Asthma is a long-lasting (chronic) lung disease. It causes symptoms like coughing, wheezing, and shortness of breath.
Aspirin-induced asthma (AIA) is asthma triggered by taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, ibuprofen, and naproxen are NSAIDs.
This kind of asthma is not common in children.
What is the cause?
Asthma symptoms are caused by two different problems in the airways.
One problem is that the muscles in the airways tighten up, which causes the feeling of chest tightness and wheezing.
The other problem is swelling, irritation and too much mucus in the airways.
If you have asthma, symptoms often start after you are exposed to a trigger. Asthma triggers can include:
Allergies, such as dust, pollen, mold, or animal fur
Something that irritates your lungs, such as cold air, smoke, or strong smells like paint or perfume
Medicines like aspirin or NSAIDs
An infection such as a cold, the flu, or a sinus infection
Strong emotions or stress
Indigestion, also called gastroesophageal reflux disease, or GERD. If you often have problems with acid indigestion you may have more asthma symptoms, especially at night.
What are the symptoms?
The first symptoms of AIA may include sneezing, a runny or stuffy nose, and redness and warmth of the face. Symptoms start 1 to 3 hours after taking aspirin or NSAIDs. The asthma attack triggered by aspirin and NSAIDs can be life threatening. In many cases, people with AIA also have nasal polyps (growths in the lining of the nose or sinuses), long-term sinus disease, and loss of the sense of smell.
Adults with asthma may not be as sensitive to aspirin as children. They may have taken aspirin or NSAIDS in the past without any side effects. Symptoms may not start until adulthood.
How is it diagnosed?
There are no blood tests or skin tests that will diagnose allergy to aspirin or NSAIDs. Your healthcare provider will ask about:
Your use of aspirin
How often you are having symptoms
Any other allergies or triggers
The provider may refer you to an allergy specialist to see if you have other allergies.
How is it treated?
If you have been diagnosed with AIA, do not take products that contain aspirin.
In general, AIA is managed in the same way as other types of asthma. Three types of medicines are used to control asthma:
Quick-relief medicines, also called reliever, or rescue medicines. These medicines are used as needed to treat asthma attacks. They are not used on a regular, daily basis to prevent asthma symptoms. You should learn to recognize the symptoms of an asthma attack and take these medicines as soon as symptoms start. To prevent asthma attacks, you may need a different type of medicine called a controller.
Long-term control medicines, also called controller medicines. By taking this medicine regularly every day, it helps to control your symptoms. You will take these medicines every day, even if you are not having symptoms. They do not provide quick relief of wheezing in acute asthma attacks.
Steroid medicines, also called asthma controller medicines, because by taking them regularly every day, they help to control your symptoms. You will take these medicines every day, even if you are not having symptoms. They do not provide quick relief of wheezing in acute asthma attacks. Steroid medicines are similar to hormones made by your body. They block some of the chemicals that cause irritation and swelling in your airways. By lessening the swelling, you will have fewer symptoms and be able to breathe better.
Some people may be treated with a kind of therapy called aspirin desensitization. You start by taking a very small dose of aspirin in a medical setting where there is emergency support. The dose is carefully and gradually increased until a normal dose of aspirin can be taken without causing symptoms. As the dose is increased, there is a chance of a sudden asthma attack. This process must be supervised by an experienced healthcare provider. Once you are able to take a normal dose of aspirin without having symptoms, you will keep taking that dose every day. As this happens, your symptoms will decrease. This can reduce the need for asthma medicines and improve asthma control.
Itâ€™s a good idea to wear some form of ID (such as a Medic Alert bracelet) that says that you have aspirin-induced asthma. If you need emergency care, surgery, or lab tests, this helps the healthcare provider know how to treat you.
Can it be prevented?
AIA can be prevented. Avoid products that contain aspirin. Be sure to read labels. There are several medicines that contain aspirin or other NSAIDs.
Do not give aspirin to children 18 years or younger unless told to do so by your healthcare provider. This is due to the risk of Reye’s syndrome (an illness that causes inflammation of the brain and liver).
If you have asthma, use NSAIDs such as ibuprofen with caution. If you have asthma and nasal polyps, do not use NSAIDs without the approval of your healthcare provider.
In rare cases, acetaminophen may also trigger an asthma attack. Reactions are usually less intense than reactions to aspirin or other NSAIDS. Acetaminophen is the medicine most often used for fever and pain relief for people who cannot take aspirin and NSAIDs.
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Adult Advisor 2015.1 published by RelayHealth. Last modified: 2013-05-10 Last reviewed: 2014-04-01
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Aspirin-Induced Asthma: References
Aspirin exacerbated respiratory disease in UpToDate
Aspirin-sensitive asthma and upper airway diseases. Chang JE, Chin W, Simon R. Am J Rhinol Allergy. 2012 Jan-Feb; 26(1):27-30.
Chang JE, White A, Simon RA, Stevenson DD. Aspirin-exacerbated respiratory disease: burden of disease. Allergy Asthma Proc. 2012 Mar-Apr;33(2):117-21. doi: 10.2500/aap.2012.33.3541.
Aspirin-sensitive respiratory disease. Farooque SP, Lee TH. Annu Rev Physiol. 2009;71:465-87. Review.PMID: 19575683
National Heart, Lung, and Blood Institute. Expert Panel Report 3:Guidelines for the Diagnosis and Management of Asthma, Full Report2007. NIH publication 07-4051. US Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, Aug. 28, 2007. Accessed December 17, 2007 from <http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf>.
Expert Panel Report 3 (EPR-3): Guidelines for the diagnosis and management of asthma-summary report 2007. J Allergy Clin Immunol 120 (2007):S94-138.
Stevenson DD, Szczeklik A. Clinical and pathologic perspectives on aspirin sensitivity and asthma. J Allergy Clin Immunol 118 (2006):773-86.