Cardiovascular prophylaxis and aspirin "allergy"

Immunol Allergy Clin North Am. 2013 May;33(2):263-74. doi: 10.1016/j.iac.2012.11.004. Epub 2012 Dec 27.


Aspirin is an important antiplatelet agent in the treatment of cardiovascular disease. Aspirin "allergy" often directs the physician away from this potentially life-saving modality. The majority of patients with a history of "reactions to aspirin" have aspirin/nonsteroidal anti-inflammatory drug (NSAID)-induced gastritis, easy bruisability, or other side effects. The minority of these patients has a "true allergy," referred to as a hypersensitivity reaction. The former group can be started on aspirin without the need for special challenge. Adding a proton-pump inhibitor can often mitigate the gastrointestinal side effects. Patients with aspirin hypersensitivity can be safely challenged with aspirin.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Aspirin / administration & dosage
  • Aspirin / adverse effects*
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / drug therapy*
  • Desensitization, Immunologic
  • Drug Hypersensitivity / complications*
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / prevention & control*
  • Humans
  • Premedication


  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin