SRQ Allergy & Asthma
Patient Handout

NSAID Allergy or Sensitivity: What to Avoid and What to Do

NSAIDs are pain and inflammation medicines such as aspirin, ibuprofen, and naproxen. Reactions may be true allergies or non-allergic sensitivity. Until your clinician reviews your reaction, treat it as important and avoid the medicine that caused it.

Medicine that caused a reaction
Reaction symptoms
Date
Call911Now

Get emergency help for any severe or fast-worsening reaction.

  • Trouble breathing, wheezing, tight chest, or repeated coughing
  • Swelling of the tongue, throat, lips, or face
  • Trouble swallowing, hoarse voice, or throat tightness
  • Faintness, dizziness, confusion, collapse, or blue/gray lips
  • Widespread hives with vomiting, diarrhea, or severe stomach cramps
  • Symptoms in more than one body area or symptoms that worsen quickly

If you have an epinephrine auto-injector, use it at the first signs of anaphylaxis and call 911. Do not drive yourself.

Symptoms Possible NSAID reaction signs

  • Hives, itchy rash, flushing, or skin swelling
  • Swelling around the eyes, lips, face, or hands
  • Runny or blocked nose, sneezing, or sinus pressure
  • Asthma flare, wheezing, cough, or chest tightness
  • Nausea, vomiting, stomach pain, diarrhea, dizziness, or fainting
Many NSAID reactions occur within minutes to a few hours. A painful rash, blisters, peeling skin, mouth sores, or fever after a medicine needs urgent medical advice.

Avoid Until your clinician says it is safe

Aspirin ASA, acetylsalicylic acid, many heart/stroke prevention tablets, some headache products.
Common NSAIDs Ibuprofen, naproxen, diclofenac, ketorolac, indomethacin, meloxicam, and other prescription NSAIDs.
Hidden sources Cold/flu, sinus, migraine, menstrual cramp, sleep-plus-pain, stomach, and topical pain products may contain NSAIDs or salicylates.

Check the active ingredient. Brand names change, and combination products can hide aspirin or another NSAID.

Options Safer choices to discuss

  • Acetaminophen (Tylenol, APAP, paracetamol) is not an NSAID and is often tolerated, but it can harm the liver if too much is taken.
  • Ask a pharmacist to check every over-the-counter medicine before you take it.
  • Non-medicine options such as ice, heat, rest, stretching, splints, or physical therapy may help some pain problems.
  • A specialist may consider celecoxib or another anti-inflammatory option only after reviewing your reaction. Do not test this at home.
Tell your clinician if you have liver disease, heavy alcohol use, kidney disease, ulcers, blood thinners, pregnancy, heart disease, or asthma before choosing a pain reliever.

Important If you take daily aspirin

If aspirin was prescribed to protect your heart, after a stroke, or after a stent, do not stop or restart it on your own. Contact the prescribing clinician promptly for a plan. If you are having emergency symptoms, call 911 first.

Some people who need aspirin can be evaluated by an allergy specialist for a supervised challenge or desensitization.