![]() These reactions are thought to occur mainly due to the inhibition of cyclooxygenase-1 enzymes (COX-1). Nonallergic NSAID reactions are allergy-like reactions that are not immunologically mediated. 1 Nonallergic NSAID-Induced Hypersensitivity Reactions They are then further subdivided by the presence of underlying disease and timing of reaction ( Table 1). 1 These classifications are first divided into two groups: those that are nonimmunologically mediated (nonallergic or cross-reactive reactions) versus those that are immunologically mediated (allergic or selective reactions). The 2013 classification and management strategies set forth by the European Academy of Allergy and Clinical Immunology are the most widely accepted. 5-8 Although NHRs are more prevalent in patients with these conditions, people who do not have these conditions may also be affected.īecause of the frequency and complexity of NHRs, international collaborative efforts have been made to help classify and manage these reactions. In fact, up to 30% of all patients with chronic respiratory and/or cutaneous diseases will be affected by NHRs. Studies show that patients at highest risk for developing NHRs are those with underlying chronic respiratory and skin conditions. NSAID-induced hypersensitivity reactions (NHRs) have been reported in about 0.3% to 6% of the general population and are thought to account for 20% to 30% of all drug-related reactions, placing them second behind antibiotic-associated hypersensitivity reactions. Despite the fact that they are often consumed daily, their use comes with a broad variety of adverse effects ranging from gastrointestinal irritation to severe, life-threatening anaphylaxis. There are currently more than 15 different forms of NSAIDs commercially available in the United States, and they are available as both prescription and OTC drugs. Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesic, anti-inflammatory, and antipyretic medications on the market. Pharmacists should be aware of and understand the differences associated with the various NHR reaction types. Symptoms associated with these reactions can range from respiratory and/or cutaneous reactions to angioedema. There are five types of NHRs, categorized as either nonimmunologically mediated or immunologically mediated reactions. ABSTRACT: Although nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed and consumed drug classes, they are associated with a wide range of adverse effects, including NSAID-induced hypersensitivity reactions (NHRs). ![]()
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