When a cold or flu hits, many of us will do just about anything to relieve the fever, aches and pain. But for people with asthma, a smart approach to pain relief begins with understanding how different medications can affect your breathing and your immune system.

There are two basic types of pain relievers that you can buy in the U.S. without a prescription:

• acetaminophen
• NSAIDs: aspirin, ibuprofen and naproxen

Acetaminophen works to reduce fever and relieve pain by affecting the parts of the brain that receive pain messages and control body temperature.

Brand names include Tylenol® and Midol®. Acetaminophen is also found in many combination cold and flu medications and prescription drugs, sometimes listed as APAP or paracetomol.

Caution: More is definitely not better. Too much acetaminophen can damage your liver, so it’s important to read labels carefully and follow dosing instructions. Pay particular attention if you are taking more than one kind of pain, cold or flu medication, whether prescription or over-the-counter. The symptoms of liver problems are easily overlooked, since they can be similar to flu symptoms. Parents should be aware that infant drops carry a much more concentrated dose of medication than children’s liquid (oral suspension) versions.

NSAIDs – nonsteroidal anti-inflammatory drugs – relieve inflammation, fever and pain by suppressing the production of prostaglandins, hormone-like substances that also play a role in the immune system. There are three types available without a prescription:

• aspirin (acetylsalicylic acid): Bayer®, St. Joseph® and other brand names; also found in Anacin®, Bufferin®, Excedrin® and Vanquish®
• ibuprofen: brand names Advil®, Motrin®, Nuprin®
• naproxen: brand name Aleve®

Caution: Allergists say people with asthma may be sensitive to aspirin or other NSAIDs. According to the American College of Allergy, Asthma & Immunology, aspirin can decrease lung function in about 5 percent of people with asthma. Aspirin-like products such as ibuprofen and naproxen can cause the same effects, although some research indicates the risk is low. In addition, anyone taking oral corticosteroids should talk with their doctor before using an NSAID. The Food and Drug Administration also cautions NSAIDs may cause stomach bleeding.

First published:  The MA Report, January 2007
Updated:  February 2009

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