Sensitivity to other medicines

There are a number of medicines available that can aggravate asthma in some people; usually those which contain aspirin, as well as medicines taken for heart disease, blood pressure and eye conditions. Not everybody with asthma is sensitive to these medicines. However, their use should be discussed with your doctor.

Which medicines may affect my asthma?

Medicines that may make your asthma worse are usually:

• Aspirin or acetylsalicylic acid: Taken to relieve pain, fever and inflammation and to reduce the risks of blood clotting.
• Beta-blockers (tablets and eye drops): Taken for heart disease, to control high blood pressure and in eye drops to treat high ocular pressure in conditions such as glaucoma.
• NSAIDs (non-steroidal anti-inflammatory drugs): Taken to relieve pain and inflammation.
• Complementary/herbal products: such as echinacea, 'royal jelly'.

The use of these medications should always be discussed with your doctor or pharmacist.

What should I do if my asthma gets worse after taking these medications?

Follow your asthma self management plan immediately and start taking your reliever medicine (eg. Ventolin, Bricanyl). If you require urgent medical treatment call 111 for an ambulance.

How can I avoid problems?

Be aware of the medications that can cause potentially serious attacks, such as aspirin or acetylsalicylic acid, beta-blockers and NSAIDs (non-steroidal anti-inflammatory drugs). Some health supplements, such as echinacea and 'royal jelly' can also make asthma worse. These products are freely available at supermarkets, pharmacies and health food stores.

Always check that any products that you take for relief of symptoms (eg, for colds and flu, pre-menstrual syndrome) do not contain aspirin or ibuprofen or other NSAIDs. Ask your pharmacist or doctor if unsure.

Always read the information leaflet and any warning labels on all products from all sources. Whenever consulting anyone about your health, make sure you tell them you have asthma.

Inform your doctor. If you have a reaction or your asthma gets worse after you have used any medicines or product, you should report this to your doctor as they need to detail this in your medical notes. It is also useful to let your pharmacy know so they are aware of which medicines you react to.

What pain relievers should I take?

Paracetamol has been regarded as the safest medication for occasional use to treat aches, pain and fever in people with asthma. Recent research has suggested that the longer term use of high-dose paracetamol can aggravate asthma and may even contribute to the development of asthma. 

At present, paracetamol is still regarded as safer than other analgesics (pain relievers), but it is suggested that you avoid using it regularly or in high doses, if possible.

Medicines that may make asthma worse

Aspirin-based products

Examples of aspirin-based products:

Alka Seltzer, Aspec, Aspro, Cardiprin, Cartia, Disprin, Heartcare Aspirin, Solprin.

Salicylates

Examples of products containing salicylates:

Bonjela, Ora-sed Jel (Gel).

NSAIDs (non-steroidal anti-inflammatory drugs)

The following medicines are NSAIDs, which may have an effect on asthma:

• ibuprofen (eg. ACT-3, Apo-Ibuprofen, Brufen, Fenpaed, I-Profen, Nurofen, Panafen)
• naproxen (eg. Naprogesic, Naprosyn, Naxen, Sonaflam, Synflex)
• ketoprofen (eg. Oruvail)
• indomethacin (eg. Arthrexin, Rheumacin)
• sulindac (eg. Clinoril, Daclin)
• diclofenac (eg. Apo-Diclo, Cataflam, Diclax, Flameril, Voltaren)
• mefenamic acid (eg. Ponstan) 
• piroxicam (eg. Piram-D)
• tenoxicam (eg. Tilcotil)
• tiaprofenic acid (eg. Surgam)
• flurbiprofen (eg. Strepfen [and Ocufen - eye drops]).

Beta blockers

The following medicines, beta blockers, may have an effect on asthma:

• acebutolol (may not currently be available in NZ)
• atenolol (eg. Pacific Atenolol)
• carvedilol (eg, Dilatrend) 
• celiprolol (eg. Celol)
• esmolol (eg. Brevibloc)
• nadolol (eg. Apo-Nadolol)
• metoprolol (eg. Betaloc CR, Betaloc IV, Lopresor, Slow-Lopresor)
• pindolol (eg. Pindol)
• propranolol (eg. Cardinol, Cardinol LA)
  
• sotalol (eg. Sotacor, Sotalol)
• timolol (eg. Apo-Timol).

Beta blocker eye drops

The following medicines are beta blocker eye drops (for glaucoma) which can affect asthma:

• betaxolol (eg. Betoptic, Beptoptic S)
• levobunolol (eg. Betagan, Levobunolol HCl 5%)
• timolol (eg. Apo-Timop, Combigan, Cosopt, Timoptol, Timoptol-XE).

Related topics

Also see: Asthma and anaesthetics and Asthma medicines and Keeping your asthma under control

Original material provided by The Asthma Foundation of New Zealand, 2010. Edited by everybody, December 2010.