What are the maximum recommended daily doses and minimum hepatotoxic dose of N-acetyl-p-aminophenol (APAP) in acetaminophen toxicity/poisoning?

Updated: Jan 17, 2020
  • Author: Susan E Farrell, MD; Chief Editor: Michael A Miller, MD  more...
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Answer

Currently, the maximum recommended daily dose of APAP is 75 mg/kg for children and 4 g for adults. The minimum hepatotoxic dose of APAP as a single acute ingestion is 150 mg/kg for a child and 7.5-10 g for an adult.

The ingested amount of APAP at which toxicity may occur may be less in the setting of chronic ethanol use, compromised nutritional states, fasting, or viral illness with dehydration. Co-ingestions of substances or medications known to induce the activity of the APAP-metabolizing cytochrome P (CYP) oxidative enzymes also increase the risk of hepatotoxicity; however, when proper dosing recommendations are followed, the risk of hepatotoxicity is extremely small.


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