What pain medication to take in NSAIDs allergy?

NSAIDs are the drugs most commonly involved in hypersensitivity drug reactions. http://buff.ly/1tI92CZ

Most NSAIDs cross-react with each other in patients with NSAIDs allergy. The safest pain medication to use in such patients is Tylenol (acetaminophen).

COX-2 inhibitors (Celebrex) are the second line choice in those who need more effective chronic pain control (RA, severe OA) or episodic acute pain treatment (monthly menstrual pain).

Which medication class is the most common cause of drug allergy?

1. PCN.
2. NSAIDs.


Mind map of adverse reactions to drugs. See other related mind maps on AllergyCases.org.

What are the best alternative therapeutic choices for a patient who develops urticaria when taking ibuprofen?

(A) Keterolac

(B) Naproxen

(C) Celecoxib

(D) Aspirin

(E) Tylenol

(F) Motrin

Answers: C and E.

Related reading:

Can NSAIDs-allergic patients use COX-2 inhibitors?
Practical approach to management of hypersensitivity to NSAIDs - 2013 EAACI position paper http://buff.ly/GNVDCa
From the Blogs: When is a Drug Allergy Not a Drug Allergy?
Drug Hypersensitivity. Allergy Cases.

The Kounis-Zavras syndrome with the Samter-Beer triad http://goo.gl/g7qGh

Selective COX-2 inhibitors may be unsafe in subjects with urticaria and/or angioedema caused by hypersensitivity reactions to NSAIDs with cross-intolerance if they are intolerant to paracetamol. Allergy, 2011.
How Can We Better Classify NSAID Hypersensitivity Reactions – Validation from a Large Database  http://goo.gl/sal36
Image source: Wikipedia