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Subscribe to RSSAcetaminophen may worsen asthma symptoms in both adults and children, a provocative new report suggests.
The report, which was published in the journal Pediatrics on Monday, reviewed recent studies on the medication, which is also marketed as Tylenol. Those studies suggest that the drug may exacerbate asthma in children and adults who already have the condition and could even spark new cases.
Dr. John McBride says he wrote the report because he realized that few of his fellow pediatricians had ever heard of the studies linking acetaminophen with asthma – and therefore most parents hadn’t either.
“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,” said McBride, director of the Robert T. Stone Respiratory Center at the Akron Children’s Hospital.
One of the more worrisome studies McBride cites looked at 520,000 children from 122 centers in 54 countries. In a report on that data published in The Lancet in 2008, researchers found that the risk of developing asthma jumped by 60 percent in 6- to 7-year-olds who had taken acetaminophen at least once a year but less than once a month. In children who took the medication at least once a month, the risk more than tripled.
A second report using the same data was published in the American Journal of Respiratory and Critial Care Medicine in 2011. That report found 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. In children of the same age group who took the medication at least once a month, the risk more than doubled. Other studies found acetaminophen associated with an increased risk of asthma in adults.
Asthma experts cautioned that the studies don’t absolutely prove that acetaminophen is the direct cause of asthma or its exacerbation – just that the drug is associated with an increased risk. The association could be due to something else that people who took acetaminophen had in common.
But, experts interviewed by msnbc.com said the studies at the very least underscore the need for parents to be cautious when dispensing any medication, regardless of whether it is sold over the counter.
“I think people get the false idea that because something is sold over the counter that means it is completely safe to use,” said Dr. Fernando Holguin, an assistant professor of medicine in the pulmonary, allergy and critical care division at the University of Pittsburgh Medical Center. “That is not correct.”
Holguin was familiar with the studies cited in the Pediatrics paper. His 4-year-old son suffers from asthma and for that reason, Holguin chose to use ibuprofen rather than acetaminophen when his son is feverish and achy.
The new study reminds us that we always need to be cautious with children.
“With children we need to think twice before giving any medication,” said Dr. Andrea Apter, a specialist in allergy and immunology and a professor of medicine at the University of Pennsylvania. “This [new report] is worrisome. It raises our caution and concern. A prospective randomized controlled trial, if feasible, would be very important because randomization balances all the other factors, known and unknown, that may be related to taking acetaminophen and to having an asthma exacerbation.”
People need to remember that all drugs can have side effects, said Dr. Maria Garcia-Lloret, an assistant professor of allergy and immunology at the University of California, Los Angeles. “I always tell my patients that any medicine you don’t need is a bad medicine,” she said.
The new research may prompt more physicians to tell their patients about the possible risks associated with acetaminophen.
“The bottom line,” Holguin said, “is that acetaminophen may not be safe for children with asthma. If a child has asthma and no contraindications to medications like ibuprofen, I’d suggest one of those.”
At least one study that looked at the impact of ibuprofen and acetaminophen in children with asthma found that while acetaminophen appeared to increase airway problems, ibuprofen did not.
Further, McBride points out, “in a double-blind study of acetaminophen versus ibuprofen in asthmatic children with fever that was published in 2002 in Pediatrics, children who were randomized to receive acetaminophen had twice the risk of treatment for an asthma exacerbation compared to the children randomized to ibuprofen.”
Still, Holguin said, “it’s harder to comment on everyone else. You don’t want to altogether block the use of a useful medication.”
Holguin and others interviewed by msnbc.com said they would tell their patients about the studies in the new report, along with the limitations of those studies – and then leave the decision up to the patients themselves.
As for McBride, “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.”
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This is just another example of how prescription and over-the-counter medications can be so dangerous. I once started taking Exedrin Migraine for my migraine headaches. That brought on a long-term episode of migraines that sent me to the Emergency Room many many times. I had to detoxify for several months with no medications whatsoever to get it all out of my system. It was a very painful experience. Exedrin Migraine is a pain reliever with caffeine in it, and it shouldn't be marketed as a migraine medicine. It might work for a few people, but in some people it just makes them much worse.
