One of the most commonly prescribed medications in the medical sector is nonsteroidal anti-inflammatory medicine (NSAID), and hypersensitivity to NSAID is a typical adverse drug reaction. NSAID hypersensitivity, on the other hand, manifests a wide range of symptoms induced by a variety of pharmacological and immunological mechanisms. Because of the disease’s heterogeneity, a new concept for NSAID hypersensitivity classification has recently been developed to diagnose and manage NSAID hypersensitivity for tailored treatment. This classification differentiated between acute and delayed reactions, and identifying symptoms and hypothesising putative causes aids clinicians in making the correct diagnosis. NSAID-exacerbated respiratory disease is a distinct phenotype of NSAID hypersensitivity that includes upper airway comorbidities (chronic rhinosinusitis with nasal polyps) as well as asthmatic characteristics. NSAID hypersensitivity can manifest as cutaneous phenotypes, and cross-reactivity with different types of NSAIDs should be addressed when making a thorough diagnosis.

A single NSAID hypersensitivity can cause urticaria/angioedema and anaphylaxis, with an IgE-mediated immune response thought to be the primary mechanism. Avoidance, pharmaceutical treatment according to conventional guidelines, and aspirin desensitisation are all options for managing NSAID hypersensitivity reactions. NSAID hypersensitivity should be classified, diagnosed, and managed on an individual basis by determining its phenotype.