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Aspirin and Asthma

Q: I'm asthmatic, and whenever I take aspirin to relieve a headache or muscle pain, I wind up congested and sometimes even gasping for air. Why is aspirin triggering my asthma attacks, and is there anything else I can safely take for pain?

Dr. Donnica:
Stop taking aspirin! For most adults with asthma, aspirin is fine. But you are clearly in the group of 3-5% of adults with asthma who have a bad reaction to aspirin. In sensitized individuals, aspirin causes the body to produce excessive amounts of chemicals called leukotrienes, which cause the muscles surrounding the bronchial tubes to contract. As a result, in these individuals, aspirin can exacerbate asthma, often causing wheezing or a severe and sudden attack. Susceptible asthmatics may also notice nasal congestion and abdominal pains after aspirin usage. This sensitivity to aspirin develops in adulthood and may be found in conjunction with nasal polyps. You should ask to be checked for this.

As a result of this known sensitivity, many adults with asthma have been advised to avoid aspirin. The only way to know if you're in this group is to have had a bad reaction.

While there are now medicines called leukotriene blockers (e.g. Accolate®; Singulair®; and Zyflo®) that can reduce leukotriene overproduction, your best protection is to avoid aspirin, aspirin-containing medications (like Excedrin, Alka Seltzer, or Pepto Bismol), AND all non-steroidal anti-inflammatory drugs (e.g. Motrin, Advil, Nuprin, Naprosyn, etc.). You didn't specify why you were taking pain medication, but this certainly limits your options. Tylenol (and other forms of acetaminophen) is safe to take and can usually be used as a substitute for aspirin. A complete list of medications, both prescription and over-the-counter, that contain aspirin and non-steroidal anti-inflammatory drugs is available at www.asthma.partners.org.

Created: 1/8/2005  -  Donnica Moore, M.D.

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