Should high‐dose N‐acetylcysteine be given in cases of massive paracetamol overdoses: A narrative review

• Published in: Basic & clinical pharmacology & toxicology Vol. 135; no. 3; pp. 285 - 294
• Main Authors: Erichsen, Philip Ahle, Dalhoff, Kim, Andersen, Michael Asger
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.09.2024
• Subjects: acetaminophen; Acetaminophen - administration & dosage; Acetaminophen - poisoning; Acetylcysteine; Acetylcysteine - administration & dosage; Acetylcysteine - therapeutic use; Analgesics; Analgesics, Non-Narcotic - administration & dosage; Analgesics, Non-Narcotic - poisoning; Antidotes - administration & dosage; Antidotes - therapeutic use; Chemical and Drug Induced Liver Injury - etiology; Chemical and Drug Induced Liver Injury - prevention & control; Dose-Response Relationship, Drug; Drug Overdose - drug therapy; Hepatotoxicity; Humans; Narratives; N‐acetylcysteine; Observational studies; Observational Studies as Topic; Overdose; Paracetamol; Patients; poisoning; Risk analysis; Risk reduction; acetaminophen; paracetamol; poisoning; N‐acetylcysteine

N‐acetylcysteine (NAC) is regarded as an effective treatment of paracetamol overdoses. However, in cases of “massive” paracetamol overdoses, recent studies indicate that patients may not be sufficiently treated with the standard dose of NAC (300 mg/kg over 20–21 h). The subject is further complicate...