Adult Dosing

Acetaminophen overdosage

Patient 40 kg

• Loading dose: 150 mg/kg IV, in 200 mL dilutent over 60 mins
• Second dose: 50 mg/kg IV, in 500 mL of dilutent over 4 hrs
• Third dose: 100 mg/kg IV, in 1000 mL of dilutent over 16 hrs

Patient 20 kg - <40 kg

• Loading dose: 150 mg/kg IV, in 100 mL dilutent over 60 mins
• Second dose: 50 mg/kg IV, in 250 mL of dilutent over 4 hrs
• Third dose: 100 mg/kg IV, in 500 mL of dilutent over 16 hrs

Note:

• To be administer within 0-8 hrs of ingestion, efficacy diminishes progressively after 8 hours

Pediatric Dosing

Acetaminophen overdosage

Patient 40 kg

• Loading dose: 150 mg/kg IV, in 200 mL dilutent over 60 mins
• Second dose: 50 mg/kg IV, in 500 mL of dilutent over 4 hrs
• Third dose: 100 mg/kg IV, in 1000 mL of dilutent over 16 hrs

Patient 20 kg-<40 kg

• Loading dose: 150 mg/kg IV, in 100 mL dilutent over 60 mins
• Second dose: 50 mg/kg IV, in 250 mL of dilutent over 4 hrs
• Third dose: 100 mg/kg IV, in 500 mL of dilutent over 16 hrs

Patient 20 kg

• Loading dose: 150 mg/kg IV, in 3mL/kg of body weight of dilutent over 60 mins
• Second dose: 50 mg/kg IV, in 7mL/kg of body weight of dilutent over 4 hrs
• Third dose: 100 mg/kg IV, in 14mL/kg of body weight of dilutent over 16 hrs

Note:

• To be administer within 0-8 hrs of ingestion, efficacy diminishes progressively after 8 hours

[Outline]

• Adult Dosing
• Pediatric Dosing

• To prevent or lessen hepatic injury following potentially hepatotoxic overdosage of acetaminophen

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Serious anaphylactoid reactions, including death has been reported in patients with asthma receiving acetylcysteine intravenously, use cautiously in patients with asthma or history of bronchospasm
• Intravenous acetylcysteine can cause acute flushing and erythema of the skin within 30-60 mins of infusion, but it resolves spontaneously despite continued infusion of acetylcysteine
• Serious anaphylactoid reaction have been observer with acetylcysteine infusion, provide appropriate treatment like antihistamine and epinephrine in serious cases, and interrupt the infusion until treatment of the anaphylactoid symptoms has been initiated and then carefully restart it, if anaphylactoid reaction returns upon reinitiation of treatment or increases in severity, discontinue the infusion and consider the alternative management
• To avoid fluid overload, adjust the volume of dilutent for patients less than 40 kg and for those requiring fluid restriction and reduced it as needed. The fluid overload can occur if volume is not adjusted resulting in hyponatremia, seizure and death

Cautions: Use cautiously in

• Asthma
• History of bronchospasm

Pregnancy Category:B

Breastfeeding: Safety unknown; Manufacturer advises caution.

• GI: Nausea, vomiting, GI bleeding
• DERM: Pruritus, rash, urticaria
• CV: Tachycardia, hypotension, decreased cardiac function, EKG changes
• IMMU: Anaphylactoid reaction
• NEURO: Status epilepticus
• RESP: Bronchospasm, Pharyngitis, rhinorrhoea throat tightness, ronchi, wheezing, shortness of breath, respiratory distress
• MISC: Fever

• Antidote; protect against acetaminophen overdose-induced hepatotoxicity, by producing the glutathione precursor cysteine and thus maintaining or restoring hepatic concentrations of glutathione, which inactivates intermediate metabolite of acetaminophen that is thought to be hepatotoxic
• Partially metabolized by liver
• Renally excreted 22%
• Half life: 5.6 hrs (adult); 11 hrs (newborns)

US Trade Name(s)

• Acetadote

US Availability

acetylcysteine (generic)

• INJ: 200 mg/mL

Acetadote

• INJ: 200 mg/mL (30 mL vial)

Canadian Trade Name(s)

• Mucomyst
• Parvolex

Canadian Availability

acetylcysteine (generic)

• INJ: 200 mg/mL

Mucomyst

• INJ: 200 mg/mL

Parvolex

• INJ: 200 mg/mL

UK Trade Name(s)

• Parvolex

UK Availability

Parvolex

• INJ: 200 mg/mL (10 mL amp)

Australian Trade Name(s)

• Acetadote
• Parvolex

Australian Availability

acetylcysteine (generic)

• INJ: 200 mg/mL (10 mL amp)

Acetadote

• INJ: 200 mg/mL (30 mL vial)

Parvolex

• INJ: 200 mg/mL (10 mL amp)

[Outline]

Pulmonary

Mucolytics

Emergency/Critical Care

Antidotes

Pricing data from www.DrugStore.com in U.S.A.

• Acetylcysteine 10 % SOLN [Vial] (AMERICAN REGENT)
  4 % = $13.99
  8 % = $17.97
• Acetylcysteine 20 % SOLN [Vial] (AMERICAN REGENT)
  10 % = $22.99
  20 % = $36.97
• Acetylcysteine 20 % SOLN [Vial] (AMERICAN REGENT)
  4 % = $16.99
  12 % = $29.97
• Acetylcysteine 10 % SOLN [Vial] (HOSPIRA)
  30 % = $20.3
  60 % = $30.45
• Acetylcysteine 10 % SOLN [Vial] (ROXANE)
  30 % = $25.99
  90 % = $54.99

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.