If you people think for yourselves instead of listen to television commercials, you will find that any medicine that has so many interactions and warnings can't be good for you. On another note, aspertame or Nutrasweet which is the sugar substitute that all of you people are gulping down in your "diet" pop has caused all kinds of problems in children causing hypertension and brain dysfunction. If it is so bad for children, why are you adults drinking and eating it? It's poison, and none of you are getting thinner. In another ten years, they will have more solid evidence that it is killing people or causing autism or some awful thing, but by then you will all have diabetes or some incurable disease. Stop listening to the marketing techniques designed to make billions for these companies and start listening to your bodies!
I guess I'm screwed......... I quit taking aspirin a long time ago because it makes me bleed a lot. ......and that's not all that much fun.
So I went to Ibuprofen. Then I discovered that around 24 hours after I took an Ibuprofen, my lips and tongue would swell up and I couldn't really breath much. .......that wasn't all that much fun either. Just figuring out what was causing the problem was kind of tricky.
So I went to Acetaminophen. Right now I'm doing Advair and a few other things because of the "emphysema." Now I have to wonder how much of that is due to the Acetaminophen.
Drat. I'm screwed.
I guess I'll just move along to my current health improvement program which is soak in the hot tub lots, and eat pop-tarts. That seems to be working pretty well.
Tylenol has always been a very dangerous drug. When it first came on the market the pharmaceutical industry scared people away from aspirin (a safe & cheap drug for pain & fever), so they could make large profits on Tylenol. Doctors and hospitals bought into the lie. The only reason not to use aspirin is when the risk of bleeding is high, since it is a blood thinner.
I remember when they had the children's chewable tylenol. I would ask for it as a toddler because it tasted so good and I'm sure once or twice I faked feeling bad to get it. I preferred it to actual candy and to this day crave that taste.
The fact is that the relief provided by tylenol is so minor, I would rather put up with the symptoms than get the inevitable asthma attack. It provides so little and often unnoticeable relief, that I cannot really understand its widespread use.
It has recently been shown that acetaminophen acts on the cannabinoid system and therefore I would argue that it is the most useless and dangerous cannabinoid substance known, other than the suicide causing drug (now banned) for weight loss which blocks cannabinoid receptors.
THC, CBD, and other plant-derived cannabinoids have proven much safer in practice than tylenol. They can be more effective in reducing fever, pain, headache, etc. and specifically have been shown to control asthma symptoms. All of this on top of the fact that these substances are not toxic. The US government has even patented them as neuro-protectant in cases of stroke and old age. Maybe it is better to be a little forgetful than suffocating or dead?
finally! maybe my doctor and others will believe me when I say I can't take anything with acetaminophen. Been suffering with asthma for over 32 years and noticed years ago that taking anything with acetaminophen slows my breathing. Have always told my doctor and actually argued with a nurse about it during a hospital stay. I know my body and have come to recognize all triggers for my asthma. This goes with everyone, everyone's body reacts differently to everything and people need to understand their bodies and what they are capable of.
I have issues with science reporting in general, and this article hits
several of them.
As usual, this report equates correlation with causation. Falsely,
obviously. This retrospective study describes frequency of asthma and
frequency of acetaminophen use and finds they are linked. They then go
on to repeatedly describe an increased percentage of risk. Completely
bogus. Frequency describes occurrence of events in a group; risk
describes the probability of an event happening to an individual. But
numeric probability only operates in a random environment, which human
life/health is not.
Buried in the middle of the article, they briefly quote a doc who
points this out, noting that we don't know what else these patients
had in common; the confounding factors.
For example, consider that children are most often given
tylenol/acetominophen because they are sick, most frequently with
contagious respiratory viruses, which cause, among other things,
exacerbation of asthma. So the kids with most colds, therefore most
likely to see their asthma kick up, would get more tylenol.
