home
RSS
April 6th, 2011
02:33 PM ET

Allergic to aspirin: Are there alternatives?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Mary of Fort Wayne, Indiana

I am allergic to aspirin and wonder: If I ever needed a blood thinner or daily aspirin, is there any option for me? There is a history of heart disease in my mother's family. I do take irbesartan (Avapro) for high blood pressure and simvastatin (Zocor) for cholesterol control.

Expert answer

Dear Mary:

Aspirin is an old drug with lots of uses. It was noted more than 2,000 years ago that chewing the bark of the willow tree was therapeutic for headache, some musculoskeletal pains and fever. The compound responsible for these effects was isolated more than a century ago, turned into a pill and named aspirin. Aspirin was the first of a class of drugs known as nonsteroidal anti-inflammatories, or NSAIDs. Today, NSAIDs are some of the most commonly used drugs in medicine.

After aspirin had been in use for more than 70 years, studies showed that it could reduce the risk of cardiovascular disease. We continue to learn about these compounds. We now know that most of the other NSAIDs do not reduce the risk of cardiovascular disease, and some actually increase it. More recently, studies also have shown that aspirin and several other NSAIDs may reduce the risk of colon polyps and colon cancer.

Your question is important, as it has been estimated that 5% of people have some difficulty taking aspirin or other NSAIDs. These reactions are categorized as pseudo-allergic or allergic. Pseudo-allergic reactions are nonimmunologic reactions related to the person having an alteration in the biochemical pathway through which the NSAID is normally metabolized or handled after it is ingested. True allergic reactions are due to the immune system rejecting the drug. Both reactions can be acquired, meaning someone can have no difficulty with NSAIDs for years and then all of a sudden have a reaction.

The person with a pseudo-allergic reaction tends to have the reaction with a number of NSAIDs, whereas those with true allergic reactions tend to be sensitive to one specific NSAID. Some patients also have a reaction to a high dose of an NSAID but not to a lower dose of the same drug.

The pseudo-allergic and true allergic reactions can be a combination of drug-induced asthma, runny and stuffy nose, itching or swelling. Some people have severe swelling of the throat and upper airway that can lead to suffocation in very severe reactions. Patients with a history of nasal polyps are at especially high risk of NSAID allergy.

The cardiovascular effects of aspirin are due to its ability to decrease the effectiveness of platelets in the blood. This decreases the blood's ability to clot. Today, aspirin is commonly prescribed to reduce the risk of vascular problems in patients who have had:

  • An acute myocardial infarction (or heart attack),
  • An occlusive stroke (a stroke caused by a blood clot),
  • A transient ischemic attack (also known as a TIA or mini-stroke),
  • Stable cardiac chest pain or angina
  • Heart bypass surgery.
  • Aspirin therapy decreases the risk of a subsequent cardiovascular event in this population by up to 20%. Several well-designed clinical trials have also established the net benefits of giving an aspirin to a person who is actively having a heart attack. It can decrease the amount of heart damage and cut the risk of death from the heart attack.

    There has been debate about the use of low-dose or baby aspirin (81 mg daily) or whole adult aspirin (325 mg daily) for disease prevention. The prevailing evidence is that there is no difference in efficacy or side effects in doses ranging from 81 mg to 325 mg per day.

    Some prescribe aspirin to people who have not had a cardiovascular event but are at high risk of cardiovascular disease because of diabetes, obesity, hypertension or smoking. The net benefit is clear among those with a history of cardiovascular disease but is less clear for this latter population. We use the term "net benefit" as it is clear that there are disadvantages to aspirin therapy. It causes some people to have stomach bleeding or even hemorrhagic stroke.

    Aspirin or NSAID desensitization is successful in some patients. This can allow for a daily prophylactic aspirin, or for patients with rheumatologic conditions to regularly take aspirin or other NSAIDs. This procedure involves starting with a low dose of the NSAID and progressively giving larger doses over time. It should be done under the supervision of a physician experienced in this procedure.

    Patients who need cardiovascular prevention who cannot be desensitized to aspirin may be candidates for therapy with the non-NSAID clopidogrel (Plavix). It, too, inhibits platelet activity and is sometimes used with aspirin.

