Non-steroidal anti-inflammatories (NSAIDs) and aspirin are a large group of medications which are freely available over the counter in both pharmacies and stores such as supermarkets.  They are used for pain most often, but also for fever and sometimes other reasons. 

There are several ways in which people can have adverse reactions to NSAIDs and aspirin. 

1. Worsening asthma, coughing or rhinitis/nose running.
2. Urticaria (hives).
3. Angioedema (swelling lips tongue or around the eyes).
4. Anaphylaxis (severe reaction).
5. Other serious rashes.

In general, because these medications all work the same way, if you have reacted to one of them, the risk is now there for all of them so all must be avoided.
Also, the risk is often intermittent, so tolerating an NSAID or aspirin one day, does not guarantee tolerating an NSAID or aspirin another day. Furthermore, it is not uncommon to have a mild reaction or no reaction sometimes, then on another day to have a severe reaction.  This is unpredictable, and therefore they all should be avoided at all times.
Finally NSAIDs work for several hours, so although reactions may occur in just a few minutes, they can also occur several hours after taking the tablet.

NSAIDs are very common medications and there are a large number of different names for them, so check the ingredients/back of packets to make sure your medication is not an NSAID.  This includes even cold and flu remedies, some throat lozenges. We can provide a list of the aspirin and NSAID containing medication in New Zealand for you.  This list is very long and hard to remember, so the safest way is to check the back of any tablet packet and look for the warning NSAID or non-steroidal anti-inflammatory or aspirin.   The main risk is a severe asthma attack or anaphylaxis.

Most people will need treatment for pain at some stage in their life.  Arcoxia® is an anti-inflammatory which is likely be safe for you, but this needs to be discussed and a challenge test is necessary first to prove this is safe.  This may be useful to provide an effective pain relief option in the future for you which could be invaluable.  Otherwise paracetamol is generally safe, and there are other pain relief options such as codeine which can be taken with the usual precautions.

LIST OF MEDICATIONS AVAILABLE IN NEW ZEALAND THAT CONTAIN ASPIRIN AND ASPIRIN-LIKE DRUGS, JUNE 2007

This sheet lists most aspirin or non-steroidal anti-inflammatory (NSAID) containing preparations available in New Zealand, however, there are new preparations coming onto the market all the time. As well as this, there are many other aspirin-containing preparations that originate from overseas. It is therefore important to check any preparations that you use carefully, particularly those used for pain relief and for treating colds. If you are unsure whether a particular preparation contains aspirin or other NSAID, please check with your doctor and/or pharmacist.

Ibuprofen and aspirin are both available from supermarkets and may have different brand names.

Preparations of these products are made by Pam’s^®, Signature Range^® and other brands – look out for the medicine that they contain.

*Wintergreen and wintergreen oil is another name for methyl salicylate – this ingredient may be found in other muscle or pain creams, balms or rubs. Willow Bark is a herbal compound that has aspirin-like properties, it may be present in oral or topical products.

Salicylic acid may be found in corn and wart removal products, dandruff and psoriasis treatments as well as some face washes for acne.