Asthma and Acetaminophen
Updated June 08, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Is there a relationship between asthma and acetaminophen? Some doctors and scientists have noted that along with the increasing use of medications for pain and fever over the last 30 years, the number of people with asthma has also demonstrated a similar increase. This observation has led them to wonder if a possible causal relationship exists between asthma and acetaminophen.
There are several different reasons that might explain increased asthma among people using acetaminophen:
It appears that acetaminophen use during pregnancy is associated with asthma or wheezing in a child's early life. Studies examining asthma and acetaminophen use during pregnancy in a number of different countries, including the United States, United Kingdom, Denmark and Spain, have associated acetaminophen use with episodes of wheezing, in 10 to 30 percent of children at 5 years of age.
A number of studies have shown a relationship between acetaminophen use in the first year of life and asthma symptoms at age 7. More frequent use and higher doses of acetaminophen increased the association between acetaminophen and asthma.
Additionally, studies in adults have also demonstrated that there appears to be some relationship between acetaminophen and asthma.
As both a parent and a physician, I was surprised there were enough children who had not received acetaminophen to even compare kids who had not received acetaminophen to determine if there might be a relationship between asthma and acetaminophen. But I was also concerned, given how commonly acetaminophen is used to treat fever and pain in kids and adults. Importantly, many other common fever/pain medications, like ibuprofen, have not been studied to see if similar relationships exist.
I doubt many physicians or parents will change how they treat children's fever or pain based on only a few studies, but it is an interesting topic to keep your eye on. Further study is needed and a number of researchers have called for randomized controlled trials to better determine if there is a relationship between acetaminophen and asthma in children and adults. These studies would also be important because they might determine at what doses and frequency asthma and acetaminophen might be linked.
Sources:
Akashdeep Singh. Accessed October 22, 2011. Acetaminophen and asthma CMAJ. 2009 October 27; 181(9): 616.
Adrian J Lowe, John B Carlin et al. Accessed October 22, 2011. Paracetamol use in early life and asthma: prospective birth cohort study BMJ. 2010 Sep 15;341:c4616.
S. C. Dharmage and K. J. Allen. Accessed october 22, 2011. Does regular paracetamol ingestion increase the risk of developing asthma?
Mahyar Etminan, Mohsen Sadatsafavi, Siavash Jafari et al. Accessed October 22, 2011. Acetaminophen Use and the Risk of Asthma in Children and Adults:A Systematic Review and Metaanalysis CHEST November 2009 vol. 136 no. 5 1316-1323.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Is there a relationship between asthma and acetaminophen? Some doctors and scientists have noted that along with the increasing use of medications for pain and fever over the last 30 years, the number of people with asthma has also demonstrated a similar increase. This observation has led them to wonder if a possible causal relationship exists between asthma and acetaminophen.
How Are Acetaminophen And Asthma Linked?
There are several different reasons that might explain increased asthma among people using acetaminophen:
- Acetaminophen lowers glutathione levels. Glutathione is an antioxidant in the lungs. Consuming antioxidants in your diet have been associated with less development and symptoms of asthma. Lower levels of glutathione, in contrast, can lead to bronchoconstriction and asthma symptoms, such as wheezing, chest tightness, shortness of breath, and chronic cough.
- Acetaminophen increases IgE levels. IgE may be elevated in allergic asthma, and there is an anti-IgE treatment called Xolair (omalizumab) that may benefit some patients.
- Acetaminophen may allow one of the key enzymes that causes inflammation in asthma -- cyclooxygenase -- to act unchecked. As a result, there may be increased production of prostaglandins that promote early inflammatory events in asthma.
Pregnancy, Asthma And Acetaminophen
It appears that acetaminophen use during pregnancy is associated with asthma or wheezing in a child's early life. Studies examining asthma and acetaminophen use during pregnancy in a number of different countries, including the United States, United Kingdom, Denmark and Spain, have associated acetaminophen use with episodes of wheezing, in 10 to 30 percent of children at 5 years of age.
Asthma and Acetaminophen Use in Kids and Adults
A number of studies have shown a relationship between acetaminophen use in the first year of life and asthma symptoms at age 7. More frequent use and higher doses of acetaminophen increased the association between acetaminophen and asthma.
Additionally, studies in adults have also demonstrated that there appears to be some relationship between acetaminophen and asthma.
Conclusions About Asthma And Acetaminophen
As both a parent and a physician, I was surprised there were enough children who had not received acetaminophen to even compare kids who had not received acetaminophen to determine if there might be a relationship between asthma and acetaminophen. But I was also concerned, given how commonly acetaminophen is used to treat fever and pain in kids and adults. Importantly, many other common fever/pain medications, like ibuprofen, have not been studied to see if similar relationships exist.
I doubt many physicians or parents will change how they treat children's fever or pain based on only a few studies, but it is an interesting topic to keep your eye on. Further study is needed and a number of researchers have called for randomized controlled trials to better determine if there is a relationship between acetaminophen and asthma in children and adults. These studies would also be important because they might determine at what doses and frequency asthma and acetaminophen might be linked.
Other Medications & Your Asthma
- Are Your Other Medications Leading to Worsening Asthma?
- Aspirin-Induced Asthma
- Which Medicines Can Worsen Asthma?
- Effects of High Blood Pressure Medications on Asthma
Learn More About Your Asthma
- How Is Your Asthma Control?
- What Are the Risk Factors for an Asthma Attack?
- Are Your Other Medications Leading to Worsening Asthma?
- Why It Is Important To Monitor Asthma Symptoms
Sources:
Akashdeep Singh. Accessed October 22, 2011. Acetaminophen and asthma CMAJ. 2009 October 27; 181(9): 616.
Adrian J Lowe, John B Carlin et al. Accessed October 22, 2011. Paracetamol use in early life and asthma: prospective birth cohort study BMJ. 2010 Sep 15;341:c4616.
S. C. Dharmage and K. J. Allen. Accessed october 22, 2011. Does regular paracetamol ingestion increase the risk of developing asthma?
Mahyar Etminan, Mohsen Sadatsafavi, Siavash Jafari et al. Accessed October 22, 2011. Acetaminophen Use and the Risk of Asthma in Children and Adults:A Systematic Review and Metaanalysis CHEST November 2009 vol. 136 no. 5 1316-1323.
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