Other Medications for AERD (Samter's Triad)

Antibiotics

Because of the sinus blockage that occurs in Aspirin Exacerbated Respiratory Disease (AERD), sinus infections are quite common. Antibiotics are often prescribed to treat these infections. In addition to oral antibiotics, difficult to treat infections may also benefit from use of an antibiotic sinus rinse. Antibiotics are sometimes necessary for us, but AERD is not caused by bacterial infection. Without treatment of the underlying disease, antibiotics will not provide lasting relief or prevent the disease from progressing.

Antibiotic use should be reserved for the treatment of verified bacterial infections. Overuse of antibiotics can lead to the development of drug resistant bacteria. It can also have a variety of negative health effects, since it disrupts the healthy bacteria in your body.

Antihistamines & Immunotherapy

Antihistamines can be obtained over the counter or by prescription, in the form of tablets, nasal sprays, and eye drops. Because AERD (Samter's Triad) is not truly an "allergic" condition, antihistamines and immunotherapy (allergy shots) are not the most effective treatments. Most studies have found that about 50% of AERD patients also have environmental allergies. Allergic disease (atopy) is common in AERD patients, but it is not a necessary component of the disease. For those who do have allergies, antihistamines may provide some relief. 

 

Even in AERD patients who don’t have environmental allergies, mast cells are often overproducing inflammatory chemicals like leukotrienes. It makes sense that they may be overproducing histamine as well.  Antihistamines can have the side effect of drying out the mucous membranes, so they may provide some relief for those suffering from runny noses, regardless of the cause. Because antihistamines dry mucus membranes, they can thicken mucus secretions. Dr. Laidlaw of the Brigham & Women's AERD Center suggests that AERD patients without allergies experiment with antihistamines and decide for themselves whether or not there is any benefit. Antihistamines start working within hours and their effects fade away within 2-3 days after stopping.  Dr. Laidlaw suggests taking a daily antihistamine every day for a week and then stopping it completely for a week to see if you feel worse.  Depending on the results, you can choose to stick with the antihistamine or not.

Common antihistamines that are available over the counter include Claritin (loratidine), Allegra (fexofenadine), Zyrtec (cetirizine), and Xyzal (levocetirizine). These are generally non-sedating, unlike older antihistamine medications such as Benadryl (diphenhydramine). 

Other Over the Counter Medications

Decongestants and mucus thinners can provide some symptom relief. Guaifenesin (Mucinex) can be taken daily if needed. Decongestants, such as pseudoephedrine (Sudafed), should not be used long term and can actually cause more congestion with long term use. Be aware that many over-the-counter medications contain NSAIDs and/or aspirin. If you're not sure if a medication is safe or not, we have a handy guide!

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