Aspirin Allergy

Aspirin is an effective pain-relieving and fever-reducing drug. However, for many people it can also be the trigger for an allergic reaction. With aspirin commonly used for conditions ranging from mild aches to heart attack prevention, allergy treatment must be prioritized for those most at risk. And as with other allergies, getting a precise diagnosis and personalized treatment plan from an Atlanta area allergist is the best solution for an aspirin allergy. Here is a closer look at this common condition.

What Is an Aspirin Allergy?

Aspirin is known to cause an allergic reaction in some patients. An aspirin allergy has a high-risk factor, especially for patients with severe asthma. If a patient has an aspirin allergy, they most likely also have allergies to other types of Non-Steroidal Anti-Inflammatory Drugs (NSAID) including medications like ibuprofen, Advil, Motrin and other medications that are taken to relieve pain, decrease fevers, and inflammation.

One in ten patients with severe asthma could experience allergic reactions after taking an NSAID medication. There is a 40% increase in the possibility of being allergic to aspirin and NSAID medications if the patient whose asthma is accompanied by chronic sinusitis and nasal polyps.

Understanding Aspirin Allergy

An aspirin allergy can be divided into three different categories, each with their own different characteristics and reactions that can be mild to life-threatening. These three groups include:

1. Aspirin-exacerbated respiratory disease (AERD) – can cause symptoms such as rhinitis and asthma.
2. Aspirin-exacerbated urticaria/angioedema – can cause symptoms such as hives and swelling.
3. Aspirin-exacerbated urticaria with or without angioedema – can cause symptoms in which hives and swelling can turn into a life-threatening symptom called anaphylaxis.

Less common NSAID systems may cause serious conditions such as aseptic meningitis and hypersensitivity pneumonitis

Diagnosing Aspirin Allergy

An aspirin allergy can’t be diagnosed with other allergies including cat dander, foods, and others. These allergies are usually diagnosed by a blood test, patch test or prick test. However, with an aspirin allergy, it is most often diagnosed based on the appearance and timing of the symptoms.

In more severe cases with an aspirin allergy, an oral test like “Aspirin Desensitization” can be performed to see how a patient reacts to a specific NSAID medication. This testing should only be performed under supervision by an allergist.

Treating Aspirin Allergy

The basic treatment for an aspirin allergy is to avoid any NSAID medications that are known or believed to cause an allergic reaction to the patient. Patients with an extreme hypersensitivity should avoid all NSAID medications.

Acetaminophen (Tylenol) is usually considered safe as well as COX-2 inhibitors such as celecoxib (Celebrex).

What is Aspirin Desensitization?

In more serious cases treatment like aspirin desensitization therapy may help a patient overcome hypersensitivity. Patients with AERD that undergo surgery for polyps are usually recommended to have aspirin desensitization therapy to help them be able to enjoy the benefits of aspirin. Aspirin can help minimize needing surgery for polyps and other symptoms.

Aspirin desensitization therapy is performed to decrease a patient’s sensitivity to aspirin by exposing them to very low doses of aspirin. During the procedure, the patient will then gradually get increased doses of aspirin until they can tolerate 650 mg of aspirin. This procedure should always be done under the supervision of your allergist.

Symptoms of Aspirin Sensitivity

If you get any of the following symptoms after taking aspirin, or another nonsteroidal anti-inflammatory drug means that you can have an aspirin sensitivity:

• Itchy and watery eyes
• Itchy rashes
• Nasal congestion
• Hives
• Worsening asthma
• Rashes around the mouth
• A cough and wheezing
• Anaphylaxis— this is a severe, potentially fatal reaction.

Precautions for Persons with Aspirin Sensitivity

• Avoid aspirin and other nonsteroidal anti-inflammatory drugs
• Avoid drugs with aspirin as an ingredient
• Patients with aspirin-induced asthma, can (in most cases – check with your doctor) take acetaminophen to relieve pain
• Talk to your doctor if you think you may have aspirin sensitivity

Types of Allergic Reactions NSAIDs

The types of allergic reactions due to NSAIDs can range from mild to life-threatening. The main symptoms of an aspirin allergy are:

• Respiratory symptoms such as asthma and rhinitis
• Skin symptoms such as swelling and hives
• Severe allergic reaction and anaphylaxis

The Presence of Aspirin is Not Always Obvious

Aspirin or other NSAIDs could be present in many over-the-counter painkillers and medications, some of these could include:

• Medications for a headache, period pain, sinus pain
• Cold & flu tablets

For patients that have a high aspirin sensitivity may need to avoid other salicylates which could be present in:

• Inflammatory bowel disease drugs
• Complementary alternative medicines such as willow tree bark extract and certain herbal arthritis pills
• Topical salicylates such as arthritis creams and teething gels

If you are sensitive to aspirin, you need to carefully read medication labels and be cautious about taking any painkiller. Talk to your doctor or pharmacist before taking any medications that you are uncertain of.

Contact your Atlanta Allergist, Dr. Tom Chacko Today

For more information on aspirin allergies, or if you believe that you are experiencing symptoms that could be associated with an aspirin allergy, contact Atlanta’s top allergist, asthma and sinus doctor, Dr. Thomas Chacko at 678-668-4688 or request an appointment at one of our six locations — Alpharetta, Atlanta, Canton, Cumming, Duluth and Johns Creek.