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Administer immediately if time of ingestion is unknown, or serum acetaminophen level is not available/cannot be interpreted/is not available within 8 hours of ingestion.Administer within 8 hours from acetaminophen ingestion for maximal protection against hepatic injury for patients whose serum acetaminophen levels fall above the "possible" toxicity line on the Rumack-Matthew nomogram (line connecting 150 mcg/mL at 4 hours with 37.5 mcg/mL at 12 hours) the manufacturer product information should be consulted.If patient presents after 4 hours post-ingestion, determine the serum acetaminophen level immediately.Determine serum acetaminophen level at least 4 hours after ingestion of suspected overdose to determine the need for treatment with acetylcysteine.Initiating treatment 15 to 24 hours post-ingestion yields limited efficacy, but does not appear to worsen the patient's condition and it should not be withheld, as reported ingestion time may not be correct.Efficacy diminishes progressively after 8 hours.The critical ingestion to treatment interval is 0 to 8 hours for maximal protection against severe hepatic injury.Limited information is available regarding dosing patients weighing more than 100 kg there are no specific studies.Third Dose: 10,000 mg in 1,000 mL diluent, infused over 16 hoursĬompatible diluents: 5% Dextrose in Water, 0.45% Sodium Chloride Injection, and Sterile Water for Injection Second Dose: 5,000 mg in 500 mL diluent, infused over 4 hours Loading Dose: 15,000 mg in 200 mL diluent, infused over 1 hour

Third Dose: 100 mg/kg in 1,000 mL diluent, infused over 16 hours Second Dose: 50 mg/kg in 500 mL diluent, infused over 4 hours

Loading Dose: 150 mg/kg in 200 mL diluent, infused over 1 hour Third Dose: 100 mg/kg in 500 mL diluent, infused over 16 hours Second Dose: 50 mg/kg in 250 mL diluent, infused over 4 hours Loading Dose: 150 mg/kg in 100 mL diluent, infused over 1 hour Third Dose: 100 mg/kg in 14 mL/kg diluent, infused over 16 hours

Second Dose: 50 mg/kg in 7 mL/kg diluent, infused over 4 hours Loading Dose: 150 mg/kg in 3 mL/kg diluent, infused over 1 hour The total dose is 300 mg/kg, given as 3 separate doses, administered over a total of 21 hrs. Usual Adult Dose for Acetaminophen Overdose