Treating paracetamol overdose with intravenous acetylcysteine: new guidance

What this platform has drawn from it — 5 claims

• Intravenous acetylcysteine is the antidote for paracetamol overdose and is virtually 100% effective in preventing liver damage when given within 8 hours of the overdose, with efficacy falling substantially after that time. Review findings, opening paragraph
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• Following a Commission on Human Medicines review, UK guidance advises that all patients with a timed plasma paracetamol level on or above a single treatment line joining 100 mg/L at 4 hours and 15 mg/L at 15 hours after ingestion should receive acetylcysteine. Advice for healthcare professionals, first bullet
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• The single treatment line replaced an earlier two-line nomogram, because the Commission on Human Medicines found the evidence base for assessing hepatotoxicity risk factors poor and inconsistent, and the risk factors themselves imprecise and difficult to determine reliably in practice. Review findings, second paragraph
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• UK guidance advises extending the initial acetylcysteine infusion from 15 minutes to 60 minutes, because most common dose-related adverse reactions occur within the first hour of the initial infusion. Review findings, fourth paragraph
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• There are no specific contraindications to acetylcysteine in the treatment of paracetamol overdose, including known hypersensitivity to the product's ingredients, and patients with a history of a previous reaction should still receive treatment. Review findings, fifth paragraph
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