Updated July 30, 2015.
What is Aspirin Allergy?
Non-Steroidal Anti-Inflammatory Drugs (abbreviated NSAID) include a large number of medications that includes aspirin. Aspirin was the first NSAID discovered in the 1800’s, isolated from the bark of the willow tree. Today hundreds of chemically produced NSAIDs are used to control conditions that involve inflammation, pain, and fever.
Many different allergic reactions have been reported to NSAIDs, from mildly bothersome to life-threatening.
The most common reactions include:
- Skin symptoms, such as hives and swelling.
- Respiratory symptoms, such as rhinitis and asthma symptoms.
- Anaphylaxis.
These “allergic” reactions are distinct from other “adverse effects” such as stomach upset, bleeding, or bruising that are also commonly reported with NSAIDS but not considered allergic in nature. Find out more about the differences between drug allergy and intolerance.
Aspirin Desensitization
Depending on the type of reaction to non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin, it is possible to desensitize a person who is allergic to these medications. The purpose of desensitization is not only to allow a person to be able to tolerate NSAIDs, but to help in the treatment of certain types of asthma and chronic sinus infections and nasal polyps. People who experience urticaria and angioedema as a result of taking NSAIDs cannot be desensitized to their type of allergy.
Approximately 10% of all people with asthma are allergic to aspirin and other NSAIDs.
If these medications are taken, asthma and/or nasal symptoms can worsen. Many aspirin-sensitive asthmatics are not allergic to typical triggers, such as pollen and pet dander, and some have very severe asthma despite taking typical asthma controller medications. For these people, desensitization to aspirin can result in a significant improvement in the control of their asthma.
Desensitization to aspirin may also help people with chronic sinus infections and nasal polyps that are allergic to aspirin. Again, many of these patients have non-allergic rhinitis and may not respond to typical allergy medications. Some even require repeated sinus surgeries for nasal polyps; desensitization to aspirin may relieve much of their nasal symptoms and reduce the re-growth of polyps, resulting in the need for less sinus surgeries.
Aspirin desensitization is typically only performed in specialized medical centers, given the fact that some asthmatics may experience life-threatening reactions when given these medications. Initially, very small doses of aspirin are given over a matter of many hours, with many people experiencing some form of allergic reaction during this time. The allergic reaction is treated, and then the person often continues on the desensitization the next day with the same dose that caused the reaction on the previous day. This repeat dose is usually tolerated, and the process is repeated until the person can tolerate a full dose of aspirin.
Once a person is able to tolerate a daily amount of aspirin, the aspirin is typically given on a daily basis for a period of week to months, and in some cases years, in order to treat the asthma and/or chronic sinus disease. The desensitisation is only maintained as long as aspirin is taken daily. Once stopped, the allergy returns.
Learn more about aspirin allergy.
Source:
Namazy JA, Simon RA. Sensitivity to Nonsteroidal Anti-inflammatory Drugs. Ann Allergy Asthma Immunol. 2002;89:542-50.
Stevenson DD, Szczeklik A. Clinical and Pathologic Perspectives on Aspirin Sensitivity and Asthma. J Allergy Clin Immunol. 2006;118:773-86.
DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.