Version June 2024
| Suspected reaction type (based upon detailed history of past reactions and underlying conditions) | Symptoms of past reaction(s) | Starting dose for aspirin, in mg | Increase per step | Interval between steps | Dose range in which reactions usually occur, in mg | Usual time between administration and onset of symptoms |
| Respiratory reaction induced by multiple NSAIDs (cross-reacting) in patient with underlying AERD (type 1) Also appropriate for type 4 reactions | Rhinitis/ocular symptoms, bronchospasm | 40.5 | Double | 3 hours | 60 to 100 | 1 to 3 hours |
| Urticaria/angioedema induced by multiple NSAIDs (cross-reacting) in patient with chronic urticaria (type 2) Also appropriate for type 3 reactions | Urticaria/angioedema | 81 to 162 | Double | 3 hours | 162 to 650 | 1 to 3 hours |
| Urticaria/angioedema induced by one NSAID (no underlying conditions) (type 5)* | Urticaria/angioedema | 162 | Double | 3 hours | Not applicable¶ | Not applicable¶ |
| Anaphylaxis induced by one NSAID (no underlying conditions) (type 6)* | Anaphylaxis | 81 | Double | 3 hours | Not applicable¶ | Not applicable¶ |
The challenge is terminated when either the patient reacts or the desired therapeutic dose of aspirin/NSAID is reached without a reaction. The challenge is continued beyond the reaction in order to desensitize patients with AERD.
Aspirin is most often used for these protocols, and the doses cited here apply to aspirin. Refer to the UpToDate topic for a discussion of performing challenges with other NSAIDs.AERD: aspirin-exacerbated respiratory disease.
* These patients should avoid the suspected NSAID and be challenged with aspirin or another NSAID (chemically different from the one that caused the reaction) to prove drug tolerance.
¶ Patients are challenged with aspirin to confirm that they do not have a pseudoallergic reaction, and symptoms during challenge are not anticipated.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
