Which drug is contraindicated in patients with a history of allergic reactions to aspirin?

The choice of nonsteroidal anti-inflammatory drugs (NSAIDs) as contraindicated in patients with a history of allergic reactions to aspirin is based on the pharmacological similarities and cross-reactivity between aspirin and many NSAIDs. Both aspirin and many NSAIDs inhibit cyclooxygenase (COX) enzymes, leading to reduced production of prostaglandins, which are involved in inflammation, pain, and fever.

Patients who are allergic to aspirin often experience hypersensitivity reactions, including bronchospasm, urticaria, or anaphylaxis, also known as aspirin-exacerbated respiratory disease (AERD) or aspirin sensitivity. Many NSAIDs share similar chemical structures and mechanisms of action, which increases the risk of cross-reactive allergic responses in these patients. Therefore, using NSAIDs in individuals with a documented aspirin allergy can pose significant health risks.

In contrast, acetaminophen does not have anti-inflammatory properties and acts primarily as an analgesic and antipyretic. While it is generally considered a safe alternative for pain relief in patients with aspirin allergy, the same cannot be said for NSAIDs. Opioids and corticosteroids do not exhibit the same allergenic properties as aspirin and NSAIDs and are also viewed as safer options