Acetaminophen May Be Linked to Asthma Risk
Study Shows Painkiller Raises Risk of Asthma; Manufacturer Says Drug Is Safe
In a prepared statement, McNeil Consumer Healthcare, which makes Tylenol,
"TYLENOL® (acetaminophen) has over 50 years of clinical history to support
its safety and efficacy and, when used as labeled, TYLENOL® has a superior
safety profile compared with many other over-the-counter (OTC) pain
relievers. The well-documented safety profile for acetaminophen makes it
the preferred pain reliever for asthma sufferers."
The statement continues: "There are no prospective, randomized controlled
studies that show a causal link between acetaminophen and asthma. The
systematic review and meta-analysis published in Chest does not
establish a definitive casual relationship between the therapeutic use of
acetaminophen and an increased risk of asthma and wheezing in both children and
adults. In fact, the study investigators admit that their systematic review is
subject to several limitations, one of which is that diagnosis of asthma in
most of the studies was through self-reporting and the possibility of
misclassification of asthma with other respiratory conditions can't be
excluded. The authors also stated that additional studies would be needed in
order to verify their findings.''
Another expert said the review is strong. "This is clearly synthesizing the
studies that have been conducted over the past 10 years and is showing the
emerging evidence that acetaminophen seems to be associated with the
development of asthma and asthma-like symptoms in children and adults," says
Matt Perzanowski, PhD, assistant professor of environmental health sciences at
the Mailman School of Public Health at Columbia University in New York.
With his colleagues at Columbia, Perzanowski recently found that prenatal
acetaminophen exposure boosts the risk of wheezing in inner city, minority
children (who have high rates of asthma) at age 5.
They believe that children with a genetic mutation affecting an antioxidant
that helps ''detox'' the body may be the ones at risk, Perzanowski tells
A practicing allergist, Rebecca G. Piltch, MD, who cares for patients with
asthma and allergies in Marin County, Calif., says the association is
interesting but points out it does not prove cause and effect.
Perzanowski agrees, saying: "There is still a possibility the association is
due to some other mechanism besides the acetaminophen."
Until more research is done, what's a parent or adult to do? "The American
Academy of Pediatrics recommends acetaminophen as the drug of choice for
controlling fever," Etminan says. "Parents should still follow these guidelines
until the recommendations change."
"For adults, ibuprofen is an alternative drug that can be used," he says.
"Unlike acetaminophen, ibuprofen has not been shown to be associated with
Following the recommended dose is important, he says. The question of
whether a specific dose is linked with the risk of asthma needs to be studied,
Patients already diagnosed with asthma should check with their own doctor
about acetaminophen use, Piltch says. Those who don't have asthma ''but have
concerns about acetaminophen should discuss them with their primary care