Overdose acetaminophen

General or Other | - Others | Overdose acetaminophen (Disease)


Acetaminophen is a commonly used non-prescription medication, and acetaminophen overdose is one of the most common poisonings worldwide.

The effects of an overdose will vary, depending on a number of factors, including the acetaminophen dosage and whether it was taken with any other medicines, alcohol, or street drugs.

Soon after taking an overdose of acetaminophen, the person may have no symptoms from taking a toxic amount. They may remain symptom free for up to 24 hours after taking a toxic overdose of acetaminophen.

After this initial period, the following symptoms are common in acetaminophen poisoning: nausea, vomiting, not feeling well, not able to eat or poor appetite, abdominal pain. Acetaminophen in overdose can seriously damage the liver. If the damage is severe, a liver transplant may be necessary in order to save a life.

Causes and Risk factors

An overdose can occur as the result of a single intentional or accidental one-time overdose. However, chronically taking an acetaminophen dosage that is too high can also result in overdose. Acetaminophen is a common ingredient in a wide variety of non-prescription and prescription products, and accidental overdose is often the result of taking multiple products that contain acetaminophen

The outcome for someone who has an acetaminophen overdose depends largely on three factors: the amount of acetaminophen ingested, the timing of emergency treatment, and the initial general health of the person.

Diagnosis and Treatment

If a toxic dose is taken and emergency treatment is delayed, liver failure may follow. Liver failure may mean that a liver transplant is needed. Alternatively, if treatment of a toxic overdose is begun early, the person may recover with no long-term health problems.

If a patient presents after multiple ingestions or chronic ingestion of supra-therapeutic doses of APAP over hours or days, evaluate for the presence of a persistent serum APAP concentration and laboratory indicators of hepatotoxicity.

Begin N -acetylcysteine (NAC) therapy if the patient has elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels or a measurable serum APAP concentration.

If a patient presents 8-24 hours or later after an acute ingestion, initiate NAC therapy and evaluate for laboratory evidence of hepatotoxicity. If evidence of hepatotoxicity exists, continue NAC therapy and consult a regional poison control center for guidance on a treatment regimen.

NAC administration in cases of hepatic failure has been associated with a decreased incidence of cerebral edema and improved survival. Therefore, NAC therapy should be initiated if concern exists for potential toxicity while awaiting confirmatory laboratory studies.