Then they bring in a 2002 randomized, prospective study showing kids
who got ibuprofen had less asthma than those who got acetaminophen.
Better science, but it still only shows correlation, not causation.
Why? Because there's at least one other probable cause involved, which
they don't mention. Namely, ibuprofen is a powerful anti-inflammatory,
tylenol is not anti-inflammatory at all. So why assume tylenol caused
the asthma, rather than that ibuprofen treated or prevented it?
Mind you, I'm not saying acetaminophen is a benign drug - it really
isn't and should be used with great caution in every age group. I'm
just complaining about the careless and misleading way that research
is reported.
Here we go again. I don't listen to any "Breaking Health News". It is always conflicting, hyped, contradicted a week later and always followed by the comment "further studies are needed". In other words, I need more grant money. Then when it has been disproved, it's on page 15 of the newspapers after the list of yard sales.
Don't take anything unless it is needed, no matter what the media hype says, eat a variety of foods, and be knowledgeable about your own health.
People need to do a little research on how things work and why things happen. To make things short and simple, your body turns certain fats into mediators like prostaglandins and leukotrienes through certain biochemical pathways. Prostaglandins mediate pain in the body, so by decreasing them, we experience pain relief. Acetaminophen stops the enzymes that produce prostaglandins, but that means there is excess precursor, specifically arachidonic acid, to make leukotrienes. These mediate allergic responses, so by increasing them, you can exacerbate asthma. So asthmatics should be careful with acetaminophen. This being said, this is a dose-related effect, so you exacerbate asthma while the meds are in your system, but it is not like to take a healthy kid, give them Tylenol, and then they develop asthma.
As far as Tylenol being causes other health issues, people once again need to understand how things work. Acetaminophen is metabolized to NAPQI, a free radical. Now when people hear free radical, they conjure up terrible ideas, and while it sounds horrible, many things are metabolized in this way. To handle this, the liver uses glutathione to inactive this radial. If you drink alcohol, you reduce this enzyme, allowing the products of Acetaminophen to build up and cause damage. This also happens when a person thinks, "Hmm, if I have a headache and I take 2 Tylenol, then when I have a bad headache, I should take 4, and a really bad headache, I should take 6....." If you follow the rules printed clearly on the packaging, not exceeding the recommended dosage and not taking with or after consumption of alcohol, Tylenol is extremely safe.
In the end, ask a doctor. People think physicians are out to get the public, pushing meds and cashing checks. In reality, they are just using the knowledge they spent years gaining to increase the general well being and health of other people.
I am asthmatic and allergic to aspirins. The only way I can reduce fever is with Tylenol. Aspirin sends me into respiratory arrest. When I take the Tylenol I am fine. This study is suggesting exactly the opposite of what happens to me. Tylenol is my best friend as an asthmatic.
This is a case-control study, known to be one of the least statistically validated types of studies. What it basically says is if your kid never gets sick (and therefore never is given a Tylenol), your kid is less likely to get asthma. This is the same kind of study that had people thinking that vasectomies caused prostate cancer, when the truth was that if you were the kind of socially responsible male to get yourself snipped, you were also the type of male that would go in for screening. Honestly, there is very little here to get worked up about!
Attention Linda Carroll (author of this article)
Plurals are not formed by adding apostrophes.
So what is the answer for pain relief/reducing fevers when you have an asthmatic child who is allergic to ibuprofen and aspirin (salicylic acid)?
My husband has had asthma for about 30 years and has actually lessened in the last few years.The only medicine he can take is Tylenol, he has reactions to ibuprofen and aspirin.
Interesting, considering it's been well documented that NSAIDS like Ibuprofen, Naproxen, and Asprin often make asthma worse. I absolutely cannot take Ibuprofn or Naproxen, but Acetaminophen is ok.
It would seem that all of the above have the potential to aggravate asthma symptoms, but it all depends on the individual.