General Warnings

Drugs That Can Trigger Asthma

Asthma is a chronic respiratory condition that affects the airways in the lungs. It causes inflammation, narrowing, and swelling of the airways, which can lead to breathing difficulties, coughing, wheezing, and chest tightness.

Asthma is a very common chronic respiratory condition that affects the airways in the lungs. According to the World Health Organization (WHO), an estimated 339 million people worldwide have asthma. In the United States, the Centers for Disease Control and Prevention (CDC) estimates that approximately 25 million Americans have asthma, which is about 1 in 13 people.

Asthma can affect people of all ages, but it often begins in childhood. In fact, the CDC reports that asthma is the most common chronic condition among children, affecting about 1 in 12 kids in the United States. While asthma can be a serious and sometimes life-threatening condition, it is also manageable with proper treatment and care. With the right management plan, most people with asthma are able to lead healthy, active lives.

There are various types of asthma, including:

1.        Allergic asthma: This is the most common type of asthma and is triggered by allergens.

2.        Non-allergic asthma: This type of asthma is triggered by factors other than allergens, such as exercise, cold air, or stress.

3.        Occupational asthma: This type of asthma is caused by exposure to certain substances in the workplace, such as chemicals or dust.

4.        Exercise-induced asthma: This type of asthma is triggered by physical activity.

5.        Childhood asthma: This type of asthma is diagnosed in children and can be either allergic or non-allergic.

Asthma can be triggered by a variety of factors, including allergens (such as dust mites, pollen, and pet dander), air pollution, exercise, cold air, and stress. It can also be triggered by certain medications. Drug-induced asthma occurs when the airways in the lungs become inflamed and narrowed in response to a medication, leading to symptoms such as wheezing, shortness of breath, and coughing.

Drugs That Can Trigger Asthma

There are several types of drugs that can trigger asthma in susceptible individuals. These drugs can cause inflammation and narrowing of the airways, leading to symptoms such as wheezing, shortness of breath, and coughing. Some of the most common drugs that can trigger asthma include:

1.        Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs such as aspirin and ibuprofen can cause asthma symptoms in some people, especially those with nasal polyps or chronic rhinosinusitis. This is known as aspirin-exacerbated respiratory disease (AERD) or aspirin-induced asthma.

According to WebMD, approximately 10% to 20% of adults with asthma have sensitivity to aspirin or a group of painkillers called non-steroidal anti-inflammatory drugs. Some examples of nonsteroidal anti-inflammatory drugs (NSAIDs) that can trigger asthma in some people include:

  • Aspirin (acetylsalicylic acid)
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Diclofenac (Voltaren)
  • Indomethacin (Indocin)
  • Ketorolac (Toradol)
  • Piroxicam (Feldene)

It’s important to note that not everyone with asthma will experience symptoms after taking NSAIDs, and the severity of symptoms can vary from person to person. If you have a history of asthma or are at risk for developing it, it’s important to discuss any new medications with your healthcare provider before taking them. They can help identify any potential risks and recommend alternative medications if necessary.

2.        Beta-blockers: Beta-blockers, which are commonly used to treat high blood pressure, heart disease, and other conditions, can also trigger asthma symptoms in some people. They can cause bronchospasm, which is a sudden constriction of the airways.

Some examples of beta-blockers that can trigger asthma symptoms in susceptible individuals include:

  • Propranolol (Inderal)
  • Metoprolol (Lopressor, Toprol-XL)
  • Atenolol (Tenormin)
  • Nadolol (Corgard)
  • Timolol (Blocadren)

It’s important to note that not all beta-blockers can trigger asthma, and some may be safer for people with asthma than others. If you have asthma or are at risk for developing it, it’s important to discuss any new medications with your healthcare provider before taking them. They can help identify any potential risks and recommend alternative medications if necessary. If you experience symptoms of asthma after taking a medication, it’s important to seek medical attention right away. Prompt treatment can help manage symptoms effectively and prevent complications.

3.        ACE inhibitors: ACE inhibitors are a type of medication used to treat high blood pressure and heart failure. They can also cause cough and asthma-like symptoms in some people.

