Acetaminophen Use and Asthma Linked in New Report

A new report, published in the journal Pediatrics on Monday, links acetaminophen and worsened asthma symptoms in both adults and children.

The report examined recent studies on the medication, which is also marketed with the brand name of Tylenol. The report says that past studies suggest that acetaminophen may worsen asthma in children and adults who already have the condition. It may, the report said, even cause new cases.

Dr. John McBride, vice chair of the department of pediatrics and director of the Robert T. Stone Respiratory Center at the Akron Children’s Hospital, said he wrote the report because he felt that most other pediatricians unaware of the studies linking acetaminophen with asthma. “I decided … to do what I could to make sure pediatricians and other primary care physicians – as well as my own patients and their parents – realized that there is a possibility that simply avoiding acetaminophen in preference of some other equally effective treatment for fever or pain might make an important difference to a child’s asthma."

McBride added, "The fundamental issue is that there's an epidemiological problem associated with acetaminophen and asthma. Is that because acetaminophen contributes to asthma, or is it just because people with asthma tend to take acetaminophen?"

One study, with a report published in the Lancet in 2008, looked at 520,000 children from 122 medical centers in 54 countries. In the report, researchers found that the risk of developing asthma was 60 percent higher in 6- to 7-year-olds who had taken acetaminophen at least once a year, but less than once a month. If the frequency of taking the drug increased to at least once a month, the risk more than tripled.

A more recent report, using the same data, was published in the American Journal of Respiratory and Critial Care Medicine this year. That report said that the risk of developing asthma jumped by 40 percent in 13- to 14-year olds who had taken acetaminophen at least once a year but less than once a month. If the rate of intake was increased to at least once a month, the risk more than doubled. Other studies linked acetaminophen with an increased risk of asthma in adults.

Dr. Len Horovitz, an internist and pulmonary specialist at Lenox Hill Hospital in New York City, said, "This information suggests that we have to be cautious about acetaminophen in children with asthma or a family history of asthma. The alternative is ibuprofen, which a lot of parents seem to prefer anyway," adding, "I do think further research is needed." That last comment is necessary. Notably, as with many of these reports, this report shows a correlation between acetaminophen and asthma. It is not the same as causation.

That said, McBride says that “my partners and I now recommend that our patients avoid using acetaminophen if at all possible until there is convincing evidence that it is safe.”

Image Source: Wikimedia Commons

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