What is aspirin-induced asthma? Causes, symptoms and more

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Aspirin-induced asthma (AIA) is a condition in which asthma symptoms may appear after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). It is also known as Aspirin-Exacerbated Respiratory Disease (AERD) or Samter’s Triad.

The American Academy of Allergy, Asthma, and Immunology (AAAAI) estimates that 9 percent of adults have asthma and that 30 percent of adults with asthma and nasal polyps may also have of an AERD.

Read on to learn more about the underlying causes and risk factors of AIA as well as how this condition can be treated.

Acetylsalicylic acid (aspirin) is a type of NSAID used to relieve pain, inflammation, and fever. Similar drugs include ibuprofen (Advil) and naproxen (Aleve).

Aspirin and other NSAIDs interact with an enzyme called cyclooxygenase-1 (COX-1). Although the exact triggers are unknown, it is believed that people with AIA are sensitive to how these drugs inhibit this enzyme.

You might be more prone to AIA if you have all three of the following conditions:

A doctor may always recommend aspirin for the treatment of other conditions, such as preventing heart attacks or strokes, in cases where a person may have had one of these conditions before – and when benefits outweigh the risks of triggering asthma symptoms.

Symptoms of AIA tend to develop soon after taking aspirin or other NSAIDs, often minutes or hours after exposure.

While it is important to treat any suspected symptoms of AIA with a doctor, here is a breakdown of mild symptoms as well as more serious symptoms that require immediate medical attention.

Mild symptoms of AIA

Mild symptoms of AIA can include:

  • sinus / nasal congestion
  • sinus pain
  • headache
  • sneeze
  • to cough
  • light wheezing
  • redness of the skin

Severe symptoms

More severe symptoms of AIA can make it harder to breathe, even if you are taking a rescue inhaler. Although rare, these acute symptoms can be life threatening.

Seek emergency medical help if you experience the following:

  • persistent cough
  • severe wheezing
  • difficult breathing
  • chest pain / tightness
  • urticaria
  • abdominal pain
  • vomiting
  • faintness
  • loss of consciousness

People who develop AIA are usually between 20 and 50 years old and likely have a combination of:

  • asthma
  • chronic sinusitis
  • sensitivity to NSAIDs

You may also be more likely if you experience the following issues on a recurring basis:

  • recurrent nasal congestion
  • polyps
  • sinus infections

Age is another consideration. More generally, you may become more vulnerable to the side effects of NSAIDs as you get older after your 50s.

It is also possible that reactions to aspirin are induced by drug allergies. Besides NSAIDs, other common drug allergies include:

  • penicillin
  • antibiotics containing sulfonamides
  • anticonvulsants
  • beta-blockers

Symptoms of AIA can also be exacerbated if you also drink alcohol. The AAAAI estimates that 75 percent of people with the condition may experience symptoms after drinking alcohol with aspirin.

AIA is usually diagnosed with the help of an asthma specialist, such as an allergist, pulmonologist, or immunologist.

There is not just one test that can diagnose AIA. Instead, a diagnosis is made with a combination of the following factors:

  • blood test that can detect elevated eosinophils indicate inflammation
  • physical tests to detect the presence of nasal polyps and determine their size
  • a complete medical history to assess previous medications, respiratory tract infections and hospitalizations
  • self-reported data, such as a personal health diary, which may show asthma exacerbations after taking aspirin

A doctor may also recommend ordering a test called an aspirin test to rule out drug allergies. This involves taking aspirin either in the doctor’s office or in the hospital under medical supervision. Any reactions you have to taking aspirin can then be identified and treated.

In addition to avoiding NSAIDs, treatment for AIA includes managing symptoms of asthma, sinusitis, and nasal polyps.

You can also discuss the following options with a doctor.

Home Care

Home treatments can include:

  • complete avoidance of aspirin, products containing aspirin and NSAIDs
  • take acetaminophen instead for occasional pain, or as directed by a physician
  • avoiding other allergies and asthma triggers, such as seasonal pollen, dust, animal dander, and stress

Medicines and surgeries

A doctor may recommend one or more of the following medical treatments:

Besides the exacerbated asthma symptoms, complications of AIA can include hives (hives). The AAAAI estimates that between 20 and 40 percent of people with chronic urticaria may have worsening symptoms if they also have AIA. A type of swelling called angioedema can also occur.

It is also important to take into account the long-term side effects of taking aspirin and other NSAIDs, especially when taken for longer than recommended. These include:

  • ulcers
  • headache
  • dizziness
  • drowsiness
  • indigestion
  • liver or kidney problems
  • conditions related to the heart and circulation, such as heart attack and stroke

Also, avoid mixing aspirin with the following products:

  • other NSAIDs
  • diuretics
  • selective serotonin reuptake inhibitors (SSRIs)
  • lithium
  • some medicines used to treat autoimmune diseases

Aspirin is a type of NSAID primarily used for pain relief. But be careful when using aspirin if you have a history of asthma, sinusitis, and nasal polyps. These underlying conditions may put you at a higher risk of developing AIA.

See a doctor if you are concerned about the risks or side effects of taking NSAIDs – or if you have a history of side effects after taking these types of medicines. They can help diagnose and treat potential AIA as well as related medical conditions.


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