Asthma Pain Relief: Dangers Of Some Pain Relievers

When managing and preventing asthma flare-ups, avoiding triggers, such as allergens, exercise, and cold weather, is important. But did you also know that certain pain medications can worsen asthma symptoms for some individuals? 

Aspirin and nonsteroidal anti-inflammatory drugs¹ (NSAIDs), including ibuprofen, can be dangerous for some people with asthma. If you're uncertain whether or not your asthma is triggered by ibuprofen, it's important to pay close attention to how you feel after taking the medication.

If you notice that your asthma symptoms worsen and you experience wheezing, coughing, and difficulty breathing, stop taking the medicine and consult your healthcare provider. They can determine whether the medication is to blame for your symptoms.

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Ibuprofen is used for adults

Ibuprofen is a common over-the-counter medication widely used to treat aches and pains, including toothaches, menstrual pain, back pain, and arthritis. It comes in various forms, such as tablets, capsules, and liquids that you consume orally. It's often used in combination with other medications, including cold and flu medicines.

Ibuprofen works by reducing the production of prostaglandins that cause swelling and pain in your body.

How does ibuprofen affect asthma?

If you have asthma and are allergic to aspirin or NSAIDs, taking these medications to reduce pain could lead to a narrowing of your airway, also known as bronchospasm. This reaction could range from mild to life-threatening. It's estimated that NSAIDs affect between 8% and 20%² of adults with asthma. 

Asthmatics who are sensitive to aspirin or NSAIDs may experience the following symptoms within twenty minutes to three hours of using the drug, with the symptoms peaking around one to two hours and resolving around three:

  • Coughing

  • Wheezing

  • Bronchospasm

  • Difficulty breathing

  • Nasal and ocular symptoms, such as nasal congestion/obstruction and watery nasal drainage.

It's uncertain why some adults with asthma are sensitive to aspirin and NSAIDs while others are not. Research³ suggests that it could be connected to a chemical imbalance that contributes to an over-production of leukotrienes, which are chemicals that are important for inflammation.

Ultimately there seems to be an imbalance between inflammatory and anti-inflammatory chemicals exacerbated by NSAIDs leading to airway inflammation and the walls of the breathing tube swelling.

Unfortunately, there is no test to predict whether a person with asthma will react to ibuprofen. However, this type 1 NSAID pseudoallergy is most common in patients with concomitant asthma and chronic rhinosinusitis with polyposis and rarer in patients with isolated asthma. It's not until you experience symptoms after taking the medication that you will know if you are sensitive to it. 

Because of this, adults with asthma can either avoid taking NSAIDS as a precaution, take the medication knowing they may experience symptoms, or ask their healthcare provider if they can take it under their supervision for about three hours. The only way to diagnose type 1 pseudoallergy to NSAIDs, including ibuprofen, would be a diagnostic challenge.

What's the risk of taking ibuprofen if you have asthma?

If you have been diagnosed with asthma and have taken ibuprofen before without experiencing any side effects, your risk of developing a reaction to the medication is low. It's also important to note that women are more likely to have a reaction to ibuprofen than men.

If you react to ibuprofen, you may also notice that your asthma symptoms become more severe and difficult to get under control after taking ibuprofen. Because of this, it could increase your chances of dying from an asthma attack. However, deaths caused by asthmatics taking ibuprofen are very rare. Generally speaking, ibuprofen is considered safe for children with asthma since reactions are less common in children than adults. 

Alternative pain relief options for people with asthma

If you have asthma and are looking for alternative options to NSAIDs to relieve pain, acetaminophen⁴ (Tylenol) is a good option. While some asthmatics may also be sensitive to this common pain reliever, it's very rare. However, numerous studies are tying early childhood acetaminophen use to the development of asthma in later years. 

Allergy medications, such as antihistamines, are usually safe for people with asthma. In some cases, they can cause side effects, particularly when taken with other medications. 

Additional ways to manage pain without the use of medication include:

  • Heating pads or packs

  • Ice packs

  • Stretching or exercising

  • Relaxation techniques, such as yoga

  • Alternative medicine, such as acupuncture

  • Healthy lifestyle changes, such as avoiding tobacco, reducing alcohol consumption, eating a balanced diet, and exercising regularly.

Before taking any medications, it's important to carefully read the instructions found on the packaging and consult your doctor if you are concerned. 

What should I do if I accidentally take ibuprofen?

Contact your healthcare provider immediately if you're sensitive to ibuprofen or another pain reliever and take it by accident. Don't wait to seek emergency medical attention if you experience severe asthmatic or allergy symptoms. These include:

  • Chest tightness

  • Facial swelling

  • Difficulty breathing.

The lowdown

Although uncommon, some adults diagnosed with asthma are sensitive to non-steroidal pain relievers, including ibuprofen. These medications can worsen asthma symptoms, including wheezing, coughing, and chest tightness.

If you're uncertain whether you're sensitive to ibuprofen, pay close attention to how you feel after taking the medication or speak with your healthcare provider about using it under their supervision. If you experience a reaction, it's best to avoid NSAIDs in the future to manage pain. Instead, it's best to stick with pain-relieving alternatives, such as acetaminophen.

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