Acetaminophen and the risk of asthma: the epidemiologic and pathophysiologic evidence

Chest. 2005 Feb;127(2):604-12. doi: 10.1378/chest.127.2.604.


The prevalence of asthma has increased worldwide. The reasons for this rise remain unclear. Various studies have reported an association between acetaminophen, a widely used analgesic, and diagnosed asthma. In a prospective cohort study, the rate of newly diagnosed asthma was 63% higher among frequent acetaminophen users than nonusers in multivariate analyses. Studies of patients with asthma suggest that acetaminophen challenge can precipitate a decline in FEV(1) > 15% among sensitive individuals. Plausible mechanisms to explain this association include depletion of pulmonary glutathione and oxidative stress. This article reviews the existing literature and evaluates the epidemiologic and pathophysiologic evidence underlying a possible link between acetaminophen and asthma.

Publication types

  • Review

MeSH terms

  • Acetaminophen / adverse effects*
  • Acetaminophen / therapeutic use
  • Analgesics, Non-Narcotic / adverse effects
  • Analgesics, Non-Narcotic / therapeutic use
  • Asthma / chemically induced*
  • Asthma / epidemiology
  • Asthma / physiopathology
  • Cohort Studies
  • Cross-Sectional Studies
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology
  • Glutathione / metabolism
  • Humans
  • Immunoglobulin E / blood
  • Lung / drug effects
  • Lung / physiopathology
  • Oxidative Stress / physiology
  • Prospective Studies
  • Prostaglandin-Endoperoxide Synthases / physiology
  • Risk


  • Analgesics, Non-Narcotic
  • Acetaminophen
  • Immunoglobulin E
  • Prostaglandin-Endoperoxide Synthases
  • Glutathione