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Can acetaminophen cause asthma in children?

Circumstantial evidence suggests a possible connection between the use of acetaminophen and the increasing rate of childhood asthma over the past three decades. Research on the biochemistry of acetaminophen suggests that the drug could contribute to or exacerbate asthma symptoms in some individuals. It can, for example, decrease an antioxidant known as glutathione, and glutathione deficiency can predispose some people to more inflammation of the airways. And studies done more than a decade ago by British researchers indicated that children with asthma were more likely than non-asthmatic children to have used acetaminophen. Other studies since then have reached similar conclusions.

However, experts caution that there’s not enough proof of a link to advise that parents should stop giving the drug to their infants and children. “These have been observational studies in which the conditions are not controlled,” notes UCLA pediatric pulmonologist Sande Okelo, M.D. “You can establish an association, but it might be that people with asthma are simply using acetaminophen more because they have more colds and fevers.”

More rigorous studies are necessary to determine whether there is a direct link between acetaminophen use and greater asthma risk, Dr. Okelo says. Other important questions need to be answered as well. For example, if there is a link, how much acetaminophen is necessary to produce the effect? The previous studies suggested that the association between acetaminophen and asthma was most significant in high-frequency users of acetaminophen; it could be, Dr. Okelo notes, that low-frequency users would not be affected.

Childhood asthma rates have been on the rise since the 1980s. The increase began about the time parents began switching from aspirin to acetaminophen for their children to lower fevers.

“The link between aspirin and Reye’s syndrome in children caused a rethinking that led pediatricians in the 1980s to recommend acetaminophen as the first-line drug for fevers,” says Eric Curcio, M.D., a pediatrician at Mattel Children’s Hospital UCLA. While asthma rates started to go up, “it is important to note that many other things were happening at that time, so we can’t say for sure, based on that evidence alone, that that’s the cause.”

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.