Asthma triggered by ibuprofen?

[Swimmingaddict]

Yesterday I had a very large hip labral tear repaired. My resps apparently went so low with Fentanyl I wasn’t allowed any more. Apparently that is 10 resps per min. At 8 they have to breath for you.

Anyway I am undergoing a raft of tests at the moment as the GP thinks no wheeze and a normal peak flow and stats 12 hours post an attack means I don’t have asthma.

The only people who heard me wheeze are the paramedics which the consultant has recorded as they felt they heard a wheeze! I thought they only have you nebs if they heard a wheeze.

Anyway to get to the point consultant asked me two weeks ago after my appointment to double my Fostair to 2 puffs a day even though he didn’t think it would make a difference. He has confirmed a dust allergy by blood test and since the increase in Fostair I have only used my blue inhaler when I have reacted to dust where before I was using it daily.

Last night with the pharmacist it was decided to skip my Montelukast. About 21:30 felt my chest tightening and peak flow had dropped so I took my inhaler. I couldn’t understand why that should have happened in a hospital bed. I then realised I had taken ibuprofen at 21:00. So eventually this is my question can ibuprofen affect the breathing that quickly? I also was a bit wheezy last night which is unusual for me.

This morning I matched my personal best peak flow for the first time in ages. Below is my peak flows after the increased dose (mid November).

[twinkly29]

I imagine it can affect it quickly. I tried codeine in hospital (as I'd been advised by some drs to avoid it due to my asthma, yet others say it's ok). I had major asthma issues within 20 mins of taking it and it's on my notes now as a severe allergy.

Nebs only being given for wheezing isn't right. Many asthmatics don't wheeze at all and are still given nebs.

[Swimmingaddict in reply to twinkly29]

Thank you twinkly29. That sounds like it was the trigger and maybe explains why I was worse last year when I was taking ibuprofen for my shoulder injury.

That makes sense as I thought I had been given the news first. I think I don’t generally wheeze and it is frustrating that it is fixated on.

[Snowdrop27]

I was told by asthma uk that it can this type of painkiller can affect people with asthma. So it sounds that you are effected in this way.

I would go back to your doctor and talk to them about your reaction.

May I ask why you didn't take your monkelaust last night? I am prescribed this medication because of the allergic part of my asthma (like you house dustmite) . I also use Fostair Nexthaler 200/6 two puffs twice a day. Both these medication have really helped in controlling my asthma.

It will take a bit of time for the fostair to work but I hope like me you will be better controlled.

[Swimmingaddict in reply to Snowdrop27]

Hi,

Because of all the anaesthetic and pain meds they weren’t sure about me taking it. If I am honest I didn’t think one missed dose would matter, nor did I know I had a problem with ibuprofen. I had a suspicion but I think this has confirmed it. I feel very uncomfortable going to my GP, but might try to see the asthma nurse.

I have noticed a huge difference with the Montelukast and the consultant said he didn’t think it would make any difference.

Thank you for the reassurance.

[Snowdrop27 in reply to Swimmingaddict]

Hi if you are uncomfortable seeing your GP then do go and see your asthma nurse.

I have been talking monkelaust for nearly 4 years. Mine was prescribed by the then asthma nurse (20 yrs experience) I had at my surgery.

The nurse told me it would either work or not within 6 weeks. It did work. She believed that one of my trigger was caused by house dustmite. I hadn't had IgA blood test for allergies. Two years later when I was having a really bad time again with my asthma a consultant did that blood test on me. Guess what the results were I am very allergic to house dustmite!

Keep us updated on what happens when you see your asthma nurse.

[Swimmingaddict in reply to Snowdrop27]

Thank you. I will.

[Wheezycat in reply to Snowdrop27]

I am also on Montelukast but not due to allergies. I do have the odd allergy, but it does not seem to play a part in my asthma. Rather, I was told (ordered) to take it due to my lungs over reaction when I get a cold. The asthma nurse felt I had been on pred rather too many times in a year. I am still not sure if they make a difference, though I think they do. I just haven’t had a significant cold, just little ones for a while.

[Snowdrop27 in reply to Wheezycat]

thats interesting wheezy cat I haven't heard that explanation on why an asthmatic should take monkleaust.

I still get colds but I have only had two in 2 years. I do get little ones which I catch from the children I work with on a daily bases.

[Yetti1]

Sure Ibuprofen can induce breathing problems, well known - sounds like you are on Fostair to help your breathing generally, as part steroid [anti-inflam.] part broncho-dilator, with the monkelaust as a further medication to damp down your reaction [to dust here] - I am unclear as to why the Pharmacist asked you not to take the monkelaust, particularly given your situation, and no surprise that the problems ensued but the blue inhaler [Ventolin-Salbutamol] is there for just this 'as necessary' intervention. Other nebulisers have specific roles too, like the Fostair - intended more as a maintenance to limit acute episodes.

I would discuss your respiratory medication [and others for possible interactions] with your Resp. Consultant and team, meanwhile being wary of analgesics, be they specifically pain relief or anti-inflammatory - they all have side effects!! Oh, and effects can be very quick, on just one dose even!! Very Best Wishes

[Swimmingaddict in reply to Yetti1]

Thank you. I suppose it was only about 3 hours since I had woken up from the anaesthetic so I wasn’t best placed to be making decisions. I think she wasn’t sure about any cross interactions but with hindsight that should have been checked first.

Thank you for the reply.

[Yetti1]

You are welcome - it pays to be questioning …. and breathing comes top of my list!! Best Wishes.

[Poobah]

If you're reacting to ibuprofen then you may have the classic aspirin allergy, common in asthmatics. You can have this tested. If you have a positive result your Dr may need to review your wet inhalers as some propellants cause asthma in those with sensitivity to aspirin.

[Swimmingaddict in reply to Poobah]

Thank you. I didn't know that. I have booked an appt with the AN for next week. I will ask her. My Mum is unable to take aspirin but is not a diagnosed asthmatic.

[Poobah]

Me again. I should have also said that once an aspirin allergy is identified it should be highlighted on your records in order to avoid future mishaps in prescribing. But always raise it in non-asthma related consultations to cover yourself. They should always ask what you're allergic to, but it only takes one lapse.

Aspirin allergy has been known about for decades but I'm always surprised at the lack of knowledge from pharmacists to consultants.

[Swimmingaddict]

Thanks!