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Acetaminophen Overdose Management

Acetaminophen overdose can be effectively managed by focusing on a few basic principles. As in all cases of poisoning, obtain a careful history and have a high index of suspicion. When acetaminophen overdose is a possibility, obtain a plasma acetaminophen level and initiate antidotal therapy. When the antidote, acetylcysteine, is administered using current recommendations, morbidity is significantly reduced and mortality virtually eliminated. The prognosis for patients with acetaminophen overdose is excellent, provided treatment is given expeditiously and appropriately.

An overdose of acetaminophen is a relatively unusual event that can be effectively managed. When the antidote, acetylcysteine,* is administered using current recommendations, morbidity is significantly reduced and mortality virtually eliminated. The prognosis for patients with acetaminophen overdose is excellent, provided treatment is given expeditiously and appropriately.

Available for download on this site are two essential tools for managing acetaminophen overdose:

• Guidelines for the Management of Acetaminophen Overdose: A monograph that provides comprehensive direction for assessment, administration of antidote, managing special populations, and related needs. View PDF
• Nomogram for Acute Acetaminophen Overdose: A helpful graph that uses acetaminophen serum concentrations at various time intervals post-overdose to determine whether the antidote should be administered. View PDF

McNeil Consumer & Specialty Pharmaceuticals continues to sponsor a toll-free telephone number (1-800-525-6115), available 24 hours a day, at the Rocky Mountain Poison and Drug Center. Please do not hesitate to call this number if you need individualized consultation on managing a patient with acetaminophen overdose.

*About the antidote

In 1985, the FDA approved the oral administration of acetylcysteine as an antidote for the treatment of acetaminophen overdose. In 2004, the FDA approved the intravenous formulation of acetylcysteine (Acetadote®, Cumberland Pharmaceuticals, Nashville, TN).

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