Paracetamol...... please be aware!!

[stevesdonna]

Maybe it is just me (8 years dispenser) and my 7 years qualified pharmacist who did not know that paracetamol can cause: wheezing, tightness of chest and bring on astma attacks!!
If anyone else has come across this please post.

Cheers

[Sir_Dispensalot]

Well i suppose being a (very) distant chemical cousin of the NSAIDs someone could have a cross-reaction and have an NSAID-like attack. But they'd already have to have asthma, and it would be an even more rare reaction than the one we see with nsaids. I might consider a caution if the child has asthma already diagnosed and never had paracetamol before (although most children have had some by the time they're 6 months old)

[stevesdonna]

Thanks for replying. I honestly, have never come across this before. Customer asked for Sainsburys own brand but not the ones we sell on the pharmacy, they had to be the ones from the shop floor. When I questioned this he showed me the additives (one being nipasept) which causes his wife problems with her asthma. I was gobsmacked and very humbled as I tried desperately to convince him they were exactly the same. I have thought about emailing Wockhart Pharmaceuticals to ask why they produce two types of paracetamol. One with lots of additives and one without. Or if they just don't list them on the old packaging. I'm still reeling... somewhat, but thanks for a bit of insight. I will do a bit more investigation.

[Koul Kougar]

I don't think it's the paracetamol that causes that reaction, more the additives, like you said. The main culprit is sodium metabisulfite, which can produce asthma-like symptoms in people sensitive to sulphur.

[Nik]

The "link" between paracetamol use and asthma has been around for a while, and there is no evidence of causality, just an association. The fact that so many children and infants have used paracetamol at some point itself complicates things. Could it just be that asthma patients tend to use more paracetamol than otherwise healthy children ? The problem is that the media tend to describe the reports in vague ways, i.e "doubles the risk" or "increases risk by 50%". These sound scary to the general public but it could just be that the risk increases from say 0.001% to 0.002% or whatever. That's where we come in, and use the grey stuff between our ears to critically appraise such research, and not rely on what the newspapers or online news sites say as the basis for what we recommend in professional practice.