{"id":"ccd3d39b-071d-5c93-b627-201aac86653a","stable_key":"3238e4f0-8d45-5c72-8624-6e9a8b20527c:ibu-cross-reacts-pharmacologically","predicate":"causes","statement":"A 53-year-old aspirin-sensitive asthmatic man with nasal polyps developed an urticarial rash, laboured breathing, laryngeal oedema and chest tightness after a 400 milligram ibuprofen tablet, requiring isoproterenol, subcutaneous epinephrine, intramuscular diphenhydramine and intravenous hydrocortisone; the reaction was not mediated immunologically but resulted from the prostaglandin synthetase inhibitor activity shared by aspirin, ibuprofen and other analgesics, so selection of an analgesic for an aspirin-sensitive patient should be based on that activity.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"positive","is_public":true,"mechanism_event_id":"7a51af5a-6e7c-5975-84ea-caaaebfc9ba4","mechanism_event_label":"The reaction is not an allergy to the drug but to what the drug does, so any drug that does the same thing will do it too.","subject":{"id":"b429f269-1d01-59f4-881a-868de0849d0d","slug":"ibuprofen","display_name":"Ibuprofen","entity_type_key":"drug"},"object":{"id":"3318b72a-dbc1-5b0e-8185-a635479f94cb","slug":"laryngeal-oedema","display_name":"Urticaria, laryngeal oedema and bronchospasm","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"7a51af5a-6e7c-5975-84ea-caaaebfc9ba4","stable_key":"3238e4f0-8d45-5c72-8624-6e9a8b20527c:ibu-cross-reacts-pharmacologically-event","event_type":"observed_intervention","label":"The reaction is not an allergy to the drug but to what the drug does, so any drug that does the same thing will do it too.","description":"A 53-year-old aspirin-sensitive asthmatic man with nasal polyps developed an urticarial rash, laboured breathing, laryngeal oedema and chest tightness after a 400 milligram ibuprofen tablet, requiring isoproterenol, subcutaneous epinephrine, intramuscular diphenhydramine and intravenous hydrocortisone; the reaction was not mediated immunologically but resulted from the prostaglandin synthetase inhibitor activity shared by aspirin, ibuprofen and other analgesics, so selection of an analgesic for an aspirin-sensitive patient should be based on that activity.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"8ac405bf-3ea0-539a-8e5e-abf503dc7081","slug":"aspirin","display_name":"Aspirin / acetylsalicylic acid","entity_type_key":"drug"},"role":"cross_reacting_drug","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"8e81d950-fb51-511c-93ae-a4a176aea66a","slug":"aspirin-sensitive-asthma","display_name":"Aspirin-sensitive asthma with nasal polyps","entity_type_key":"cellular_process"},"role":"predisposing_condition","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"1d62e970-b0a6-5529-ba39-dd0ad2abff7e","slug":"pharmacological-cross-reactivity","display_name":"Cross-reactivity between analgesics that share cyclooxygenase-inhibiting activity","entity_type_key":"cellular_process"},"role":"mechanism","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"6284d26c-01e2-5e12-b192-ee391dd107e2","slug":"ptgs1","display_name":"Cyclooxygenase-1 (PTGS1)","entity_type_key":"protein"},"role":"shared_target","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""},{"entity":{"id":"b429f269-1d01-59f4-881a-868de0849d0d","slug":"ibuprofen","display_name":"Ibuprofen","entity_type_key":"drug"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":4,"notes":""},{"entity":{"id":"3318b72a-dbc1-5b0e-8185-a635479f94cb","slug":"laryngeal-oedema","display_name":"Urticaria, laryngeal oedema and bronchospasm","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":5,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/ibuprofen-research/696734.abstract.txt\", \"locator\": \"Indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"ca9f025b68310a2b49def4e15ad6f25fb14fc900284de8d68cd80aa6a7f47139\", \"start_char\": 0, \"end_char\": 949, \"text_sha256\": \"ca9f025b68310a2b49def4e15ad6f25fb14fc900284de8d68cd80aa6a7f47139\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Clinical case report of an adverse reaction in an aspirin-sensitive asthmatic","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"A single 400 milligram ibuprofen tablet in a 53-year-old aspirin-sensitive asthmatic with nasal polyps","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"A single case, but it identifies the basis of the reaction as shared pharmacology rather than immunology, which is what determines whether a substitute drug is safe.