Can people develop an allergy to ibuprofen (Nonsteroidal Anti-Inflammatory Drug, NSAID)?

From the Guidelines

Yes, people can develop allergic reactions to ibuprofen, though true allergies are relatively uncommon. Symptoms of an ibuprofen allergy can range from mild skin reactions like hives or rashes to severe, life-threatening reactions such as anaphylaxis, which may include difficulty breathing, swelling of the face or throat, and a drop in blood pressure 1. If you suspect you're allergic to ibuprofen, stop taking it immediately and consult a healthcare provider.

Key Considerations

• Alternative pain relievers like acetaminophen (Tylenol) may be recommended instead, as it works through a different mechanism and is generally safe for those with ibuprofen allergies.
• It's essential to distinguish between a true allergy and other adverse reactions to ibuprofen, such as gastrointestinal upset or increased risk of bleeding, which are side effects rather than allergic responses.
• Your doctor might recommend allergy testing to confirm an ibuprofen allergy and provide guidance on which pain relievers are safe for you to use.

Important Details

• Meningitis is much more common with ibuprofen, and although it is likely drug-specific, cross-reactivity to other NSAIDs has been reported 1.
• NSAIDs are among the most common causes of drug-induced interstitial nephritis, drug-induced pneumonitis, and aseptic meningitis.
• If you experience any symptoms of an allergic reaction, such as difficulty breathing, swelling, or a drop in blood pressure, seek medical attention immediately.

From the FDA Drug Label

Ibuprofen tablets are contraindicated in patients with known hypersensitivity to ibuprofen. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients Anaphylactoid Reactions As with other NSAIDs, anaphylactoid reactions may occur in patients without known prior exposure to ibuprofen tablets. Ibuprofen tablets are contraindicated in patients with previous serious skin reactions to NSAIDs ALLERGIC Syndrome of abdominal pain, fever, chills, nausea and vomiting; anaphylaxis; bronchospasm

Yes, people can get an allergy to ibuprofen, as evidenced by the risk of anaphylactic-like reactions, anaphylactoid reactions, and other allergic symptoms. 2, 2, 2

From the Research

Ibuprofen Allergy

• Ibuprofen is a widely used nonsteroidal anti-inflammatory drug (NSAID) that can cause hypersensitivity reactions in some individuals 3, 4.
• Studies have shown that ibuprofen hypersensitivity can affect both children and adults, with females being more commonly affected than males 3, 5.
• The clinical manifestations of ibuprofen hypersensitivity can range from mild to severe, including urticaria, angioedema, and anaphylaxis 3, 4, 5.

Clinical Characteristics

• The onset of symptoms can be rapid, typically occurring within 30 minutes to 1 hour after ibuprofen exposure 3.
• The duration of symptoms can vary, ranging from 60 minutes to several hours 3.
• Cross-reactivity to other NSAIDs or acetaminophen can occur, presenting with mostly mild reactions 3, 5.

Risk Factors

• Older age and male gender have been identified as independent risk factors for immediate-type ibuprofen allergy in children 5.
• The use of ibuprofen-based medicines can increase the risk of skin reactions, including morbilliform rashes, urticaria, and angioedema 6.

Management

• Drug provocation tests (DPTs) can be used to confirm or exclude ibuprofen allergy and to find safe alternative drugs 5.
• Management of allergic reactions and anaphylaxis in the emergency department typically involves the use of epinephrine, corticosteroids, and antihistamines 7.