Treatment of paracetamol overdose

Initially 140 mg/kg and then 70 mg/kg/24h for 72 hours (17 in total doses).

Acetylcysteine should be administered by intravenous infusion preferably using Glucose 5% as the infusion fluid. Sodium Chloride 0.9% solution may be used if Glucose 5% is not suitable.

Adults

The full course of treatment with acetylcysteine comprises 3 consecutive intravenous infusions:

• First infusion: Initial loading dose of 150 mg/kg body weight infused in 200 mL over 1 hour.
• Second infusion: 50 mg/kg in 500 mL over the next 4 hours.
• Third infusion: 100 mg/kg in 1 litre over the next 16 hours.

The patient should therefore receive a total of 300 mg/kg over a 21 hour period.

A ceiling weight of 110 kg should be used when calculating the dosage for obese patients.

Dosage should be calculated using the patient’s actual weight.

Children

Children should be treated with the same doses and regimen as adults; however, the quantity of intravenous fluid used should be modified to take into account age and weight, as fluid overload is a potential danger.

N-acetylcysteine should be administered by intravenous infusion preferably using Glucose 5% as the infusion fluid. Sodium Chloride 0.9% solution may be used if Glucose 5% is not suitable.

Doses should be administered using an appropriate infusion pump.

The full course of treatment with N-acetylcysteine comprises 3 consecutive intravenous infusions:

• First infusion: Initial loading dose of 150 mg/kg infused over 1 hour (150 mg/kg/h). Given as a 50 mg/mL solution at a rate of 3 mL/kg/h.
• Second Infusion: Dose: 50 mg/kg infused over 4 hours (12.5 mg/kg/h). Given as a 6.25 mg/mL solution at a rate of 2 mL/kg/h.
• Third Infusion: Dose: 100 mg/kg infused over 16 hours (6.25 mg/kg/h). Given as a 6.25 mg/mL solution at a rate of 1 mL/kg/h.

Acetylcysteine should be administered by intravenous infusion preferably using Glucose 5% as the infusion fluid. Sodium Chloride 0.9% solution may be used if Glucose 5% is not suitable.