APD: Understanding Aspirin-Exacerbated Respiratory Disease and Related Conditions

When you take a common painkiller like aspirin and suddenly can’t breathe right, that’s not just bad luck—it might be APD, Aspirin-Exacerbated Respiratory Disease, a condition where NSAIDs trigger severe breathing and sinus reactions. Also known as Samter’s Triad, it’s not an allergy in the usual sense, but a chemical imbalance in your airways that turns everyday medications into triggers.

APD isn’t just about aspirin. It links directly to asthma, a chronic lung condition where airways tighten and swell, often worsening with NSAID use, and nasal polyps, noncancerous growths in the nose that block airflow and reduce smell. People with APD usually have all three: chronic asthma, recurring polyps, and bad reactions to ibuprofen, naproxen, or aspirin. It’s not rare—up to 1 in 10 adults with asthma and nasal polyps have it. And if you’ve had sinus surgeries that didn’t help, or your asthma got worse after taking Advil, APD could be the missing piece.

What makes APD different from a regular allergy? Your body doesn’t react to the drug itself—it reacts to how the drug blocks certain enzymes, causing a flood of inflammatory chemicals in your lungs and sinuses. That’s why antihistamines don’t help. The real fix? aspirin desensitization, a controlled process where you’re slowly exposed to aspirin under medical supervision, often leading to long-term improvement in breathing and fewer polyps. Some patients even stop needing steroids after starting it. Biologics like dupilumab are also showing strong results for those who can’t tolerate desensitization.

There’s no blood test for APD. Diagnosis comes from your history: when did your symptoms start? Did they get worse after taking painkillers? Have you had multiple sinus surgeries? If you’re on daily asthma meds, have polyps that keep coming back, or avoid NSAIDs because you get wheezy—this is your condition. The good news? Once you know, you can manage it. Avoiding NSAIDs helps, but it’s not the whole answer. You need a plan that includes safe alternatives, targeted treatments, and sometimes, a path to long-term relief.

Below, you’ll find real-world guides on how APD connects to other conditions like chronic sinusitis, what drugs to avoid, and how treatments like biologics and desensitization actually work in practice. No theory—just what patients and doctors are doing now to get better.