    Acetaminophen (Tylenol) is not an NSAID. It is usually well tolerated by those with a history of NSAID reactions. Acetaminophen can be used for fever control and treatments of some types of pain. It is not useful in the prevention of cardiovascular disease.


    soundoff (1,337 Responses)
    1. rv washing near me

      The very next time I read a blog, Hopefully it doesn't disappoint me as much as this one. After all, Yes, it was my choice to read through, however I truly thought you would probably have something interesting to talk about. All I hear is a bunch of whining about something you can fix if you were not too busy searching for attention.

      http://michaey.com/__media__/js/netsoltrademark.php?d=ocrvcenter.com

      May 8, 2021 at 14:12 | Report abuse | Reply
    2. trailer service and repair near me

      Aw, this was an extremely good post. Taking the time and actual effort to create a superb article… but what can I say… I hesitate a whole lot and never seem to get nearly anything done.

      http://zaxbysfranchising.biz/__media__/js/netsoltrademark.php?d=ocrvcenter.com

      May 8, 2021 at 14:19 | Report abuse | Reply
    3. Video Marketing Pro

      I blog often and I truly appreciate your information. Your article has truly peaked my interest. I'm going to bookmark your site and keep checking for new information about once a week. I opted in for your Feed too.

      https://aljico.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 8, 2021 at 14:49 | Report abuse | Reply
    4. Digital Marketing Quotes

      I absolutely love your site.. Great colors & theme. Did you create this website yourself? Please reply back as I’m hoping to create my own personal website and would like to find out where you got this from or exactly what the theme is named. Thanks!

      https://livingourvalues.net/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 8, 2021 at 15:00 | Report abuse | Reply
    5. Internet Marketing Company California

      http://www.iatn.net/redirect/?src=wiki&pageid=320&url=http://affordableranking.com

      May 8, 2021 at 15:06 | Report abuse | Reply
    6. RV Wraps Riverside

      https://skiplink.org/e2j3o1J

      May 8, 2021 at 19:15 | Report abuse | Reply
    7. Internet Marketing Association

      https://bluetech.co.uk/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 8, 2021 at 20:34 | Report abuse | Reply
    8. RV Upgrades Riverside

      https://bit.ly/2Qj2hua

      May 8, 2021 at 21:45 | Report abuse | Reply
    9. Content Marketing Consultants

      http://www.headlinemonitor.com/SicakHaberMonitoru/Redirect/?url=http://www.affordableranking.com

      May 8, 2021 at 23:57 | Report abuse | Reply
    10. Seo Marketing Agencies

      Hello, I do think your website could be having internet browser compatibility problems. Whenever I take a look at your website in Safari, it looks fine but when opening in I.E., it's got some overlapping issues. I merely wanted to provide you with a quick heads up! Apart from that, excellent blog!

      http://www.irving-spitzberg.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 9, 2021 at 01:07 | Report abuse | Reply
    11. RV AC California

      http://adfoc.us/62936178788456

      May 9, 2021 at 04:23 | Report abuse | Reply
    12. Local Marketing Agency Costa Mesa

      You need to be a part of a contest for one of the highest quality blogs online. I'm going to highly recommend this website!

      http://www.pounds.installzamma.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 9, 2021 at 06:56 | Report abuse | Reply
    13. Social Media Marketing Pros

      After looking over a handful of the blog articles on your site, I really appreciate your way of blogging. I saved it to my bookmark webpage list and will be checking back in the near future. Take a look at my web site as well and tell me your opinion.

      https://campaign2014jobs.net/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 9, 2021 at 07:56 | Report abuse | Reply
    14. Content Marketing Reviews

      This is a topic that's close to my heart... Thank you! Where are your contact details though?

      http://www.shephoffman.com/__media__/js/netsoltrademark.php?d=www.affordableranking.com

      May 9, 2021 at 08:21 | Report abuse | Reply
    15. Social Media Marketing Brea

      Aw, this was a very good post. Finding the time and actual effort to produce a really good article… but what can I say… I hesitate a lot and never manage to get nearly anything done.

      http://law.udc.edu/link.asp?finalurl=//affordableranking.com

      May 9, 2021 at 09:41 | Report abuse | Reply
    16. Digital Marketing Company

      Oh my goodness! Amazing article dude! Thank you so much, However I am going through difficulties with your RSS. I don’t understand why I am unable to subscribe to it. Is there anybody else having similar RSS issues? Anyone that knows the answer will you kindly respond? Thanks!!

      http://www.click.imperialhotels.com/itracking/redirect?t=225&e=225&c=220767&url=http3A2F2Faffordableranking.com&email=danielkok40eldenlaw.com

      May 9, 2021 at 10:53 | Report abuse | Reply
    17. Digital Marketing Businesses

      https://ibuyfurniture.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 9, 2021 at 13:44 | Report abuse | Reply
    18. RV Slide Out Riverside

      https://bonus-books.com/rv-repair-near-me-16/

      May 9, 2021 at 15:22 | Report abuse | Reply
    19. Digital Marketing Agency Orange County

      https://countrybancorporation.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 9, 2021 at 17:32 | Report abuse | Reply
    20. по этой ссылке всё

      Отголосок под этот вопрос
      кажется исключительно несложным: ясное
      дело же, на том вебсайте, который представляет это конечно выполнить.
      Только все впрямь легко и просто
      с одной стороны и еще в разы труднее, чем реально показалось бы, с другой.

