There’s a chance people with asthma may have a bad reaction to nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. You can talk with your doctor about other options, including Tylenol.

Some people with asthma may not always be able to take ibuprofen, like Advil and Motrin. They may experience hypersensitivity to this type of medication, which can lead to more severe asthma symptoms and reactions.

Ibuprofen is a common over-the-counter (OTC) medication that is classified as a nonsteroidal anti-inflammatory drug (NSAID). It’s typically used to relieve pain and reduce fever or inflammation.

According to ibuprofen’s package insert, you shouldn’t take it if you have experienced asthma, urticaria (hives), or an allergic reaction after taking an NSAID.

As many as 10% to 20% of people with asthma may experience hypersensitivity to ibuprofen, but that estimate is based on older research. Other research notes that an NSAID-exacerbated respiratory disease is even less common, but still can cause severe reactions for people with asthma.

Some people with asthma may be more sensitive to ibuprofen because of how this and related medications work. They inhibit a protein called cyclooxygenase, but it’s unclear why some people with asthma are overly sensitive to these inhibitors.

It may be related to the overproduction of chemicals called leukotrienes. In people with asthma, allergy cells in the bronchial tubes release leukotrienes into the airways. This causes bronchial muscles to spasm and bronchial tubes to swell.

Medications to be careful with

Ibuprofen is sold under a variety of brand names, including:

  • Advil
  • Motrin
  • Nuprin

Certain combination drugs also contain ibuprofen. These include medicines for cold and flu, sinus problems, and stomach upset. Other OTC NSAIDs include:

  • aspirin (Anacin, Bayer, Bufferin, Excedrin)
  • naproxen (Aleve)

Your doctor may also prescribe other types of NSAID combo medications.

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Make sure to take ibuprofen as directed, especially if you live with asthma and may be more at risk for developing an aspirin allergy or sensitivity.

If you do have aspirin-sensitive asthma, ibuprofen can trigger symptoms of asthma or allergy. Symptoms of severe allergic reaction usually develop within a few hours after taking the drug.

Some symptoms may include:

  • nasal congestion, runny nose
  • cough
  • wheezing, breathing problems
  • bronchospasm
  • tightness in your chest
  • skin rash, hives
  • facial swelling
  • abdominal pains
  • shock

This 2024 research analyzing studies on children with asthma found that symptoms usually develop within 30 to 180 minutes but can take up to 24 hours. While ibuprofen sometimes causes exacerbation of asthma symptoms in children, it’s not linked to hospitalizations.

If you’re ibuprofen-sensitive, it’s important to scrutinize medication labels carefully. Avoid products that contain ibuprofen, aspirin, or any other NSAID.

You can discuss with a healthcare professional whether taking acetaminophen (Tylenol) instead of ibuprofen to treat fever or pain may be an option.

For frequent or chronic pain, your doctor may be able to provide alternate solutions based on the cause.

If you’ve had a bad reaction in the past and accidentally take ibuprofen, contact your doctor right away. Seek emergency medical care or call 911 if you have symptoms of severe allergic reaction such as:

Most people with asthma aren’t ibuprofen-sensitive. But there’s no medical test that can determine if you are. If you’ve never taken an NSAID, ask your doctor if you can take a test dose under medical supervision.

Of course, taking any medication may cause an allergic reaction. Tell your doctor if asthma symptoms get worse after taking a new medication. If possible, use a peak flow meter to measure any changes to airflow, and report changes that occur after taking medication.

Remember, if you’ve had a bad reaction to one NSAID, it’s important that you avoid them all.