Oral N-acetylcysteine for acute paracetamol poisoning

In the UK, a 20 h intravenous N-acetylcysteine (NAC) regimen is the standard antidote for significant acute paracetamol poisoning. In the USA, although the Food and Drug Administration approved the use of an intravenous formulation of NAC in 2004, a 72 h oral NAC protocol is still standard practice. 1 If the US experience demonstrates that oral NAC is safe and effective, then it might be reasonable occasionally to use it in the UK-for example, in cases of difficult or refused intravenous access.

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