      Больше всего-лишь надобно подбирать сайты вместе с неплохой подборкой
      порно видео – это конечно дает функцию обычно выбирать те видео роликов, каковое насаждает и поэтому тот или иной хочется смотреть.
      Так например что если на ресурсе итого несколько важных десятков видеороликов, значит больше всего-навсего навсегда всего его отнюдь не довольно.

      Ещё весьма нужно прослеживать данные обновлений –
      все они должны находиться достаточно плотными, в идеале
      – каждодневными. Это обеспечивает юзеру милый свободное время и изрекает о таком, что администрация web-сайта вправду о нем печется, совсем как беспокоится да
      и о собственных пользователях.

      Точь в точь, подбирая, где рассматривать порно в онлайне,
      следует созерцать и на так называемые стилевое многообразие.
      Это в целом все-таки абсолютно не приватная сборка, таким образом что именно там должен быть препровождено все, что единственно допускается
      для себя представить – да и, ясное дело же, то, что продемонстрировать невозможно.

      по этой ссылке всё

      May 9, 2021 at 18:49 | Report abuse | Reply
    21. RV Interior Remodeling California

      This web site really has all of the information I needed about this subject and didn’t know who to ask.

      https://www.heilpflanzen-welt.de/files/jump/?http://ocrvcenter.com

      May 9, 2021 at 19:30 | Report abuse | Reply
    22. RV Bedroom Los Angeles

      http://www.ace-ace.co.jp/cgi-bin/ys4/rank.cgi?mode=link&id=26651&url=http://ocrvcenter.com

      May 9, 2021 at 20:40 | Report abuse | Reply
    23. RV Slide Out California

      I was more than happy to find this site. I want to to thank you for your time just for this wonderful read!! I definitely appreciated every little bit of it and I have you book-marked to look at new stuff on your website.

      http://agbina.ru/bitrix/rk.php?goto=http://ocrvcenter.com

      May 9, 2021 at 22:30 | Report abuse | Reply
    24. Google Marketing Service

      http://a-guide.net/rank/01/rl_out.cgi?id=gekiyasu&url=http3A2F2Faffordableranking.com

      May 10, 2021 at 13:34 | Report abuse | Reply
    25. Internet Marketing Quotes

      https://dermoviva.us/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 10, 2021 at 14:17 | Report abuse | Reply
    26. Internet Marketing Studio

      Hi, I do think your website could be having browser compatibility issues. When I take a look at your blog in Safari, it looks fine however when opening in IE, it has some overlapping issues. I merely wanted to give you a quick heads up! Other than that, wonderful site!

      http://www.speedrail.cn/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 10, 2021 at 14:22 | Report abuse | Reply
    27. Content Marketing Companies

      http://www.gold-hyip.com/check/goto.php?url=http://affordableranking.com

      May 10, 2021 at 14:26 | Report abuse | Reply
    28. Digital Marketing Agency Near Me

      http://www.wheretrendsstart.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 10, 2021 at 15:51 | Report abuse | Reply
    29. Internet Marketing Companies Irvine

      http://dontbuymercury.biz/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 10, 2021 at 16:28 | Report abuse | Reply
    30. Local Marketing Consultant

      https://northenendowment.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 10, 2021 at 16:53 | Report abuse | Reply
    31. Seo Marketing Quotes

      You've made some really good points there. I checked on the web for additional information about the issue and found most individuals will go along with your views on this web site.

      https://www.daniellavelloso.com.br/?wptouch_switch=mobile&redirect=https://affordableranking.com

      May 10, 2021 at 19:12 | Report abuse | Reply
    32. Content Marketing Consultants

      I couldn’t refrain from commenting. Exceptionally well written!

      http://www.3dcreaturesex.com/cgi-bin/at3/out.cgi?trade=http://affordableranking.com

      May 10, 2021 at 22:02 | Report abuse | Reply
    33. Seo Marketing Services

      http://www.publishing.ninja/V2/php/linkTracking.php?magazineID=143&pageID=2411&link=http://affordableranking.com

      May 10, 2021 at 22:40 | Report abuse | Reply
    34. Digital Marketing Agency Orange County

