For some people, taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can trigger severe asthma attacks, nasal congestion, and sinus inflammation. This condition is called Aspirin-Exacerbated Respiratory Disease (AERD), also known as Samter’s Triad. If you’ve experienced breathing issues after taking NSAIDs, understanding AERD can help you manage symptoms and avoid complications.
What Is AERD?
AERD is a chronic inflammatory condition involving: ✔️ Asthma – Often severe and difficult to control.
✔️ Nasal polyps – Growths in the sinuses leading to congestion and loss of smell.
✔️ NSAID sensitivity – Respiratory symptoms triggered by aspirin or NSAIDs.
Symptoms of AERD
AERD symptoms usually appear 30 minutes to 3 hours after taking NSAIDs and may include:
- Severe nasal congestion and sinus pressure.
- Wheezing, shortness of breath, and asthma attacks.
- Runny nose and sneezing.
- Loss of smell and taste.
- Facial pain from chronic sinus inflammation.
How Does AERD Develop?
Unlike traditional drug allergies, AERD is not caused by IgE antibodies. Instead, NSAIDs trigger an imbalance in inflammatory chemicals called leukotrienes, leading to severe respiratory inflammation.
Diagnosing AERD
AERD is often misdiagnosed as uncontrolled asthma or chronic sinusitis. A specialist may recommend: ✔️ Medical history review – Checking for a pattern of asthma, nasal polyps, and NSAID reactions.
✔️ Aspirin challenge test – A supervised test where small doses of aspirin are given to confirm sensitivity.
✔️ Lung function tests – To assess asthma severity.
✔️ Sinus CT scan – To evaluate nasal polyps and inflammation.
Treatment Options for AERD
- Avoid NSAIDs (but not all pain relievers!)
- Acetaminophen (Tylenol) is generally safe for pain relief.
- COX-2 inhibitors (Celecoxib/Celebrex) may be tolerated in some cases.
- Medications to Control Symptoms
- Leukotriene inhibitors (Montelukast/Singulair, Zileuton) help reduce inflammation.
- Nasal steroid sprays (Fluticasone, Mometasone) shrink polyps and improve congestion.
- Biologics (Dupixent, Xolair, Nucala, Fasenra) can reduce asthma severity and nasal polyps.
- Aspirin Desensitization (for Some Patients)
- Supervised procedure where patients take gradually increasing doses of aspirin.
- Once desensitized, patients take a daily aspirin dose to maintain tolerance.
- Helps reduce nasal polyp regrowth and improve asthma control.
- Sinus Surgery (If Needed)
- Removes nasal polyps to improve breathing.
- Often combined with aspirin desensitization or biologic therapy to prevent regrowth.
FAQ: NSAIDs and AERD
Q: Can I develop AERD later in life?
A: Yes! AERD typically appears in adulthood (ages 20–50), even in people who previously tolerated NSAIDs.
Q: Can antihistamines help with AERD?
A: No, because AERD is not an IgE-mediated allergy—antihistamines don’t address the underlying inflammation.
Q: Will my asthma get better if I avoid NSAIDs?
A: Avoiding NSAIDs prevents flare-ups, but managing inflammation with medication or aspirin desensitization is key for long-term control.
A Personal Story
One of my patients, Mike, had severe asthma and constant sinus infections. After an aspirin challenge confirmed AERD, he started leukotriene inhibitors and biologic therapy as well as allergy shots. His breathing improved, and he needed fewer sinus surgeries—finally finding relief after years of misdiagnosis.
The Bottom Line
If you have asthma, nasal polyps, and NSAID sensitivity, you may have AERD. Avoiding NSAIDs isn’t always enough—targeted treatments like leukotriene inhibitors, biologics, or aspirin desensitization can help improve symptoms and quality of life. Talk to an allergist about the best treatment options for you!
What are you waiting for? If you or your child need help controlling allergies or if you think you need testing or treatment or that you might be a good candidate for allergy shots, Dr. Wendt and her team staff at Relieve Allergy, Asthma & Hives would love to help. Call for testing or treatment today!
Call 480-500-1902 or request an appointment at https://relieveallergyaz.com/contact now! Begin your allergy testing journey with Dr. Wendt at Relieve Allergy in Scottsdale, Arizona—It’s time to take care of yourself!
Learn more about Dr. Wendt and Relieve Allergy Asthma & Hives at www.relieveallergyaz.com or connect with us: https://www.facebook.com/RelieveAllergy/, https://www.linkedin.com/in/julie-wendt/, https://x.com/RelieveAllergy, https://www.instagram.com/relieve_allergy/ or https://www.youtube.com/@JulieWendt-qx7jm.
Did you know? Dr. Wendt wrote the book on allergies. Buy it NOW!
Relieve Allergy Asthma & Hives is located near Kierland Commons, 21803 N. Scottsdale Road Ste. 200, and has convenient evening and morning hours to accommodate your schedule. Dr. Wendt is also available for telemedicine appointments as appropriate. Most insurance plans are accepted.
DISCLAIMER: This blog is not meant to substitute for medical care by an Allergist-Immunologist nor is it intended to provide medical advice or imply a Physician-Patient relationship with its readers or their family. It is intended to provide guidance, direction, and moral support from someone experienced in testing and treating allergies. This is also not meant to be a “do-it-yourself” manual or a “how to” overcome your allergies. Some of the issues mentioned, whether allergic or look-a-like, can be dangerous or if left unchecked, deadly. Please develop a relationship with a Physician you trust to help you with diagnosis, advice, questions, and treatment regarding your and your family’s medical conditions.
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