Which Medicines Can Worsen Asthma?

Question: Which Medicines Can Worsen Asthma?

Answer: When we think of triggers for asthma, the use of medicines for other medical problems doesn’t usually come to mind. Usually, medicines help a person’s medical conditions – doesn’t worsen them. However, there are some medicines that a person can take that can worsen asthma symptoms, or cause other respiratory symptoms such as coughing. Therefore, it is important that you inform each and every doctor that treats you about your asthma and other medical problems.

Beta-Blockers

Beta-blockers are commonly used medicines for the treatment of high blood pressure, heart arrhythmias and for the prevention of migraine headaches. They are also used in eye-drop form for the treatment of glaucoma. Beta-blockers act on certain receptors present on different organs throughout the body – resulting in decreased heart rate, blood pressure, and “pump function” of the heart. Unfortunately, beta-blockers have the opposite effect on the lung that albuterol does, and can result in constriction of the muscles around the airways. This has even been reported with the use of beta-blocker eye drops.

While newer beta-blockers are only supposed to act on the heart (termed “cardio-specific”), older beta-blockers are known to worsen asthma symptoms. In some cases, a person with asthma has a dire need for a beta-blocker. If this is the case, the person should ask their doctor for a cardio-specific version of a beta-blocker. If asthma symptoms are still worsened, an inhaled medication with anti-cholinergic effects, such as ipratropium (Atrovent HFA) or tiotropium (Spiriva), may be helpful to counteract this problem.

Aspirin and Aspirin-like Medications

Aspirin and related medicines, termed non-steroidal anti-inflammatory medicines (NSAIDs), are commonly used medicines for the treatment of joint and muscle pain and inflammation, headaches, fever, as well as anti-platelet drugs for the prevention of heart attacks and strokes. NSAIDs are available in many forms over-the-counter and by prescription. Some people have allergic reactions to NSAIDs, which can result in worsening of allergy and asthma symptoms, or urticaria/angioedema or even anaphylaxis. Approximately 10% of people with asthma can experience worsening asthma symptoms as a result of taking NSAIDs – this increases to 40% of people with asthma when nasal polyps are also present.

When an alternative to NSAIDs is needed, many people with NSAID-reactions can tolerate acetaminophen (Tylenol). If a stronger medicine with more anti-inflammatory effects is needed, celecoxib (Celebrex) is tolerated by many (but not all) people with NSAID allergy.

Angiotension Converting Enzyme Inhibitors (ACE Inhibitors)

ACE inhibitors are commonly used medicines for the treatment of high blood pressure and heart failure. Common generic-brand forms include lisinopril, ramipril, and many other forms ending in the letters “pril.” and However, some people have respiratory side effects from this class of medicine, with approximately 10% having a nagging, dry cough. This cough can be mistaken for worsening asthma or other common causes of a cough. Generally, the cough will go away within a few weeks of stopping the ACE inhibitor. However, if the cough is severe, or the ACE inhibitor cannot be stopped, inhaled cromolyn (Intal) or nedocromil (Tilade) may be useful to treat an ACE inhibitor-induced cough.

_Source:

_{Common Medicines Can Have Major Side Effects. Allergy and Asthma Issues. Winter 2009/2010. American Academy of Allergy, Asthma and Immunology Website. Accessed January 31, 2010.}

_{DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.}