Asthma Risk and Acetaminophen: Mounting Evidence

Hi,

Thank you for your questions. I suspect a few other readers of this posting share your concerns. I cannot advise particular medications for you to give your child through this medium. My posting should not, at this point lead to any major change in the approach to managing fever in children or adults. There is not enough information supporting the acetaminophen (Tylenol) connection with asthma to advise avoidance at this point.

That said, health experts recommend not giving aspirin to children (those under age 18) for treatment of fever, viral syndromes and upper respiratory tract infections because of the risk of Reye's syndrome. Here is a link to a very good review on Reye's syndrome.

Furthermore, a small percentage of children and adults with asthma may have severe wheezing and shortness of breath (asthma attack) after being given ibuprofen (Motrin, Advil and many other brands) other related pain killers or aspirin. About 6-8% of asthma patients have this hypersensitivity.

Most reports have not associated ibuprofen and related drugs with Reye's syndrome. A few reports warn that the risk of this serious disease may be increased by ibuprofen because of its similarity to aspirin (similar mechanism of action). Again, this is why Tylenol became so popular over the last three decades.

So, what do you do?

Avoid giving your child aspirin unless advised by your doctor. Ask your family doctor or pediatrician whether acetaminophen or a brand of ibuprofen is preferred for treating fever or mild pain relief.

Best of Luck!

J. Thompson, MD