The primary antidote for paracetamol (acetaminophen) overdose is N-acetylcysteine (NAC), also known as acetylcysteine.
While paracetamol is safe in normal doses, it is hepatotoxic and potentially fatal in overdose. Fortunately, N-acetylcysteine (NAC) is a safe and effective antidote which if used correctly prevents serious hepatic injury after paracetamol overdose.
Acetylcysteine IV (N-acetylcysteine, Parvolex®, NAC) is the treatment of choice. It has near 100% efficacy in preventing paracetamol-induced hepatotoxicity if given within the first 8 hours from ingestion of overdose. It may also be effective up to and possibly beyond 24 hours.
Intravenous acetylcysteine is the antidote to treat paracetamol overdose and is virtually 100% effective in preventing liver damage when given within 8 hours of the overdose.
According to current FDA-approved protocols for the treatment of acute acetaminophen ingestion, oral acetylcysteine is given as a loading dose of 140 mg per kilogram of body weight, with maintenance doses of 70 mg per kilogram that are repeated every 4 hours for a total of 17 doses.
Side effects of other antidotes vary with each type of drug. A few of the most common side effects may include: Acetylcysteine (antidote): Nausea and vomiting.
Help save a life with naloxone
Naloxone is an antidote to opioid overdoses. You can now buy over-the-counter (OTC) naloxone nasal spray. It's also available nationwide at the pharmacy without an individual prescription.
The treatment is a medicine called acetylcysteine. It is given as 2 infusions, and takes about 12 hours.
First stage (30 min to 24 hours): may be asymptomatic or may have nausea and vomiting. Second stage (18 to 72 hours): right upper quadrant abdominal pain, hypotension. Third stage (72 to 96 hours): liver failure, renal failure, coagulopathy, metabolic acidosis, encephalopathy, death is most common at this stage.
Patient outcomes are dependent upon what phase of paracetamol poisoning that treatment is initiated in. If the antidote is given during phase one (in cases where medical history reveals a suspicion of paracetamol overdose), patients are expected to fully recover with only a transient period of liver injury[57,58].
All paracetamol-containing products sold in retail outlets such as supermarkets and grocery stores must now be in blister packaging. The maximum number of tablets or capsules that can be sold in this setting has been reduced from 20 to 16 tablets or capsules.
Emergency healthcare team will assess the person who has overdosed based on their condition. The emergency team will: Do a full assessment – which may include blood tests, observation and psychological review. Do a physical examination.
However, taking Dolo 650 without medical need or exceeding the daily maximum can be harmful. Paracetamol is metabolized by the liver, and overdose—even unintentionally—can lead to liver toxicity. If you've taken two tablets accidentally, monitor for symptoms like nausea or fatigue.
The Scottish and Newcastle Anti-emetic Pre-treatment (SNAP) protocol is a shorter, 12-hour NAC regimen. The SNAP regimen has been shown to be as effective as the standard 21-hour regimen in preventing liver injury in paracetamol overdose and is associated with fewer adverse reactions.
The following drugs may not be safe to take with paracetamol:
Acetaminophen is the generic name assigned using the United States Adopted Names (USAN) system. Paracetamol is the name assigned using the International Nonproprietary Name (INN) generic name system.
Liver damage is maximal 3 – 4 days after paracetamol overdose. Therefore, even if there are no significant early symptoms, patients who report taking a paracetamol overdose should be transferred to an acute hospital urgently.
Paracetamol is a medicine used to treat mild to moderate pain. Paracetamol can also be used to treat fever (high temperature). It's dangerous to take more than the recommended dose of paracetamol. Paracetamol overdose can damage your liver and cause death.
Mortality from paracetamol overdose is now about 0.4%, although severe liver damage occurs without treatment in at least half of people with blood paracetamol levels above the UK standard treatment line.
While it is well-known that paracetamol overdose may lead to toxicities including severe hepatic toxicity, some recent reports have highlighted its “in situ” toxicity on brain tissue at high doses, even in the absence of hepatotoxicity. This can result in acute leukoencephalopathy (AL), coma, or even death.
Acute liver failure can happen in as little as 48 hours. Seek medical care at the first signs of trouble, such as: Fatigue. Nausea.
Measuring your blood paracetamol level at a known time point between four and 15 hours after a single overdose has been taken can show the likelihood of liver damage developing after two or three days.
Research shows that current over-the-counter low-dose codeine containing medicines for pain relief offer very little additional benefit but high health risks, when compared to similar medicines without codeine. Codeine can cause opioid tolerance, dependence, addiction, poisoning and in high doses, even death.
The strongest over-the-counter (OTC) painkiller for inflammation is generally considered Naproxen (Aleve), offering longer relief (8-12 hrs) than Ibuprofen (Advil, Motrin), making it great for chronic inflammation or injuries, though Acetaminophen (Tylenol) is a good alternative for general pain/fever, and a combination like Ibuprofen + Acetaminophen can be very effective. Always read labels, follow dosage, and consult a doctor if you're over 65, have heart/kidney issues, or take other meds, as NSAIDs (like naproxen/ibuprofen) have risks.
Codeine is an opioid drug closely related to morphine and, like morphine, is derived from opium poppies.