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Sensitivity to Aspirin and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

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.

 

List of oral or injectable medications that contain aspirin or other NSAIDs

TRADE NAME

ASPIRIN / NSAID

Acetyl Salicylic Acid

Aspirin

ACT-3®

Ibuprofen

Alka-Seltzer®

Aspirin

Apo-Diclo EC®

Diclofenac

Apo-Ibuprofen®

Ibuprofen

Arthrexin®

Indomethacin

Aspec 300 or 75®

Aspirin

Aspro/Aspro Clear®

Aspirin

Brufen®

Ibuprofen

Calm-U®

Salicylamide

Cardiprin®

Aspirin

Cartia®

Aspirin

Cataflam®

Diclofenac

Clinoril®

Sulindac

Daclin®

Sulindac

Diclax®

Diclofenac

Disprin and Disprin Max®

Aspirin

Ecotrin®

Aspirin

Ethics Aspirin®

Aspirin

Ethics Ibuprofen®

Ibuprofen

Fenpaed® liquid

Ibuprofen

Flameril ®

Diclofenac

Heartcare Aspirin®

Aspirin

Ibucare®

Ibuprofen

Ibuprofen-lysine injection

Ibuprofen

I-Profen®

Ibuprofen

Mobic®

Meloxicam

Naprogesic®

Naproxen

Naprosyn®

Naproxen

Naxen®

Naproxen

Noflam®

Naproxen

Nurofen®(including, Nurofen®cold & flu)

Ibuprofen

Oruvail®

Ketoprofen

Panafen®

Ibuprofen

Piram-D®

Piroxicam

Pirophen®

Aspirin

Ponstan®

Mefenamic acid

Rheumacin®

Indomethacin

Solprin®

Aspirin

Sonaflam®

Naproxen

Surgam®

Tiaprofenic acid

Synflex®

Naproxen

Tilcotil®

Tenoxicam

Voltaren®

Diclofenac

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.

 

List of topical medications that contain aspirin or other NSAIDs

 

TRADE NAME

ASPIRIN / NSAID

Crampeze®

Wintergreen oil*

Coco-scalp®

Salicylic acid

Deep Heat®

Methyl salicylate

Duofilm® wart gel/paint

Salicylic acid

Egozite®

Salicylic acid

Ionil-T®

Salicylic acid

Metsal®

Methyl salicylate

Nurofen®

Ibuprofen

Posalfilin®

Salicylic acid

Oruvail®

Ketoprofen

Rheumon®

Etofenamate

Sebitar®

Salicylic acid

Sloan’s®

Methyl salicylate or glycol monosalicylate

Tiger Balm muscle rub®

Methyl salicylate

Voltaren emulgel®

Diclofenac

Whitfields®

Salicylic acid

 

Willow Bark

*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.

 

 

List of mouth/throat preparations that contain aspirin or other NSAIDs

 

TRADE NAME

ASPIRIN / NSAID

Difflam® (oral and throat products)

Benzydamine

Strepfen® (oral and throat products)

Flurbiprofen

 

 

 

 

List of ocular (eye) preparations that contain aspirin or other NSAIDs

 

TRADE NAME

ASPIRIN / NSAID

Acular®

Ketorolac

Ocufen®

Flurbiprofen

Voltaren®

Ibuprofen

 

List of medications that contain COX-2 inhibitors*

 

TRADE NAME

COX-2 INHIBITOR

Arcoxia®

Etoricoxib

Celebrex®

Celecoxib

Dynastat® injection

Parecoxib

Prexige®

Lumiracoxib

*COX-2 (cyclo-oxygenase-2) inhibitors work in a similar way to aspirin but are more selective in their action. Because of this, there is likely to be a slightly increased risk of reactions in those sensitive to NSAIDs. They can still be used in most people who are sensitive to NSAIDs but medical advice should be sought prior to use.

Vioxx® (Rofecoxib) and Bextra® (Valdecoxib) were withdrawn from sale in 2004 and 2005 respectively. Both of these products are COX-2 inhibitors.

This page was last updated at 11:08AM on March 24, 2021.