Aspirin (acetyl-salicylic acid)

"Allergy" or Sensitivity

Aspirin (acetyl-salicylic acid or ASA) may cause allergy-type reactions in persons who develop this unusual sensitivity. This idiosyncratic type reaction can be very serious - sometimes even life-threatening.

Those people who have both moderate to severe asthma and chronic sinusitis are more likely to be aspirin sensitive.

The main types of reactions are:

1. SKIN REACTIONS- itching, rashes, hives, or swelling of extremities or mouth
2. RESPIRATORY / OCULAR - Acute or immediate: nasal congestion, itchy/watery eyes, swollen eyes, cough, difficulty breathing or wheezing (swelling of the inside of the throat and asthma attacks which can be mild to very severe). Chronic: nasal polyps, sinusitis (leading to loss of smell, cough, post-nasal drip), and worsening of chronic asthma.
3. CARDIOVASCULAR - in very rare cases cardiovascular collapse (anaphylactic-type of shock) has occurred.

Stomach pains due to aspirin are not allergic or idiosyncratic types of reactions, but are usually due to irritation of the stomach lining.

One very important point is that most NSAID's (or Non-steroidal anti-inflammartory drugs) cross-react with aspirin - meaning that they can cause the same types of reactions in aspirin sensitive people. These drugs are mostly used for arthritis and other painful disorders. Common NSAID's (not a complete list) include: Advil, Anaprox, Ansaid, Butazolidin, Clinoril, Dolobid, Feldene, Ibuprofen, Indocin, Motrin, Naproxyn, Nuprin, Orudis, Rufen, Tolectin, and Voltaren.

A drug commonly used for aches and pains is Acetaminophen (TylenolÔ, e.g.) Acetaminophen, however, is very commonly safe in aspirin sensitive people when used at recommended doses. As with all medication decisions, you should discuss this with your doctor (you may want to ask the doctor about non-acetylated salicylates which are also mostly safe in ASA sensitive people.

ASPIRIN (acetyl salicylic acid or ASA) and NSAID's are found in many home remedies, over-the-counter (OTC) drugs, and prescription medications. Please check the list below. THIS IS NOT A COMPLETE LIST AS NEW PREPARATIONS ARE BEING ADDED ALL THE TIME. Look for ASA (aspirin) in medications for headaches, colds, coughs, allergies, sinus problems, arthritis, rheumatism (joint pain), menstrual cramps, stomach acidity, backache, or urinary pain. Please read all labels carefully, or ask the pharmacist before trying any medication. An over-the-counter medication label may say in small print "don't take this medicine if you are allergic to aspirin or NSAID's." Also, remember to tell your doctor, dentist, and nurse that you are sensitive to aspirin.

Artificial coloring, for example Tartrazine Yellow (FD&C No. 5), may rarely mimic aspirin sensitivity. This dye is present in many foods including alcoholic and soft drinks, candies, artificial orange juice (TANG), luncheon meats, preserves, jams, fruit gelatins, ice cream, colored baked goods, toothpaste, and mouth wash. Always read the labels on packaged foods and try to avoid those that contain this artificial coloring if you're sensitive to aspirin.

Tartrazine dyes are also present in some medicines including some antihistamine preparations used to treat allergies. Use only those medications prescribed by your doctor, and be suspicious of any colored pills if you develop an itch, rash, or stuffy nose after you start taking them.

MEDICATIONS CONTAINING ASPIRIN OR ASA-LIKE SUBSTANCE (NSAID's)

(Again, please be aware that this is not a complete list)

Treatment options includes use of antihistamines like benadryl or DPH elixir (H1 blockers) cimetidine ranatidine(H2 Blockers) . epinepherine sc , oral or intravenous steroids though more intense management may become nescessary. Suggest seeing your doctor for optimal care! Continue to remind yoyr doctor on every visit of your particular drug allergy. Ensure that your medical records clearly define all of your allergies as in the long run your are the one that benefits.