Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

A Reminder About The Dangers of Aspirin and Reyes's Syndrome

Worst Pills, Best Pills Newsletter article October, 2003

The flu season is approaching and with it the risk of Reye's syndrome when aspirin is used to treat the symptoms of an influenza infection.

Reye's syndrome is primarily a children's disease, although it can occur at any age, some cases occur up to age 40.  It affects all organs of the body but is most harmful to the brain and the liver B causing an acute increase of pressure within the brain and, often, massive accumulations of fat in the liver and other organs.  Reye's syndrome...

The flu season is approaching and with it the risk of Reye's syndrome when aspirin is used to treat the symptoms of an influenza infection.

Reye's syndrome is primarily a children's disease, although it can occur at any age, some cases occur up to age 40.  It affects all organs of the body but is most harmful to the brain and the liver B causing an acute increase of pressure within the brain and, often, massive accumulations of fat in the liver and other organs.  Reye's syndrome generally occurs in people who have used aspirin in conjunction with a previous viral infection, such as the flu or chicken pox. The disorder commonly occurs during recovery from a viral infection, although it can also develop three to five days after the onset of the viral illness.

The symptoms of Reye's syndrome include persistent or recurrent vomiting, listlessness, personality changes such as irritability or combativeness, disorientation or confusion, delirium, convulsions, and loss of consciousness. If these symptoms are present during or soon after a viral illness, medical attention should be sought immediately. The symptoms of Reye's syndrome in infants do not follow a typical pattern; for example, vomiting does not always occur. The cause of Reye's syndrome remains a mystery. However, studies have shown that using aspirin or salicylate-containing medications to treat viral illnesses greatly increases the risk of developing Reye's syndrome.  A physician should be consulted before giving a child any aspirin or anti-nausea medicines during a viral illness.

The Spanish Medicines Agency announced that, effective June 20, 2003 all over the counter OTC drug products containing aspirin for use exclusively in children have been withdrawn from the market due to the risk of Reye's syndrome in children with viral illnesses.  In addition, the product information for all other OTC aspirin contain products is to be updated to include a contraindication for use in patients less than 16 years of age.  Prescription products will be contraindicated in patients less than 16 years of age when used for the treatment of fever, chickenpox and viral illnesses.

Here in the United States, aspirin products contain the following warning:

Warnings: Reye's syndrome: Children and teenagers should not use this medicine for chicken pox or flu symptoms before a doctor is consulted about Reye's syndrome, a rare but serious illness reported to be associated with aspirin.

The Health Research Group pushed a recalcitrant Department of Health and Human Services and Office of Management and Budget to require a warning label on all bottles of aspirin, which they did in 1986. Now the number of Reye's syndrome cases is but a fraction of the hundreds of cases a year occurring in the U.S.

What You Can Do

People under 40 who have flu, chickenpox, or flu-like illness and need a drug simply to relieve pain or reduce fever should use acetaminophen (TYLENOL) rather than aspirin.