Acetaminophen Not Associated with Worse Asthma in Kids

​Children with mild, persistent asthma did not have worse asthma symptoms after taking acetaminophen (e.g., Tylenol) for pain or fever, compared to using ibuprofen (e.g., Advil), according to the results of a randomized, double-blind clinical trial recently published in the New England Journal of Medicine.
Previous observational reports have linked the use of acetaminophen with asthma exacerbations, however well-designed clinical trials evaluating the association were lacking. Some physicians have recommended that children with asthma completely avoid taking acetaminophen until data on safety become available.

“Our study is the first to provide rigorous evidence that acetaminophen is as safe as ibuprofen for children with asthma,” said Rachel Robison, MD, study co-author and allergist at Ann & Robert H. Lurie Children’s Hospital of Chicago, as well as Assistant Professor of Allergy/Immunology at Northwestern University Feinberg School of Medicine. “This should be reassuring for parents and physicians.”

The 48-week study, funded by the National Heart, Lung, and Blood Institute, was conducted at 18 sites in the United States. It included 300 children, 1 to 5 years old, who had asthma symptoms on more than two days per week, but not daily, and required treatment every day to manage their disease. During the study, caregivers gave children either acetaminophen or ibuprofen as needed. None of the study investigators, caregivers, or children knew which study drug each child was receiving.

“We measured asthma exacerbation rate, the number of days of asthma control, the need for rescue medications and unscheduled medical visits for asthma,” said Jacqueline Pongracic, MD, study co-author, Head of Allergy and Immunology Division at Lurie Children’s and Professor of Pediatrics and Medicine at Northwestern University Feinberg School of Medicine. “We did not find a higher risk of asthma worsening in children taking acetaminophen compared to ibuprofen, even during periods of respiratory illness.”

More research is needed in older children with asthma and those with more severe disease.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge.

Lurie Children’s is ranked as one of the nation’s top children’s hospitals in the U.S.News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 174,000 children from 50 states and 48 countries.

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