Allergy and adverse reactions to NSAIDs

Patients may suffer from adverse reactions such as

  • Skin symptoms, such as hives and swelling. 
  • Respiratory symptoms, such as rhinitis and asthma.
  • Anaphylaxis
  • due to accidental or careless administration of drugs despite known allergies or allergic-like reactions is common. Analgesics (anti-pain drugs) and antibiotics (potent anti-bacterial drugs) are responsible for the majority of the adverse reactions to medication.

    Non-Steroidal Anti-Inflammatory Drugs (abbreviated NSAID) include a large number of medications that are closely related to aspirin. The symptoms due to non-allergic drug hypersensitivity appear within 30 minutes to two hours after intake of the aspirin or NSAIDs. The symptoms manifest as swelling around the eye, nasal congestion, respiratory distress, rashes, perspiration and occasionally gastrointestinal problems.

    How is NSAID allergy treated?

    Avoidance of all of the NSAIDs is the usual treatment for NSAID allergy. It is important to be aware of the huge variety of medications that contain aspirin or related NSAIDs. In some situations, such as certain medical conditions, an NSAID is a required therapy. For these people a desensitization procedure is a possible treatment, and should only be performed by allergy physicians skilled in the desensitization of drugs. Desensitization to NSAIDs may be successful for patients with respiratory-NSAID allergy or anaphylaxis, but does not work for skin-NSAID allergy.

    Prescription medications to avoid.

    Diclofenac (Voltaren®) , Diflunisal (Dolobid®), Etodolac (Lodine®), Fenoprofen (Nalfon®), Flurbiprofen (Ansaid®), Ibuprofen (Motrin® products, Advil® products, many generic forms), Indomethacin (Indocin®),Ketoprofen (Orudis®), Ketorolac (Toradol®), Meloxicam (Mobic®) , Nabumetone (Relafen®), Naproxen (Aleve®, Naprosyn®, Anaprox® products), Oxaprozin (Daypro®), Piroxicam (Feldene®), Salsalate (Disalcid®)

    What drugs are “safe” in a person with NSAID allergy?

    Except in extremely rare cases, Tylenol® (acetaminophen) is safely tolerated and is considered the drug of choice in NSAID-allergic patients. The newer COX-2 inhibitors, available only as celecoxib (Celebrex®) in the United States at present, are usually tolerated as well, although it is recommended that patient be monitored in a physician’s office for the first full dose of these medications. Most narcotics are safe, with the exception of some combination products containing NSAIDs.

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