Johns Hopkins Health Alerts | Lung Disorders | Asthma and Drug Interactions

Play it safe -- talk to your doctor about ALL the medications you’re taking.

Many adults with asthma may take a number of prescription and over the-counter medications to treat a variety of conditions. Some of these medications may trigger or worsen asthma symptoms. If you take any of the medications discussed below, it’s important to talk to your doctor about their possible negative effects on your asthma.

And remember: It’s not just prescription drugs that reduce the effectiveness of your asthma medications. You have to watch out for over-the-counter drugs, too.

• Asthma and nonsteroidal anti-inflammatory drugs (NSAIDs). These over-the counter pain relievers include aspirin, ibuprofen (Motrin, Advil), and naproxen (Naprosyn, Aleve). NSAIDS can trigger severe and even fatal asthma attacks. A safer over-the-counter alternative is acetaminophen (Tylenol). Alternative prescription painkillers include propoxyphone (Darvon), and codeine.

• Asthma and beta-blockers. These prescription medications are given in pill form to treat conditions such as high blood pressure, heart disease, or migraines. Beta-blockers also come in the form of eye drops for treating glaucoma. Both forms of beta-blockers can worsen asthma symptoms by interfering with the effectiveness of beta-agonist asthma drugs.
• Asthma and ACE Inhibitors. These drugs are typically used to treat high blood pressure and heart disease. Lisinopril (Zestril) and enalapril (Vasotec) are examples. Although they usually don’t make asthma worse, some people who use these drugs develop a very troublesome cough, which can trigger increased wheezing. In addition, any cough can lead to reflux (acid coming up from the stomach into the esophagus), which, in turn, can cause more cough and worsen asthma.
• Asthma and diuretics. Diuretics, used to treat high blood pressure and congestive heart failure, help the body to excrete urine. Some diuretics can cause a loss in potassium and are therefore referred to as non-potassium-sparing diuretics. These diuretics may interact with asthma medications such as steroids and beta 2 agonists, which also lead to potassium loss. The result is an additive, dangerous amount of potassium depletion. If left untreated, this depletion increases the risk for disturbances in heart rhythm that can occasionally lead to cardiac arrest.
• Asthma and sleeping pills and tranquilizers. Sleeping pills, tranquilizers, and other sedative drugs make you breathe more slowly and less deeply, which can be dangerous if you have lung problems such as asthma.

Drug interactions are a two-way street. In addition to some drugs worsening your asthma, some asthma drugs can aggravate other health conditions. So it’s important that your doctor is aware of ALL the medications you are taking.

Johns Hopkins Health Alerts | Lung Disorders | Asthma and Drug Interactions