Contrary to earlier reports, giving acetaminophen (Tylenol, etc.) for pain and fever does not worsen asthma in children, according to a multicenter, randomized, prospective trial conducted by Boston Children’s Hospital.
The study enrolled 300 children 1 to 5 years old with mild, persistent asthma. Their families were randomized to use either acetaminophen or ibuprofen as indicated for pain and fever over 48-weeks.
Both groups received the same asthma-control therapies, and medication adherence was closely monitored. The amounts of acetaminophen and ibuprofen used for pain or fever were similar between groups (median 5.5 doses). Of the original 300 children, 226 (75 percent) completed the study.
During the 48 weeks, there were no statistically significant differences between groups, and researchers concluded that acetaminophen does not aggravate asthma in young children on controller therapy for mild asthma.
The researchers note that earlier studies linking acetaminophen with increased asthma symptoms did not use a randomized design. Those studies therefore couldn’t rule out the possibility that the asthma exacerbations were caused by the respiratory infections themselves.
“The toddler age is a wheezy age when kids are developing asthma, but they also get a lot of fevers and colds,” says Phipatanakul. “Without a randomized design, it’s hard to tease out the effects of medications.”
Since the study was limited to young children with mild persistent asthma receiving asthma controller therapy, the authors also note that their findings may not apply to other age groups or children with more severe asthma. Further studies will be necessary to answer those questions.