, soap, shampoos, and skin cleaners.

Control your symptoms. Your doctor may prescribe a limited course of steroids depending on how much of a problem you have. If you have asthma, take your medicine to keep it under control.

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Change your diet. Some foods have high levels of salicylates, natural chemicals that are the main ingredients in aspirin. It may help to cut back on these foods -- like some fruits, vegetables, nuts, coffee, and tea. Ask your doctor.

Consider treatment. You can try a process called desensitization. You’ll start off taking small doses of aspirin and work your way up to more. Your doctor will watch you closely for reactions. If it works, you may be able to take aspirin without problems -- as long as you keep taking it daily. This can help ease asthma and sinus symptoms, too.

Remove nasal polyps. If they’re a problem, your doctor may suggest surgery. Keep in mind that they can grow back.

WebMD Medical Reference Reviewed by Sabrina Felson, MD on July 25, 2017

Sources

SOURCES:

American Rhinologic Society: "Aspirin Desensitization."

Brigham and Women's Hospital: "Aspirin Exacerbated Respiratory Disease," "Aspirin Exacerbated Respiratory Disease: Aspirin Desensitization."

University of Texas Medical School at Houston: ASA Triad.

World Asthma Foundation: Asthma & Aspirin Sensitivity.

UpToDate.

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