Aspirin, NSAIDs, and other medications can trigger an asthma attack in some people with asthma. It's a good idea to be aware of these meds, especially if you know you have asthma. If these medications have never triggered your asthma, you're probably fine to use them, but use caution because a reaction can occur at any time.
Tell your doctor about any medication that seems to trigger an asthma attack or worsen symptoms of asthma.
Asthma, Aspirin, and NSAIDs
Up to 20% of adults with asthma have sensitivity to aspirin or a group of painkillers called nonsteroidal anti-inflammatory drugs, or NSAIDS. NSAID products include aspirin, ibuprofen, ketoprofen, and naproxen. These drugs are frequently used to treat pain and reduce fever.
Sensitivity to these meds in people with asthma can cause allergic symptoms such as coughing and wheezing. Some people may also develop hives and facial swelling. If you have a reaction, get medical care right away. Afterward, do not use aspirin -- or any other NSAID -- without your doctor's permission.
Asthma attacks caused by any of these medications can be severe and even fatal, so these drugs must be completely avoided in people who have aspirin-sensitive asthma. If you have had a bad reaction to one of these drugs -- aspirin, ibuprofen, ketoprofen, or naproxen -- you're likely to have a similar reaction to the others.
NSAIDs. Why are people with asthma at special risk from NSAIDs? Experts aren't sure, but it seems that these medicines can trigger a dangerous immune response leading to constriction of the airways. People who are older and who have more severe asthma may be more sensitive to these drugs.
Symptoms include a cough, runny nose, shortness of breath, and wheezing. In some people, these medicines can also cause swelling of the face or hives. If you have any reaction, get help right away.
The cause and effect isn't always clear because the allergic response to an NSAID can take up to 2 hours to take effect.
Some doctors suggest that it's best to avoid NSAIDs altogether if you have asthma.
Higher doses of NSAIDs are available by prescription. Since they are more powerful versions of over-the-counter NSAIDs, they often have the same or greater risks. Some examples are Daypro, Indocin, Lodine, Naprosyn, Relafen, and Voltaren.
Cox-2 inhibitors are a newer kind of NSAID. They were thought to have fewer stomach and intestinal side effects than standard NSAIDs, but they can still cause the same allergic reaction in people with asthma.
Nasal polyps. Some people with asthma cannot take aspirin or NSAIDs because of what’s known as Samter’s triad -- a combination of asthma, aspirin/NSAID sensitivity, and nasal polyps. Nasal polyps are small growths that form inside the nasal cavity.
About 30% to 40% of people who have both asthma and nasal polyps will also have this aspirin/NSAID sensitivity. Many people with Samter's triad have nasal symptoms such as runny nose, postnasal drip, and congestion along with asthma symptoms such as wheezing, cough, and shortness of breath. Talk to your doctor about options other than aspirin and NSAIDs if you have this.
Asthma and Other Pain Medications
Acetaminophen: Acetaminophen is considered a safer alternative for people known to have aspirin-sensitive asthma. However, some studies have linked asthma to use of acetaminophen in some people. It is important that people with aspirin sensitivity read labels of all over-the-counter drugs used to treat pain, colds and flu, and fever.
Tell your doctor so that these medications are not prescribed for you. If you have any questions whether a certain medication could trigger your asthma, seek advice from your health care provider.
Narcotics: Narcotics are another type of prescription painkiller, usually only available by prescription. Examples include OxyContin, Percocet, and Vicodin. These drugs are only used in people with severe chronic pain. They don't generally pose a risk for people with asthma. The exception is for people having a severe asthma attack. In these people, narcotics can lead to dangerously slow breathing. Narcotics do have other side effects, including constipation, fatigue, and a risk of addiction.
Other options for pain relief:
- Ice packs, for acute injuries like a sprained ankle or sore muscles, can keep down swelling and ease pain.
- Heat -- with a hot towel or heating pad -- can be helpful for treating chronic overuse injuries. (However, you shouldn't use heat on recent injuries.)
- Physical activity can help reduce some kinds of discomfort, such as arthritis pain.
- Relaxation techniques like yoga, meditation, and biofeedback may help as well, especially for pain made worse by stress, like tension headaches.
- Nontraditional techniques like acupuncture and massage benefit some people.
Asthma and Beta-Blockers
Beta-blockers are commonly prescribed medications used to treat numerous conditions including heart conditions, high blood pressure, migraine headache, and, in eye drop form, glaucoma. Your health care provider must determine the need for these medications, and you can take a few trial doses to see if they affect your asthma. It is important that you inform all of your health care providers who may need to prescribe these types of medications that you have asthma. This includes your eye doctor.
Asthma and ACE Inhibitors
ACE inhibitors are other types of medications used to treat heart disease and high blood pressure. These drugs can cause coughs in about 10% of the patients who use them. This cough is not necessarily asthma. But it can be confused with asthma or, in the case of unstable airways, may trigger asthma symptoms. If you are prescribed an ACE inhibitor and develop a cough, speak with your doctor.