A Case of Alclofenac Induced Asthma

Abstract

The paper reports a case of bronchial asthma induced by alclofenac and indomethacin.
The patient, a 59-year-old housewife, had frequent episodes of dyspnea since 1973 and was treated with oral bronchodilaters and intermittent corticosteroids. She had no nasal polyp and skin tests were negative. In 1977 she was admitted to Isesaki Public Hospital for treatment of acute bronchial asthma. In February of 1977, because of an acute asthmatic attack after administration of indomethacin suppository for lumbago, alclofenac was prescribed for pain relief. About half an hour after ingestion of alclofenac, a severe asthmatic attack occurred. To confirm the suspected relationship between the drugs and asthmatic attacks, provocative challenge tests with the drugs were performed. She developed typical signs and symptoms of asthma with marked decrease of PEFR and FEV₁ about 20 minute and 50 minute after administration of an indomethacin suppository (40mg) and ingestion of alclofenac (250mg) respectively. Challenge with benzydamine hydrochloride (50mg) was also positive but tiaramide hydrochloride was negative.