The Effects of Aspirin (NSAIDs) on the Voice

About Dr. Reena Gupta

Dr. Reena Gupta is the Director of the Division of Voice and Laryngology at OHNI. Dr. Gupta has devoted her practice to the care of patients with voice problems. She is board certified in otolaryngology and laryngology and fellowship trained in laryngology, specializing in the care of the professional voice.

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Is it dangerous to take Advil or Motrin when my voice hurts?

Question: I sing five nights a week at a lounge, which is very vocally demanding.  After the first few nights, my neck and throat are usually a little sore.  I take Advil or Motrin or Aleve when this happens, and will take one or two a day until I get a break for a few days.  This helps my pain and allows me to continue to sing.  Is this dangerous?


The image on the left is of a singer who had never had vocal problems. The large blood vessels are at risk to bleed with NSAID use, causing a vocal hemorrhage. The image on the right is of a vocal hemorrhage. Blood has leaked into the vocal cord from a burst blood vessel.

Answer:  Use of anti-inflammatories, such as Advil, can increase the risk of a vocal hemorrhage.

Non-steroidal anti-inflammatory drugs (NSAIDs) are very commonly used for pain.  Almost every pain medication, except Tylenol, has an NSAID in it.  While these drugs are excellent for pain, one of the common side effects is an increased risk of bleeding.

For many patients, this is not a problem.  However, many patients have enlarged blood vessels (see the above image) in their vocal cords.  These vessels may normally cause no problems.  However, when the voice is used forcefully and NSAIDs are used, this may result in a hemorrhage.  The only way to know if you have enlarged blood vessels is to have a stroboscopy.

The safest thing to do when you are a professional voice user is to take Tylenol for pain.

It is also important to find out why you are having pain.  There are likely issues that can be controlled, such as how you are using your voice, the singing environment (including monitors, etc), or co-existing medical problems.  Pain is not a normal symptom after singing.

Key Points

  • NSAID use can be dangerous for a professional voice user.
  • Take Tylenol for pain and see a doctor to find out why you are having pain with voice use.


 Vocal Hemorrhage

Read patient stories about Dr. Reena Gupta from The Division of Voice at the Osborne Head and Neck Institute.

To learn more about Dr. Reena Gupta, click here.