Aspirin Sensitivity & Aspirin Desensitization

Aspirin sensitivity is a harmful reaction to aspirin. Reactions include breathing, nasal/sinus and skin problems. One type of aspirin sensitivity is called aspirin-exacerbated respiratory disease (AERD). Treatment of AERD is a gradual increase in the dosage of aspirin, called aspirin desensitization. The goal is to tolerate the dose of aspirin without the harmful reactions.

What is aspirin sensitivity?

Aspirin is a widely used drug for aches, pains and fever -- one report estimates that 29 million people in the U.S. take aspirin tablets every day. People with heart disease or who are at risk of getting heart disease or of having a stroke take a daily aspirin. This helps keep their blood from forming clots that block blood vessels.

But some people react when they take aspirin or aspirin-type drugs. A harmful reaction after taking aspirin or an aspirin-type drug involves respiratory or skin symptoms (such as an itchy rash or hives). This is called aspirin sensitivity.

What are symptoms to aspirin sensitivity?

People who are sensitive to aspirin can have symptoms such as:

In rare cases, the adverse reaction to aspirin can be serious or even life-threatening.

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What is aspirin-exacerbated respiratory disease (AERD)?

Aspirin-exacerbated respiratory disease (AERD) is a condition that includes chronic asthma, and sinusitis with nasal polyps. People with AERD experience respiratory symptoms from aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen.

Approximately one of 10 adults with asthma and one of three patients with asthma and sinusitis with nasal polyps are sensitive to aspirin and NSAIDs and have AERD.

What is aspirin desensitization?

People with AERD can undergo a procedure, called aspirin desensitization, which can induce tolerance to aspirin. Even if you’ve had life-threatening respiratory reactions you’ll be able to take aspirin without reacting to it.

To do this, you’re challenged with graded doses of aspirin over a period of several days. Your provider starts by giving a very small dose of aspirin and watches to see if you react. When you get to the dose that causes symptoms, you’ll keep getting that dose until you can tolerate this dose without adverse reaction. You’ll then get higher and higher doses of the drug. As you keep getting the higher doses, your body will start to accept the drug without reacting.

Aspirin desensitization is generally done over a period of several days.

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What are the benefits of aspirin desensitization?

Benefits of aspirin desensitization include:

  • Reduced nasal/sinus and asthma symptoms.
  • Reduced reliance on medication.
  • Reduced need of professional help for asthma.
  • Reduced need for sinus surgery.
  • Improved quality of life.

How successful is aspirin desensitization?

A recent study reported that of those AERD patients who were able to continue aspirin desensitization treatment for more than one year, 87% experienced benefit.

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What are the risks of aspirin desensitization?

Aspirin's most common side effects are stomach pain, nausea, and heartburn. Some people stop taking aspirin because of these side effects. There are drugs your doctor can give you that will help with these problems so you can still take aspirin regularly.

When should I call my healthcare provider?

If you have been desensitized to aspirin, call your healthcare provider if you have gone 48 hours or longer without taking your aspirin or if you develop any of the signs of a bad reaction to aspirin, including:

  • Hives.
  • Problems swallowing.
  • Swelling of the lips or tongue.
  • Belly pain.
  • Nausea or throwing up.
Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 12/17/2020.

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