Some examples of ACE inhibitors that can trigger asthma symptoms in susceptible individuals include:

  • Enalapril (Vasotec)
  • Lisinopril (Prinivil, Zestril)
  • Captopril (Capoten)
  • Ramipril (Altace)
  • Perindopril (Aceon)
  • Quinapril (Accupril)

It’s important to note that not all individuals with asthma will experience symptoms after taking ACE inhibitors, and the severity of symptoms can vary from person to person. If you have a history of asthma or are at risk for developing it, it’s important to discuss any new medications with your healthcare provider before taking them. They can help identify any potential risks and recommend alternative medications if necessary. If you experience symptoms of asthma after taking a medication, it’s important to seek medical attention right away. Prompt treatment can help manage symptoms effectively and prevent complications.

4.        Sulfites: Sulfites are a type of preservative used in some foods and medications. They can cause asthma symptoms in some people, especially those with a history of severe asthma.

Some examples of sulfites that can trigger asthma symptoms in susceptible individuals include:

  • Sodium sulfite
  • Sodium bisulfite
  • Potassium bisulfite
  • Sodium metabisulfite
  • Potassium metabisulfite
  • Sulfur dioxide

Sulfites are often added to foods and drinks to preserve their color and flavor, so they can be found in a wide range of products, including wine, beer, dried fruits, pickled foods, and some processed meats. If you have a history of asthma or are at risk for developing it, it’s important to be aware of the potential for sulfites to trigger symptoms. Reading labels carefully and avoiding products that contain sulfites can help minimize the risk of an asthma attack. If you do experience symptoms of asthma after consuming a product containing sulfites, it’s important to seek medical attention right away. Prompt treatment can help manage symptoms effectively and prevent complications.

5.        Antibiotics: Certain antibiotics can also trigger asthma symptoms in some people. Some antibiotics have been known to trigger asthma symptoms in certain individuals, including:

  • Penicillin
  • Cephalosporins, such as cefuroxime and cephalexin
  • Macrolides, such as erythromycin and clarithromycin
  • Fluoroquinolones, such as ciprofloxacin and levofloxacin

It’s important to note that not all individuals with asthma will experience symptoms after taking antibiotics, and the severity of symptoms can vary from person to person. If you have a history of asthma or are at risk for developing it, it’s important to discuss any new medications with your healthcare provider before taking them. They can help identify any potential risks and recommend alternative medications if necessary. If you experience symptoms of asthma after taking an antibiotic, it’s important to seek medical attention right away. Prompt treatment can help manage symptoms effectively and prevent complications.

If you have asthma or are at risk for developing it, it’s important to discuss any new medications with your healthcare provider before taking them. They can help identify any potential risks and recommend alternative medications if necessary. If you experience symptoms of asthma after taking a medication, it’s important to seek medical attention right away. Prompt treatment can help manage symptoms effectively and prevent complications.

How Is Drug-Induced Asthma Managed

Drug-induced asthma can be managed by avoiding the trigger drug or by treating asthma symptoms with medication. Here are some ways drug-induced asthma can be managed:

1.        Avoiding the trigger drug: If a certain drug is identified as a trigger for drug-induced asthma, avoiding it is the best course of action. This may require working with a healthcare provider to find alternative medications or adjusting the dosage of the current medication.

2.        Using a bronchodilator: Bronchodilators are medications that help relax and open the airways, making it easier to breathe. They can be used as quick-relief medication to manage asthma symptoms when they occur.

3.        Using inhaled corticosteroids: Inhaled corticosteroids are medications that help reduce inflammation in the airways. They are often used as a long-term controller medication to manage asthma symptoms and prevent asthma attacks.

4.        Using leukotriene modifiers: Leukotriene modifiers are medications that help reduce inflammation in the airways and prevent the production of certain chemicals that can trigger asthma symptoms.

5.        Using immunomodulators: Immunomodulators are medications that help regulate the immune system, which can be helpful in managing asthma symptoms caused by certain medications.

It’s important for individuals with drug-induced asthma to work closely with their healthcare provider to develop a personalized treatment plan that works best for them. In some cases, it may be necessary to undergo allergy testing to identify any additional triggers that could be contributing to asthma symptoms. Regular monitoring and follow-up with a healthcare provider can help ensure that asthma symptoms are properly managed and under control.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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