Nonsteroidal anti-inflammatory drugs hypersensitivity

Schubert B, Grosse Perdekamp MT, Pferrlfer P, et al. Nonsteroidal anti-inflammatory drug hypersensitivity fable or reality Eur J Dermatol. 2005 15 164-7. 

Strom BL, Carson JL, Morse ML, et al. Hypersensitivity reactions associated with zompirac sodium and other nonsteroidal anti-inflammatory drugs. 

Hypersensitivity to salicylates or nonsteroidal anti-inflammatory drugs (NSAIDs). Use extreme caution in patients with history of adverse reactions to salicylates. Cross-sensitivity may exist between aspirin and other NSAIDs that inhibit prostaglandin synthesis, and aspirin, and tartrazine. Aspirin cross-sensitivity does not appear to occur with sodium salicylate, salicylamide, or choline salicylate. Aspirin hypersensitivity is more prevalent in those with asthma, nasal polyposis, chronic urticaria. 

A topical 3% gel formulation of the nonsteroidal anti-inflammatory drug diclofenac (Solaraze) has shown moderate effectiveness in the treatment of actinic keratoses. The mechanism of action is unknown. As with other NSAIDs, anaphylactoid reactions may occur with diclofenac, and it should be given with caution to patients with known aspirin hypersensitivity (see Chapter 36). 

The primary adverse effect of intravenous cidofovir is a dose-dependent nephrotoxicity. Concurrent administration of other potentially nephrotoxic agents (eg, amphotericin B, aminoglycosides, nonsteroidal anti-inflammatory drugs, pentamidine, foscarnet) should be avoided. Prior administration of foscarnet may increase the risk of nephrotoxicity. Other potential side effects include uveitis, decreased intraocular pressure, and probenecid-related hypersensitivity reactions. Neutropenia and metabolic acidosis are rare. The drug caused mammary adenocarcinomas in rats and is embryotoxic. 

Szczeklik, A, Musial J, Serwohska M (1975 b) The effect of aspirin on bleeding time and platelet aggregation in patients hypersensitivity to nonsteroidal anti-inflammatory drugs. Abstracts of the Xlth Congress of the Polish Society of Haematologists. Gdahsk, p64... 

Szczeklik A, Gryglewski RJ, Czerniawska-Mysik G (1977) Clinical patterns of hypersensitivity to nonsteroidal anti-inflammatory drugs and their pathogenesis. J Allergy Clin Immunol 60 276-284... 

Tramadol is generally considered to be a safe drug with a low risk (put at less than 0.1 % in one report) of adverse reactions. Eleven cases of angioedema, possibly related to tramadol, were reported in Sweden and in 5 of 28 patients (18 %) with chronic urticaria exacerbated by nonsteroidal anti-inflammatory drugs, tramadol-induced urticaria with one of the patients developing laryngeal edema. Hypersensitivity... 

Kowalski ML, Makowska JS, Blanca M, et al. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management review of the EAACl/ENDA and GA2LEN/ HANNA. Allergy. 2011 66 818-29. 

---