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Pharmacy Links

DRUG ALLERGY: ASPIRIN, VACCINES AND INSULIN AS TROUBLESOME DRUGS

07/04/09

Aspirin. Aspirin is the commonly used name for acetylsalicylic acid (ASA). Although aspirin didn’t show up in the Boston study of allergic skin reactions, aspirin and related compounds are the second most likely drugs to trigger allergy.

Aspirin allergy (which, for some unknown reason, most often affects women) commonly afflicts the skin, resulting in hives. Until a few years ago, many doctors thought that nasal polyps were also a hallmark of aspirin allergy. Now, however, many doctors believe that’s not so.

Aspirin does seem to produce asthma, though: one out of five asthmatics has aspirin to blame. Your airways tighten up. You wheeze heavily. Your nose continues to run like a broken tap. And quite often your skin reddens and you suffer giant, puffy hives. But the lungs and nose don’t have exclusive rights to aspirin allergy. Occasionally, aspirin-sensitive individuals experience intestinal cramps or other abdominal discomfort, diarrhoea and vomiting. A few experience tremors, rapid heartbeat, constipation – even headaches. But runny nose, asthma and hives are the most common reactions, and the pattern is fairly predictable.

Aspirin allergy does not necessarily occur alone. In one study, 75 per cent of people allergic to aspirin were also sensitive to inhalants (such as pollen and dust), 74 per cent were allergic to some sort of food and 43 per cent were allergic to other drugs (Annals of Allergy). As a matter of fact, it’s quite common for allergy to aspirin to be accompanied by allergy to other pain relievers (analgesics). (These dual allergies are called ‘cross-reactions’.)

El02, or tartrazine, often causes serious problems in people who are allergic to aspirin. The two compounds seem to cross-react. By law, drugs that contain tartrazine must list it on the label.

People allergic to aspirin and aspirin compounds may also be allergic to certain foods containing natural salicylates (which have also been linked to hyperactivity). These foods include apricots, berries, cherries, cucumbers, currants, grapes, nectarines, peaches, plums and tomatoes.

Children are not exempt from aspirin allergy. Dr Cecil Collins-Williams and a colleague tell of four children with poorly controlled asthma who began to wheeze within half an hour after taking aspirin. ‘When [aspirin] compounds were removed from their diet, there was a dramatic improvement in their asthma,’ write the doctors (Annals of Allergy).

Aspirin shows up in a variety of over-the-counter remedies for headache pain, menstrual discomfort, sinusitis, backaches, stomach upsets and other aches and pains. Read all the labels of over-the-counter products if you are allergic to aspirin. And quiz your dentist about any treatments you receive; some dentists insert aspirin-containing wicks into tooth sockets during dental repair work.

Vaccines. Flu shots, made from influenza virus cultures on egg, provoke a reaction in anyone who is highly allergic to eggs. Although these vaccines are highly purified, traces of egg occasionally cling to the virus. For this reason, authorities at the national Centers for Disease Control in Atlanta say that people who are highly allergic to eggs shouldn’t receive flu injections.

That applies to people who, when they eat eggs, develop swollen lips or tongue, have dramatic breathing difficulties or collapse in shock.

Insulin. During the first few weeks of insulin therapy, many diabetics experience a slight skin irritation at the site of the injection that usually subsides in a matter of time. Some diabetics, however, experience larger, more troublesome reactions that never let up. The injection site can be itchy, watery or painful to touch. Worse, the person may feel sick or go into anaphylactic shock. Insulin is made from extracts of either beef or pork pancreas, so if a diabetic seems to be allergic to insulin from one animal, doctors may test insulins from the other. If that doesn’t do the trick, some diabetics are able to control the disease by eating a carefully planned diet or by using less powerful drugs that are taken by mouth, or doing both.