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Ibuprofen research collection; topical membership is not evidence of a direct clinical effect, and the racemate is recorded separately from each of its two enantiomers.","comparator":null,"unit":null,"notes":"","entity":{"slug":"ibuprofen","display_name":"Ibuprofen","entity_type_key":"drug"}},{"dimension":"organism","value_text":"Human","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The reaction is not an allergy to the drug but to what the drug does, so any drug that does the same thing will do it too.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[ibu-p696734] Cross-reactivity between aspirin and ibuprofen in an asthmatic--a case report. (1978). https://pubmed.ncbi.nlm.nih.gov/696734/ DOI: 10.1093/ajhp/35.10.1245","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Airway and skin","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"07b2f0f7-8872-5ffc-b61a-ce794aadc5f5","evidence_kind":"source_excerpt","locator":"Lines 539-550","start_line":539,"end_line":550,"excerpt":"### ibu-cross-reacts-pharmacologically\nA 53-year-old aspirin-sensitive asthmatic man with nasal polyps developed an urticarial rash, laboured breathing, laryngeal oedema and chest tightness after a 400 milligram ibuprofen tablet, requiring isoproterenol, subcutaneous epinephrine, intramuscular diphenhydramine and intravenous hydrocortisone; the reaction was not mediated immunologically but resulted from the prostaglandin synthetase inhibitor activity shared by aspirin, ibuprofen and other analgesics, so selection of an analgesic for an aspirin-sensitive patient should be based on that activity.\nCondition category: biomarker_context\nnutrient_topic: Ibuprofen research collection; topical membership is not evidence of a direct clinical effect, and the racemate is recorded separately from each of its two enantiomers.\nplain_language: The reaction is not an allergy to the drug but to what the drug does, so any drug that does the same thing will do it too.\norganism: Human\ntissue_or_cell_type: Airway and skin\nexperimental_model: Clinical case report of an adverse reaction in an aspirin-sensitive asthmatic\nlimitations: A single case, but it identifies the basis of the reaction as shared pharmacology rather than immunology, which is what determines whether a substitute drug is safe.\nexposure: A single 400 milligram ibuprofen tablet in a 53-year-old aspirin-sensitive asthmatic with nasal polyps\nevidence_span: {\"source_cache\": \"artifacts/ibuprofen-research/696734.abstract.txt\", \"locator\": \"Indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"ca9f025b68310a2b49def4e15ad6f25fb14fc900284de8d68cd80aa6a7f47139\", \"start_char\": 0, \"end_char\": 949, \"text_sha256\": \"ca9f025b68310a2b49def4e15ad6f25fb14fc900284de8d68cd80aa6a7f47139\"}\n[ibu-p696734] Cross-reactivity between aspirin and ibuprofen in an asthmatic--a case report. (1978). https://pubmed.ncbi.nlm.nih.gov/696734/ DOI: 10.1093/ajhp/35.10.1245","model_system":"Clinical case report of an adverse reaction in an aspirin-sensitive asthmatic","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [ibu-p696734] Cross-reactivity between aspirin and ibuprofen in an asthmatic--a case report. (1978). https://pubmed.ncbi.nlm.nih.gov/696734/ DOI: 10.1093/ajhp/35.10.1245","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"31c4939d-f520-55c0-973b-224743caf245","stable_key":"import-3238e4f0-8d45-5c72-8624-6e9a8b20527c","title":"Ibuprofen: the enantiomer that works, the one that was called inactive, the one-way chemistry that turns one into the other, and the targets that are not cyclooxygenase (2026-09-22)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"cc2b388178f97f5906b66ecbe441fc5c86d51fd645947c5260fb0b4bdb4bcd21","revision_id":"0b4e5c65-05d3-5430-a4cd-8d6a03647dcb","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}