Paracetamol overdose advice updated

The CHM has simplified instructions for the use of intravenous acetylcysteine in the treatment of acute paracetamol overdose.

Paracetamol overdose can result in liver damage and death. | SCIENCE PHOTO LIBRARY
Paracetamol overdose can result in liver damage and death. | SCIENCE PHOTO LIBRARY

Intravenous acetylcysteine is now licensed to treat paracetamol overdose in the following circumstances:

  • irrespective of plasma paracetamol level where the overdose is staggered (that is, taken over one hour or more) or there is doubt over the time of paracetamol ingestion
  • where the timed plasma paracetamol concentration is on or above a single treatment line joining points of 100mg/L at 4 hours and 15mg/L at 15 hours on a revised overdose treatment nomogram, regardless of risk factors for hepatotoxicity.

The CHM has also made a number of other recommendations intended to reduce the risks to patients, including:

  • an increase in the duration of administration of the first dose of intravenous acetylcysteine from 15 minutes to 1 hour
  • the removal of hypersensitivity as a contraindication to treatment with acetylcysteine
  • the provision of weight-based dosing tables for adults and children, removing the need to calculate the dose
  • the inclusion of a Technical Information Leaflet for healthcare professionals in every pack of acetylcysteine, providing more detailed instructions on the preparation of acetylcysteine infusions.

View acetylcysteine drug record

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