When is IV N -acetylcysteine (NAC) indicated 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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In 2004, the FDA approved an intravenous (IV) formulation of NAC (Acetadote) for use in adults. In February 2006, this FDA approval was modified to include children (patients < 40 kg). IV NAC is the therapeutic formulation used in many hospitals. Additional indications for IV administration of NAC include the following:

  • Altered mental status

  • GI bleeding and/or obstruction

  • A history of caustic ingestion

  • Potential acetaminophen toxicity in a pregnant woman

  • Inability to tolerate oral NAC because of emesis refractory to proper use of antiemetics

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