Use of acetaminophen and increasing risk of asthma have been reported in the epidemiological studies. Despite lack of controlled prospective clinical trials evaluating these associations in children, avoidance of acetaminophen in children with asthma has become controversial. This review presents data from observational studies and a recent prospective clinical trial investigating the association with use of acetaminophen in children with mild asthma and on asthma control.
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References
1.
VernacchioL, KellyJP, KaufmanDW, MitchellAA. Medication use among children <12 years of age in the United States: results from the Slone Survey. Pediatrics, 2009; 124:446–454.
Ofirmev™ information. Cadance Pharmaceuticals, Inc., November2010. Available at www.ofirmev.com (accessed March23, 2017).
4.
Acetaminophen. Drug facts and comparisons 4.0. Efacts [online]. 2017. Wolters Kluwer Health, Inc. Available at http://online.factsandcomparisons.com (accessed March23, 2017).
5.
AndersonBJ. Paracetamol (acetaminophen): mechanisms of action. Pediatr Anesth, 2008; 18:915–921.
6.
DimovaS, HoetPH, DinsdaleD, NemeryB. Acetaminophen decreases intracellular glutathione levels and modulates cytokine production in human alveolar macrophages and type II pneumocytes in vitro. Int J Biochem Cell Biol, 2005; 37:1727–1737.
7.
KozerE, EvansS, BarrJ, et al.Glutathione, glutathione-dependent enzymes and antioxidant status in erythrocytes from children treated with high-dose paracetamol. Br J Clin Pharmacol, 2003; 55:234–240.
8.
ShaheenSO, NewsonRB, SherriffA, et al.Paracetamol use in pregnancy and wheezing in early childhood. Thorax, 2002; 57:958–963.
9.
ShaheenSO, NewsonRB, HendersonAJ, et al.Prenatal paracetamol exposure and risk of asthma and elevated immunoglobulin E in childhood. Clin Exp Allergy, 2005; 35:18–25.
10.
RebordosaC, KogevinasM, SørensenHT, OlsenJ. Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: a birth cohort study. Int J Epidemiol, 2008; 37:583–590.
11.
PerzanowskiMS, MillerRL, TangD, et al.Prenatal acetaminophen exposure and risk of wheeze at age 5 years in an urban low-income cohort. Thorax, 2010; 65:118–123.
12.
Garcia-MarcosL, Sanchez-SolisM, Perez-FernandezV, et al.Is the effect of prenatal paracetamol exposure on wheezing in preschool children modified by asthma in the mother?. Int Arch Allergy Immunol, 2009; 149:33–37.
13.
BeasleyR, ClaytonT, CraneJ, et al.Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6–7 years: analysis from Phase Three of the ISAAC programme. Lancet, 2008; 372:1039–1048.
14.
WickensK, BeasleyR, TownI, et al.The effects of early and late paracetamol exposure on asthma and atopy: a birth cohort. Clin Exp Allergy, 2011; 41:399–406.
15.
DaveyG, BerhaneY, DuncanP, et al.Use of acetaminophen and the risk of self-reported allergic symptoms and skin sensitization in Butajira, Ethiopia. J Allergy Clin Immunol, 2005; 116:863–868.
16.
LeskoSM, LouikC, VezinaRM, MitchellAA. Asthma morbidity after the short-term use of ibuprofen in children. Pediatrics, 2002; 109:E20.
17.
MatokI, ElizurA, PerlmanA, GanorS, et al.Association of acetaminophen and ibuprofen use with wheezing in children with acute febrile illness. Ann Pharmacother, 2017; 51:239–244.
18.
SofermanR, TsivionA, FarberM, SivanY. The effect of a single dose of acetaminophen on airways response in children with asthma. Clin Pediatr (Phila), 2013; 52:42–48.
19.
IoannidesSJ1, WilliamsM, JefferiesS, et al.Randomized placebo-controlled study of the effect of paracetamol on asthma severity in adults. BMJ Open, 2014; 4:e004324.
20.
SheehanWJ, MaugerDT, PaulIM, et al.NIH/NHLBI AsthmaNet. Acetaminophen versus ibuprofen in young children with mild persistent asthma. N Engl J Med, 2016; 375:619–630.
21.
FitzpatrickAM, JacksonDJ, MaugerDT, et al; National Institutes of Health/National Heart, Lung, and Blood Institute AsthmaNet. Individualized therapy for persistent asthma in young children. J Allergy Clin Immunol, 2016; 138:1608–1618.
22.
National Asthma Education and Prevention Program. Expert Panel Report III: guidelines for the diagnosis and management of asthma. Bethesda, MD: US Department of Health and Human Services, 2007.