Published: February 2009

An association between paracetamol and asthma

Prescriber Update 30(1): 1
February 2009

A recent paper published in The Lancet has highlighted the growing body of evidence of an association between paracetamol use and the development of asthma. The paper finds an increased risk of asthma symptoms in children aged 6 - 7 years who used paracetamol in their first year of life or in the year preceding the study.1

A number of studies have found that the strength of the association increases with increased frequency of paracetamol use and is found following exposure in-utero, in children, and in adults.2,3 The association remains significant after controlling for many of the known risk factors for asthma; however no studies have been able to demonstrate a causal association.

Although there is growing evidence of an association between paracetamol use and developing asthma, there is no analgesic or antipyretic which could currently be considered a safer alternative.

Considering the finding that the association is strongest with highest frequency of use of paracetamol, any clinical intervention should be aimed at reducing excessive use of paracetamol.

  1. Beasley R, Clayton T, Crane J, Von Mutius E, Lai CKW, Montefort S, StewartA, 2008, 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 The Lancet 372:1039-48.
  2. McKeever TM, Lewis SA, Smit HA, Burney P, Britton JR, Cassano PA, 2005, The Association of Acetaminophen, aspirin and ibuprofen with respiratory disease and lung function American Journal of Respiratory and Critical Care Medicine 171:966-71.
  3. Shaheen SO, Newson RB, Henderson AJ, Headley JE, Stratton FD, Jones RW, Strachan DP and ALSPAC Study Team, 2005, Prenatal paracetamol exposure and risk of asthma and elevated immunoglobulin E in childhood Clinical and Experimental Allergy 35:18-25.