Paracetamol: Debate on paracetamol-asthma link

UK. The Commission on Human Medicines has said that there is no strong evidence that paracetamol use in infancy can cause asthma. This follows a review of a study published in the Lancet that explored the link between paracetamol use in infancy and the risk of asthma, rhinoconjunctivitis, and eczema in children aged six/seven years. The results suggested an associationbetween asthma and paracetamol.

The Commission had a number of concerns over the study’s conclusion. One concern was  the possibility that use of paracetamol in infancy reflected treatment of a true underlying cause of asthma such as a viral illness, which necessitated the administration of an antipyretic. Another was the fact that paracetamol was the only available analgesic in many regions of the world so that the study comparison is between use of analgesics in infancy or not, rather than between the use of paracetamol or not. The commission also said that the study did not consider the effect of parental choice of analgesic, which may be based on the parents’ own asthmatic status and their consequent avoidance of a non-steroidal anti-inflammatory drug.

The Commission on Human Medicines is a committee of the UK’s MHRA and the review was carried out by its Pharmacovigilance Expert Advisory Group.

Reference: Drug Safety Update 2(4):9, November 2008 (www.mhra.gov.uk).

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