Asthma & Aspirin Sensitivity

For the vast majority of persons with asthma, taking aspirin has no effect on their asthma, either good or bad. However, for perhaps 3-5% of persons with asthma, aspirin can cause asthma to worsen, often in the form of a severe and sudden attack. Besides causing symptoms of asthma, aspirin can cause nasal congestion and abdominal pains in susceptible individuals. Most often, this sensitivity to aspirin develops in adulthood. It often is found in conjunction with nasal polyps (growths of extra nasal tissue that plug the nasal passageways).

Many persons with asthma have been advised by their physicians to avoid aspirin because of their asthma. This advice is precautionary, given on the possibility that you may have a sensitivity to aspirin. The only way that you can tell with certainty if you are sensitive to aspirin (and related medications) is to have experienced a bad reaction with your asthma after taking one of these medications. This pamphlet has been prepared to help patients who do have aspirin sensitivity to avoid all aspirin-related and aspirin-containing medications that might cause them problems.

How aspirin causes problems in some persons with asthma

Research (much of it done at the Brigham and Women's Hospital) has shown that in asthmatic persons sensitive to aspirin, aspirin causes the body to produce excess amounts of the class of chemicals known as leukotrienes. Leukotrienes cause the muscles surrounding the bronchial tubes to contract, resulting in wheezing and shortness of breath.

The best protection is avoidance

Although there are now medicines, the leukotriene blockers (such as zafirlukast, brand name: Accolate®; montelukast, brand name: Singulair®; and zileuton, brand name: Zyflo®), that help to protect against this overproduction of leukotrienes, the best protection for someone with aspirin-sensitive asthma is still avoidance. Avoiding these potentially dangerous medications can be difficult, for two reasons.

Identifying the medicines that can cause problems

First, not only is it necessary to avoid aspirin, it is equally important to avoid all medicines of the family called "non-steroidal antiinflammatory drugs." These medicines, such as ibuprofen and naproxen, are used to treat the inflammation of arthritis and are routinely taken as pain killers. Just like aspirin, they can cause severe attacks of asthma in persons with aspirin-sensitive asthma. Incidentally, they do not help the inflammation of the bronchial tubes in asthma.
Second, both aspirin and non-steroidal antiinflammatory drugs are sold over-the-counter in a variety of preparations and under many different names. One must be careful to read labels on over-the-counter cold remedies, allergy medicines, pain killers, and relievers of stomach discomfort, many of which contain aspirin.

Acetaminophen (Tylenol®) is safe to take

For persons with aspirin-sensitive asthma, acetaminophen (brand name: Tylenol®) is generally safe to take and can be used as a substitute for aspirin or non-steroidal antiinflammatory drugs in most instances.

The medicines that persons with aspirin-sensitive asthma should avoid

A list of medications, both prescription and over-the-counter, that contain aspirin and non-steroidal antiinflammatory drugs is provided in this pamphlet for persons with aspirin-sensitive asthma. Because this list may not be perfectly complete and because new medications are continually being introduced, it is best to read the label of any new medicine that you take, and, when in doubt, ask your pharmacist or asthma care provider about it.

Over-the-Counter Medications


  • Ascriptin
  • Empirin
  • Bufferin
  • Halfprin
  • Ecotrin

Non-Steroidal Antiinflammatory Drugs

  • Actron
  • Ibuprohm
  • Advil
  • Motrin IB
  • Aleve
  • Nuprin
  • Ibuprofen
  • Orudis KT

Aspirin-Containing Medications

  • Alka Seltzer Plus
  • Doan's
  • Anacin
  • Excedrin
  • Aquaprin
  • Goody's Headache Powders
  • Bayer Children's Cold Tablet
  • Stanback Headache Powders
  • BC Powder
  • St. Joseph Cold Tablet for Children
  • Cama Arthritis Pain Reliever
  • Vanquish
  • Cope

Prescription Medications

Aspirin-Containing Medications

  • Easprin
  • Percodan
  • Fiorinal
  • Zoprin

Non-Steroidal Antiinflammatory Drugs

  • Anaprox
  • Nalfon
  • Ansaid
  • Naprosyn
  • Clinoril
  • Orudis
  • Daypro
  • Oruvail
  • Disalcid
  • Ponstel
  • Feldene
  • Relafen
  • Indocin
  • Tolectin
  • Lodine
  • Toradol
  • Meclomen
  • Voltaren
  • Motrin