Avoiding NSAIDs

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Avoiding NSAIDs

Aspirin Exacerbated Respiratory Disease (AERD, Samter's Triad) causes severe reactions to non-steroidal anti-inflammatory (NSAID) medications. Unless you are desensitized to aspirin, it is important to avoid these medications. NSAID medications are extremely common and it can be frustrating trying to determine which medications are safe to take.

Aspirin and NSAID ingredients are found in a multitude of over the counter medications, including:

  • Pain medications 

  • Muscle relaxers

  • Anti-histamines and decongestants (allergy, sinus and cold products)

  • Caffeine (headache medications such as Excedrin)

  • Antacid medications (Alka-Seltzer)

Tips for Avoiding NSAIDs

  • Consult a doctor familiar with AERD to find out which medications you should avoid.

  • Print this list of the most common NSAIDs and give a copy to every doctor who treats you.

  • Print this wallet card and carry it with you. 

  • Read prescription and over-the-counter medication labels carefully.

  • Do not take a prescription or over-the-counter pain, anti-inflammatory, or cold and sinus medication from another person. Only take medications still in the original bottle (that you personally purchased).

  • Many cold, allergy, and sinus medications contain NSAID medications.

  • Take a list of medications to avoid on trips, particularly when leaving the country.

  • One of the many benefits of aspirin desensitization is that it allows you to safely take these medications again.

Which Pain Medications are Safe?

Tylenol (acetaminophen) is a safer choice for pain relief than aspirin or other NSAIDs, but it can still provoke reactions in some AERD patients when used at high doses. A 1995 study found that 34% of AERD patients had reactions to doses of Tylenol 1000mg or higher. These reactions were typically milder than reactions to other NSAIDs. None of the patients in the study reacted to doses below 1000mg. 

 

Research has also found that selective COX-2 inhibitors such as Celebrex (celecoxib) are safe for almost all AERD patients. A 2014 study found that out of 426 patients, none reacted to highly selective COX-2 inhibitors like Celebrex. Many patients were also able to tolerate Meloxicam, but the same study found that 8% did have a reaction to it; therefore, Celebrex is considered a safer choice. Celebrex is currently the only selective COX-2 inhibitor available in the United States (by prescription). If none of these alternative medications are unable to be tolerated, opioid medications are a safe alternative. 

Which Medications Should I Avoid?

AERD causes reactions to all medications that selectively inhibit the COX-1 enzyme. There are a wide variety of medications that can cause AERD reactions. You can see an extensive list below. The most common medications you are likely to encounter are:

Aspirin - Excedrin, Alka-Seltzer

Ibuprofen - Motrin, Advil

Naproxen - Aleve, Anaprox

Salsalate - Amigesic, Salflex, Argesic

Flurbiprofen - Ansaid

Ketorolac - Toradol

Diclofenac - Arthrotec

Printable list of most common NSAIDs. Print this list and give a copy to every doctor you see. Carry a copy with you in the event you need emergency care at a hospital. 

Printable wallet card of most common NSAIDs

NSAID Containing Medications

The list of medications containing NSAIDs is extensive, but not complete. If you're not sure about a medication, be sure to ask a doctor familiar with AERD.

