From the Guidelines
Reye's syndrome is primarily linked to the use of aspirin (acetylsalicylic acid) in children and teenagers who have viral illnesses, particularly influenza (flu) and chickenpox, as stated in the most recent and highest quality study 1. This rare but serious condition causes swelling in the liver and brain, and can lead to seizures, coma, and in some cases, death. The connection between aspirin and Reye's syndrome was discovered in the 1980s, leading to warnings against giving aspirin to children under 19 years of age during viral illnesses. Some key points to consider include:
- The exact mechanism isn't fully understood, but it's believed that aspirin affects mitochondrial function and energy metabolism in the liver during viral infections, leading to the accumulation of fatty deposits and causing liver dysfunction.
- Due to this established link, parents and healthcare providers should use alternative fever reducers and pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for children with fevers or viral symptoms.
- Always check medication labels for aspirin or salicylates, as they may be present in over-the-counter medications that aren't obviously labeled as aspirin products, as recommended by 1. The use of aspirin in children with viral illnesses should be avoided, and alternative treatments should be used instead, as supported by 1 and 1. Some important considerations for healthcare providers include:
- Children who are taking salicylates long-term should receive an annual influenza vaccine, as stated in 1.
- Although vaccine manufacturers recommend that salicylates be avoided for 6 weeks after the administration of varicella vaccine, physicians need to weigh the theoretical risks associated with varicella vaccine against the known risks of wild-type varicella in children receiving long-term salicylate therapy, as noted in 1 and 1.
From the FDA Drug Label
Children and teenagers who have or are recovering from chicken pox or flu-like symptoms should not use this product, if changes in behavior with nausea and vomiting occur, consult a doctor because these symptoms could be an early sign of Reyes syndrome, a rare but serious illness The use of aspirin is linked to Reye's syndrome, particularly in children and teenagers who have or are recovering from chicken pox or flu-like symptoms 2.
- Key factors that increase the risk of Reye's syndrome include:
- Using aspirin during or after a viral infection
- Exhibiting symptoms such as changes in behavior, nausea, and vomiting It is essential to consult a doctor if these symptoms occur, as they could be an early sign of Reye's syndrome.
From the Research
Reye's Syndrome Linked to Aspirin
- Reye's syndrome is a serious, acute encephalopathy that has been linked with aspirin use in children and teenagers under 18 years of age 3.
- Studies strongly support a link between the use of aspirin and Reye's syndrome, with reported cases on the decline 4, 5.
- The evidence suggests that aspirin acts as a co-factor in susceptible individuals, and that no dose of aspirin can be considered safe in the presence of a viral infection 3.
- Epidemiologic studies have shown a dose-response relation between risk of Reye's syndrome and dose of aspirin ingested during the antecedent illness, providing further supportive evidence for a causal link between Reye's syndrome and aspirin 5.
- However, some studies suggest that the relationship between aspirin and Reye's syndrome is not fully understood, and that the evidence for a causal link is not conclusive 6, 7.
- The incidence of Reye's syndrome has declined significantly since government health warnings were appended to aspirin-containing formulations, and the use of aspirin in children has decreased 3, 5.