Table 4

NSAIDs which cross react with aspirin in respiratory reactions

(A) Inhibitors of both COX-1 and COX-2 (there can also be reactions at the time of first administration of the drug with low doses): piroxicam, indomethacin, sulindac, tolmetin, ibuprofen, naproxen, ketoprofen, fenoprofen, meclofenamate, mefenamic acid, flurbiprofen, diflunisal, diclofenac, ketorolac, etodolac, nabumetone, aminopyrine
(B) Poor inhibitors of COX-1 and COX-2 (a small percentage of patients with aspirin sensitivity cross reacts with high doses of these drugs): acetaminophen, salsalate
(C) Relative inhibitors of COX-2 and minor inhibitors of COX-1 (there can be a cross reaction at high doses, but less serious): nimesulide, meloxicam
(D) Selective inhibitors of COX-2 (there are no controlled clinical trials but these drugs should not cross react): celecoxib, rofecoxib
(E) Non-inhibitors of COX-1 and COX-2(these are analgesic drugs having an action on the central nervous system): tramadol, nefopam
  • Modified from Szezcklik et al.5