Pediatricians often recommend against giving acetaminophen (sold under the brand name Tylenol) to children with asthma because some studies have suggested it can worsen symptoms.
But new research that compares acetaminophen to ibuprofen (sold as Advil and Motrin) finds no difference in the severity of asthma symptoms between the two medications.
“Parents tend to give acetaminophen to children who have fevers or other symptoms related to viral infections, and those viral infections are known to be common triggers of asthma episodes,” says coauthor Leonard B. Bacharier, a pediatric asthma specialist at Washington University School of Medicine in St. Louis.
“So from past studies, we couldn’t tell if it was the acetaminophen or the virus that was causing the increased likelihood of the asthma episodes.”
In the current study, published in the New England Journal of Medicine, children from ages 1 to 5 with asthma were randomly assigned to receive either acetaminophen or ibuprofen for pain relief or fever reduction as needed. Participants, caregivers, and treating physicians did not know which drug each child received since the two liquid medications were made to look and taste identical with identical dose volumes.
All children in the study had a diagnosis of mild, persistent asthma, meaning they require daily medications to control their asthma and experience symptoms at least twice per week but not daily.
The researchers found no difference in the number of exacerbations of asthma symptoms between the two groups, no difference in the need for rescue therapy, such as the use of rescue inhalers, and no difference in the number of days the children experienced good control of their asthma symptoms. There also was no difference in the number of unscheduled medical visits between groups.
While, the results of this study can’t be extrapolated to children with severe asthma, Bacharier says the new data indicate that parents and caregivers can safely give either acetaminophen or ibuprofen to young children with mild asthma without being concerned that the medications will exacerbate asthma symptoms.
The National Institutes of Health funded the work. The clinical trials network involved in the study, called AsthmaNet, is supported by a cooperative agreement with with the National Heart, Lung, and Blood Institute.