Medications that may trigger asthma symptoms

Most medicines are safe for people with asthma, but some can trigger asthma symptoms or make them worse. If you have asthma, it is important to always check with your healthcare practitioner or pharmacist before taking any medication.

Always read the information leaflet and any warning labels on all medicines or complementary medicines/herbal products. This includes medicines from the pharmacy, supermarket, health food shops and other sources. When consulting anyone about your health, make sure that you tell them you have asthma. Examples of medicines that may trigger asthma include:

  • Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs).
  • Beta blockers.
  • Complementary or herbal products.

Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs)

Aspirin (also an NSAID) is mainly prescribed in low doses as a ‘blood thinner’ to prevent blood clots in people who have had a heart attack or may be at risk of a stroke. Examples of low dose aspirin include: Cartia®, Aspec® and Ethics Aspirin®.

Aspirin is also available in pharmacies and supermarkets in higher doses for pain relief (analgesic) or to treat fever (antipyretic), but other NSAIDs are usually preferred. Examples of aspirin used in this way include: Ethics Aspirin Dispersible®, Disprin®, Aspro Clear® and Alka-Seltza®.

NSAIDs are available on prescription, but some brands can be purchased over-the-counter from a pharmacy (e.g.: Voltaren Rapid® 25 mg, Nurofen®, Ponstan®) or even at the supermarket in smaller pack sizes or lower strengths (e.g.: Nurofen®, Voltaren Rapid® 12.5 mg).

NSAIDs can be included in combination pain relief medication (e.g.: Maxigesic®, Nuromol®), in some cold and flu medications, and also in gels, creams and dermal patches.

Examples of NSAIDs available in New Zealand that may trigger asthma in some people:

  • Ibuprofen (Nurofen®, Advil®, Brufen®, I-Profen®, Ibugesic®, Fenpaed®).
  • Diclofenac (Voltaren®, Diclohexal®, Apo-Diclo®, Diclo SR®).
  • Naproxen (Noflam®, Naprosyn®).
  • Ketoprofen (Oruvail®).
  • Celecoxib (Celebrex®).
  • Mefenamic acid (Ponstan®).
  • Tenoxicam (Tilcotil®).
  • Meloxicam (Melorex®, Mobic®).

Beta blockers

Beta blockers are primarily used to control high blood pressure or treat heart failure. Beta blockers may also be used as a preventative treatment for migraines, to control atrial fibrillation (a heart rhythm disorder), for angina, and to control a fast heart rate in anxiety.

The following medicines are examples of beta blockers, which may have an effect on asthma:

  • Atenolol.
  • Labetolol (Trandate®, Presolol®).
  • Metoprolol (Betaloc CR®, Slow-Lopressor®).
  • Nadolol.
  • Propranolol (Cardinol®, Drofate®).
  • Sotalol.
  • Bisoprolol.

The following are beta blocker eye drops used to treat glaucoma, which may have effect asthma as they are absorbed into the bloodstream from your eyes:

  • Betaxolol (Betoptic®, Betoptic S®).
  • Timolol (Arrow-Timolol®, Timoptol-XE®).
  • Brimonidine + timolol (Combigan®).
  • Dorzolamide + timolol (Dortimopt®).
  • Latanoprost + timolol (Arrow-Lattim®).

Complementary or herbal products

Echinacea and royal jelly are known to worsen asthma.

What can I do to avoid problems?

Be aware of the medications that can cause potentially serious attacks.

If a reaction or worsening asthma symptoms are experienced following the use of any medicines or product, report the adverse reaction to your healthcare practitioner or pharmacist and follow your asthma action plan.

What pain relievers are recommended?

Paracetamol is the safest medication for occasional use to treat pain or colds and flu.

Recent research has suggested that the longer term use of high doses of paracetamol can aggravate asthma. If long-term paracetamol is prescribed by your healthcare practitioner, monitor your asthma control and report any worsening symptoms.