Acetylcysteine for hepatoprotection

Acetylcysteine is easily accessible and is used to prevent and treat hepatotoxicity associated with clove or pennyroyal oil ingestionKim 2019.

Acetylcysteine is indicated for:

  • patients with persistent vomiting (more than 2 vomits) or abdominal pain, or other symptoms of toxicity (see Clinical presentation)
  • asymptomatic patients who have ingested more than 5mL
  • asymptomatic patients who have taken a deliberate ingestion of unknown amount
  • patients with hepatotoxicity on liver biochemistry.

Consult a clinical toxicologist if acetylcysteine is indicated. If acetylcysteine is indicated, a two-bag (20-hour) intravenous acetylcysteine infusion is recommended.

For adults, use:

acetylcysteine 200 mg/kg (up to 22 g) in crystalloid solution 500 mL intravenously, over 4 hours1 essential oil poisoning

FOLLOWED BY

acetylcysteine 100 mg/kg (up to 11 g) in crystalloid solution 1000 mL intravenously, over 16 hours1.

For children, use:

acetylcysteine 200 mg/kg in crystalloid solution 7 mL/kg (up to 500 mL) intravenously, over 4 hours1 

FOLLOWED BY

acetylcysteine 100 mg/kg in crystalloid solution 14 mL/kg (up to 1000 mL) intravenously, over 16 hours1.

For information on immediate immune-mediated (non-IgE) hypersensitivity reactions to acetylcysteine therapy, see Immediate immune-mediated (non-IgE) hypersensitivity reactions to acetylcysteine.

1 Acetylcysteine is compatible with the following crystalloid solutions: sodium chloride 0.9% and glucose 5%.Return