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. 2010 Jun;48(5):424-30.
doi: 10.3109/15563650.2010.486381.

A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose

Vikhyat S Bebarta  1 , Louise Kao, Blake Froberg, Richard F Clark, Eric Lavonas, Ming Qi, Joao Delgado, John McDonagh, Tom Arnold, Oladapo Odujebe, Gerry O'Malley, Claudia Lares, Elizabeth Aguilera, Richard Dart, Kennon Heard, Chriss Stanford, Jamie Kokko, Greg Bogdan, Carrie Mendoza, Sara Mlynarchek, Sean Rhyee, Jason Hoppe, William Haur, Hock Heng Tan, Nguyen Nguyen Tran, Shawn Varney, Amy Zosel, Jennifer Buchanan, Mohammed Al-Helial
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A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose

Vikhyat S Bebarta et al. Clin Toxicol (Phila). 2010 Jun.

Erratum in

  • Clin Toxicol (Phila). 2010 Aug;48(7):770

Abstract

Oral and intravenous (IV) N-acetylcysteine (NAC) are used for the treatment of acetaminophen poisoning. The objective of this multicenter study was to compare the safety of these two routes of administration.

Methods: We conducted a multicenter chart review of all patients treated with NAC for acetaminophen poisoning. The primary safety outcome was the percentage of patients with NAC-related adverse events.

Results: A total of 503 subjects were included in the safety analysis (306 IV-only, 145 oral-only, and 52 both routes). There were no serious adverse events related to NAC for either route. Nausea and vomiting were the most common related adverse events and were more common with oral treatment (23 vs. 9%). Anaphylactoid reactions were more common with IV administration (6 vs. 2%).

Conclusions: IV and oral NAC are generally mild adverse drug reactions.

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Figure 1
Figure 1
Characterization of Subjects – Safety Population
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References

    1. Brok J, Buckley N, Gluud C. Interventions for paracetamol (acetaminophen) overdose. Cochrane Database Syst Rev. 2006:CD003328. - PubMed
    1. Buckley NA, Whyte IM, O'Connell DL, Dawson AH. Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning? J Toxicol Clin Toxicol. 1999;37:759–67. - PubMed
    1. Waring WS, Stephen AF, Robinson OD, Dow MA, Pettie JM. Lower incidence of anaphylactoid reactions to N-acetylcysteine in patients with high acetaminophen concentrations after overdose. Clin Toxicol (Phila) 2008;46:496–500. - PubMed
    1. Yip L, Dart RC, Hurlbut KM. Intravenous administration of oral N-acetylcysteine. Crit Care Med. 1998;26:40–3. - PubMed
    1. Kerr F, Dawson A, Whyte IM, Buckley N, Murray L, Graudins A, Chan B, Trudinger B. The Australasian Clinical Toxicology Investigators Collaboration randomized trial of different loading infusion rates of N-acetylcysteine. Ann Emerg Med. 2005;45:402–8. - PubMed

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