When is N -acetylcysteine (NAC) administered for the treatment of acetaminophen toxicity/poisoning?

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

NAC is maximally hepatoprotective when administered within 8 hours of an acute acetaminophen ingestion. When indicated, however, NAC should be administered, regardless of the time since the overdose. Therapy with NAC has been shown to decrease mortality rates in late-presenting patients with fulminant hepatic failure, even in the absence of measurable serum APAP levels.

See the image below.

Acetaminophen metabolism. Acetaminophen metabolism.

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