  • ASA

  • Actiprofen

  • Actron Ketoprofen

  • Acular ophthalmic

  • Acular LS ophthalmic

  • Acuprin

  • Acuvail ophthalmic

  • Adran

  • Addaprin-

  • Advil

  • Advil Cold & Sinus

  • Advil Congestion Relief

  • Aggrenox

  • Aleve

  • Aleve-D Sinus & Cold

  • Alka Seltzer

  • Alka Seltzer Plus

  • Alor  

  • Amersol

  • Amibufen

  • Amigesic  

  • Anacin  

  • Anaflex  

  • Anaprox  

  • Anaprox DS

  • Anflagen

  • Anco

  • Anodynos

  • Andran

  • Ansaid

  • Apo-NaproNA   

  • Apo-lbuprofen  

  • Apo ASA

  • Apo Asen  

  • Apo Keto  

  • Apo Naproxen

  • Apo Piroxicam  

  • Apo lndomethiacin

  • Aposulin  

  • Apsifen

  • Aquaprin  

  • Argesic SA

  • Arthra G  

  • Arthrinol  

  • Arthrisin  

  • Arthritis Pain Formula  

  • Arthritis Strength Bufferin  

  • Arthropan Liquid   

  • Arthrotec

  • Artria AR  

  • Asacol  

  • Ascriptin  

  • Ascriptin A/D  

  • Ascriptin with Codeine

  • Asperbuf  

  • Aspercin  

  • Aspergum  

  • Aspir-Low  

  • Aspirin

  • Aspirtab  

  • Astrin  

  • BC Tablets and Powders  

  • Bayer Aspirin  

  • Bayer Children 's Aspirin

  • Bayer Childrens  Cold Tablets

  • Bayer Time Release Tablets  

  • Bluton

  • Brufanic

  • Brufen

  • Brufort

  • Buff-A Comp Tablets  

  • Buffaprin

  • Buffasal  

  • Bufferin with or without Codeine  

  • Buffetts ll Tablets

  • Buffinol  

  • Buburone

  • Butylenin

  • Butalbitol/ Aspirin

  • Cataflam

  • Caldolor  

  • Cap-Profen

  • Capron capsules

  • Cama Arthritis Pain Reliever  

  • Canasa

  • Cataflam

  • Choline Magnesium Triasalicylate  

  • Choline Salicylate  

  • Clinoril

  • Codral

  • Combunox

  • Congesprin

  • Cope Tablets

  • Coricidin

  • Coryphen  asa  

  • Cosprin Tablets  

  • Counterpain

  • Damason

  • Daprisal

  • Darvon Compound

  • Darvon Compound with ASA  

  • Darvon Compound with Aspirin

  • Darvon Compound 65

  • Daypro

  • Diclofenac

  • Difenac  

  • Diflunisal

  • Difluzenal

  • Dimetapp Sinus  

  • Disalcid

  • Doan’s Pills

  • Dolgin

  • Dolgirid

  • Dolgit

  • Dolobid

  • Dolocyl

  • Dristan Sinus  

  • Durasol

  • Ebufac

  • Easprin

  • Ecotrin  

  • EC Naproxyn

  • Efficin

  • Emagrin  

  • Emodin

  • Emperin

  • Empirin with Codeine

  • Emprazil  

  • Endodan

  • Entrophen  

  • Epobron

  • Epromate- M

  • Equagesic

  • Esaprin  

  • Etodolac

  • Equagesic  

  • Excedrine  

  • Excedrine Migraine  

  • Excedrine lB  

  • Femadon

  • Fenbid Spansule

  • Feldene

  • Fenoprophen

  • Fenoprofen

  • Fiorinal  

  • Fiorinal with Codeine

  • Flector

  • Flurbiprofen

  • Froben

  • Gelprin  

  • Gemnisyn Goodys

  • Genacote

  • Genpril

  • Halfprin

  • Haltran  

  • Helidac  

  • Heptogesic  

  • IBU

  • Ibufen

  • Ibumetin

  • Ibuprin

  • Ibuprocin

  • Ibuprohm

  • Ibutid

  • Ifen

  • Inabrin

  • Indocin

  • Indocin SR

  • Indo-Lemmon

  • Indomethacin

  • Indomethagan

  • Inoven

  • Lamidon

  • Lebrufen

  • Ledifen

  • Liptan

  • I-prin

  • Ketoprofen

  • Ketoprofen ER

  • Ketorolac

  • Ketorolac tromethamine injection

  • Lanorinal

  • Liquiprin

  • Lodine

  • Lodine XL

  • Lortab ASA

  • Magan  

  • Magnaprin  

  • Magsal

  • Marnal  

  • Maximum Bayer Aspirin

  • Measurin

  • Meclofenamate

  • Meclofenamate Sodium

  • Meclomen  

  • Medipren  

  • Mediproxen  

  • Mefenamic Acid

  • Meloxicam

  • Menadol  

  • Mesasal  

  • Methocarbonal with Aspirin  

  • Meprogesic

  • Micranin

  • Midol (see illustration)

  • Mobic

  • Mobidin   

  • Mobigesic

  • Momentum

  • Mono-Gesic

  • Monogesic  

  • Motrin  

  • Motrin lB

  • Mynosedin

  • Nabumetone

  • Nalfon

  • Nalfon 200

  • Napacetin

  • Naprapac

  • Naprelan

  • Naproxen

  • Naxen

  • Neoprofen

  • Nobfelon

  • Nobfen

  • Nobgen

  • Norgesic

  • Norgesic Forte

  • Norwich

  • Novahistine

  • Novasal   

  • Novasen  

  • NovoGent N  

  • Novo-Naprox

  • Novoprofen

  • Novo-Sundac

  • Novomethacin

  • Novopirocam

  • Nu-Naprox

  • Nu-lbuprofen

  • Nu-lndo

  • Nuprin

  • Nupryn

  • Nurofen

  • Orafen

  • Orphengesic

  • Orphengesic Forte

  • Orudis

  • Oruval

  • Oxaprozin

  • Oxycodone HCL/ Ibuprofen

  • Oxycodone HCL/ Aspirin

  • Oxycodone HCL/ ASA

  • Pantrop

  • Paxofen

  • P-A-C Analgesic

  • Pediaprofen

  • PMS- ASA

  • PMS-Pirocam

  • Pabalate SF

  • Pamprin

  • Panasal 5/500

  • Pentazocine HCL/ Aspirin

  • Pepto-Bismol   

  • Percodan

  • Percodan-Demi  

  • Persantine

  • Persistin

  • Pirocam

  • Piroxicam

  • Ponstel

  • Profen  

  • Propoxyphene Compound 65

  • Propoxyphene HCL/ Caffeine/ ASA (aspirin)  

  • Proprinal-  

  • Rafen

  • Rebugen

  • Relafen

  • Rexolate Sodium

  • Rhovail

  • Robaxisol

  • Roidenin

  • Roxiprin

  • Rufen

  • Saleto Tablets

  • Sal-Fayne  

  • Salflex

  • Salgesic Sodium

  • Salsalate  

  • Salsitab  

  • Seclodin

  • Sine-Aid lB

  • Sloprin

  • Sodium Thiosalicylate

  • Solaraze

  • Soma Compound

  • St. Josephs Aspirin

  • Stanback

  • Sudafed Sinus and Pain 12 hour

  •  Suldinac

  • Supasa

  • Suspren

  • Synalgos-DC

  • Synflex

  • Synflex DS

  • Tabalon

  • Tabprofen

  • Talwin compound

  • Tecnal  

  • Tolectin  

  • Tolectin DS  

  • Tolectin 600

  • Tolmetin  

  • Toradol

  • Trendar

  • Tricosal   

  • Trigesic

  • Trilisate  

  • Tromethamine tablet or injection

  • Ultraprin

  • Urem  

  • Vanquish

  • Vicoprofen

  • Voltaren

  • Voltaren ophthalmic

  • Voltaren Gel

  • Wal-Profen Cold & Sinus

  • Zipsor

  • Zorprin

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