Acetaminophen Overdose and NAC Dosing

Calculates PO/IV NAC dosing for acetaminophen overdose, as well as a nomogram for determining toxic 4 hour ingestion levels.

Route of N-Acetylcysteine (NAC)
  • 21-hour course
  • 72-hour course
Patient's Weight?

PO

Loading dose is 140mg/kg PO, then 17 more doses every 4 hours of 70mg/kg PO. If patient vomits within 1 hour of dose, it must be repeated.  

IV

Patients >40 kg:
  • Loading Dose: 150 mg/kg in 200 mL of diluent administered over 60 min
  • Dose 2: 50 mg/kg in 500 mL of diluent administered over 4 hr
  • Dose 3: 100 mg/kg in 1000 mL of diluent administered over 16 hr
Patients >20 - <40kg
  • Loading Dose: 150 mg/kg in 100 mL of diluent administered over 60 min
  • Dose 2: 50 mg/kg in 250 mL of diluent administered over 4 hr
  • Dose 3: 100 mg/kg in 500 mL of diluent administered over 16 hr
Patients <20kg
  • Loading Dose: 150 mg/kg in 3 mL/kg of body weight of diluent administered over 60 min
  • Dose 2: 50 mg/kg in 7 mL/kg of body weight of diluent administered over 4 hr
  • Dose 3: 100 mg/kg in 14 mL/kg of body weight of diluent administered over 16 hr

Posted in: GastrointestinalToxicology









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