Doctor warns acetaminophen may worsen asthma

Posted Nov. 14, 2011, at 4:04 p.m.

AKRON, Ohio — An Ohio doctor is warning that a popular over-the-counter painkiller and fever reducer could cause more harm than good for kids with asthma and those at risk for developing the disease.

Dr. John T. McBride is getting national attention for his online article from the December edition of the journal Pediatrics advising against giving most young asthma patients acetaminophen, the active ingredient in Tylenol.

Most people haven’t heard about the possible risk.

But for years, medical studies have shown an association between the use of acetaminophen and the development of asthma or worsening symptoms for children and adults said McBride, the director of the Robert T. Stone M.D. Respiratory Center at Akron Children’s Hospital.

Although there hasn’t yet been a definitive study published to prove a causal link, McBride said it would be wrong for doctors not to warn patients about the potential danger.

“We’re recommending that our asthmatic patients not take acetaminophen if they can avoid it,” he said. “I don’t want to be in a position of telling my patients when a study comes up, ‘Well, I thought it might be a problem but I decided not to mention it to you until there’s a definitive study.’”

Johnson & Johnson, the maker of Tylenol, defended the product, saying there is more than 50 years of clinical history to support the contention that acetaminophen is safer than many other over-the-counter pain relievers when used as directed.

“While we are aware of the article published in the December issue of Pediatrics, there are no prospective, randomized controlled studies that show a causal link between acetaminophen, the active ingredient in Tylenol, and asthma,” the company said in a prepared statement. “Consumers who have medical concerns or questions about acetaminophen should contact their health-care provider.”

Starting in the 1980s, doctors were urging parents of children to avoid using aspirin to treat fevers because of the risk of developing Reye syndrome, which can be life-threatening, McBride said.

“Very abruptly, it was recommended children not take aspirin for fever,” he said. “Most children started taking acetaminophen.”

McBride said studies dating back more than two decades began to show ties between the skyrocketing asthma rates and the use of acetaminophen.

According to the U.S. Centers for Disease Control and Prevention, the number of Americans with self-reported asthma leaped from about 7 million in 1980 to 14.8 million by 1995.

Researchers were trying to figure out why asthma rates suddenly began climbing at an alarming rate in 1980 through the mid-1990s.

A study published in 2008 in the British medical journal Lancet found 6- to 7-year-olds were 1.6 times more likely to develop asthma if they took acetaminophen more than once per year but less than once per month, according to McBride’s review. For those who took the medication at least once a month, the risk was triple.

“The more somebody takes acetaminophen, the more likely they are to have asthma,” McBride said.

Another study children looked at children with asthma who were given either acetaminophen or ibuprofen while battling a viral respiratory infection. Researchers found those who took acetaminophen were twice as likely to have a problem with asthma symptoms.

In his article, McBride cited several other studies with similar findings.

“I had followed this issue over time, but was skeptical,” McBride said. “And then earlier in the year I looked back and read all the papers. I was stunned that the evidence is so compelling and yet nobody has seemed to feel a responsibility to tell parents that there is a possibility that acetaminophen is bad for asthmatics.”

Rachael Seifert has banned all over-the-counter medications containing acetaminophen from her Mentor, Ohio, home since McBride started sharing his concerns about the potential link between the drug and worsening asthma symptoms during her children’s appointments.

Seifert’s four children and her husband have asthma.

“We felt better to be safe and just keep it out of the house,” she said.

Seifert said she’s glad McBride has been speaking out about the possible risk.

“We’re educated, but when we read, we’re not reading medical journals,” she said. “I’m very grateful that he’s shared that with us.”

Acetaminophen has been shown to lower the levels of a compound the body makes to repair the irritation caused by oxygen, McBride said.

“Asthma just means your lungs are kind of sensitive,” he said. “However sensitive your lungs are, my feeling is that acetaminophen increases the amount of trouble you have.”

Although McBride’s focus is on children because he is a pediatric lung expert, he said the potential risk is the same for adults with asthma.

“It seemed to be there’s so much evidence now that the burden of proof is to prove that acetaminophen is safe, not that it’s dangerous,” he said.

 

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