      Everything is very open with a very clear description of the challenges. It was truly informative. Your website is extremely helpful. Thanks for sharing!

      http://www.lakeofbaysunitedchurches.org/sermons/?show&url=http://affordableranking.com

      May 10, 2021 at 22:53 | Report abuse | Reply
    35. Social Media Marketing Firm

      https://www.oneidawholesale.net/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 10, 2021 at 22:54 | Report abuse | Reply
    36. Digital Marketing Event Near Me

      http://www.glad2bhome.com/show_sponsor.php?sponsorcode=2654&fromurl=http3A2F2Fwww.affordableranking.com

      May 11, 2021 at 00:11 | Report abuse | Reply
    37. Local Marketing Firm

      I really love your website.. Pleasant colors & theme. Did you build this amazing site yourself? Please reply back as I’m wanting to create my very own site and want to know where you got this from or exactly what the theme is called. Thank you!

      http://machinespotter.com/index/incgrapicads?id=1052&url=http://affordableranking.com

      May 11, 2021 at 00:16 | Report abuse | Reply
    38. slot live22 download

      I love looking through an article that will make people think.
      Also, many thanks for allowing me to comment!

      my website – slot live22 download

      May 11, 2021 at 00:41 | Report abuse | Reply
    39. gem king855

      Hello, i read your blog occasionally and i own a similar one
      and i was just wondering if you get a lot of spam feedback?
      If so how do you protect against it, any plugin or
      anything you can suggest? I get so much lately it's driving me crazy
      so any help is very much appreciated.

      Here is my blog post ... gem king855

      May 11, 2021 at 01:07 | Report abuse | Reply
    40. Internet Marketing Studio

      http://www.obitsarchives.org/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 11, 2021 at 03:21 | Report abuse | Reply
    41. Social Media Marketing Companies Cypress

      https://charoittravel.ru/bitrix/rk.php?goto=https://affordableranking.com

      May 11, 2021 at 03:31 | Report abuse | Reply
    42. Internet Marketing Contractors

      https://www.wilddunesowners.org/ViewSwitcher/SwitchView?mobile=True&returnUrl=http3A2F2Faffordableranking.com

      May 11, 2021 at 06:38 | Report abuse | Reply
    43. Internet Marketing Companies Irvine

      Everyone loves it whenever people come together and share thoughts. Great blog, keep it up!

      https://talbotcompany.com/__media__/js/netsoltrademark.php?d=www.affordableranking.com

      May 11, 2021 at 07:10 | Report abuse | Reply
    44. Digital Marketing Service

      Very good article. I will be facing a few of these issues as well..

      https://www.empocher.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 11, 2021 at 07:14 | Report abuse | Reply
    45. Digital Marketing Associations

      http://www.carglitz.com/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 11, 2021 at 07:31 | Report abuse | Reply
    46. Seo Marketing Experts

      I have to thank you for the efforts you've put in writing this website. I'm hoping to see the same high-grade content from you in the future as well. In fact, your creative writing abilities has inspired me to get my own, personal website now 😉

      https://www.warrantcheck.info/__media__/js/netsoltrademark.php?d=affordableranking.com

      May 11, 2021 at 07:51 | Report abuse | Reply
    47. Content Marketing Mentor

      This is a really good tip particularly to those fresh to the blogosphere. Short but very accurate info… Appreciate your sharing this one. A must read post!

      http://www.shopch.jp/aflink.do?siteID=30037&afflg=1&linkurl=http://www.affordableranking.com

      May 11, 2021 at 08:28 | Report abuse | Reply
    48. Social Media Marketing Business

      Hi, I do believe this is an excellent website. I stumbledupon it 😉 I will come back once again since i have saved as a favorite it. Money and freedom is the greatest way to change, may you be rich and continue to help other people.

      http://www.domlespark.ru/bitrix/redirect.php?event1=&event2=&event3=&goto=http://www.affordableranking.com

      May 11, 2021 at 08:34 | Report abuse | Reply
    49. Content Marketing Market

      http://www.idone.com/__media__/js/netsoltrademark.php?d=www.affordableranking.com

      May 11, 2021 at 10:06 | Report abuse | Reply
    50. Internet Marketing Companies Near Me

      I blog quite often and I genuinely appreciate your information. This article has truly peaked my interest. I am going to take a note of your site and keep checking for new details about once a week. I subscribed to your Feed as well.

      https://www.cactus-mall.com/cgi-bin/redirect.cgi?location=https://www.affordableranking.com

      May 11, 2021 at 11:26 | Report abuse | Reply
    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

    Post a comment


     

    CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

    Advertisement
    About this blog

    Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.