Acetadote is the only FDA-approved IV formulation of acetylcysteine (Mucomyst), developed specifically for use after ingestion of a hepatotoxic dose of acetaminophen.
Dosage (For patients that weigh >40 kg)
- Load: 150 mg/kg in 200 mL D5W, infuse over 1 hour
- Maintenance: 50 mg/kg in 500 mL D5W over 4 hours, followed by 100 mg/kg in 1 L D5W over 16 hours
Considerations
- Serum sample should be drawn at least 4 hours after ingestion.
- Drug should be administered within 8 hours of ingestion for maximal protection against hepatic injury.
- If time of ingestion is unknown, or if the concentration level cannot be obtained or is unable to be interpreted within 8 hours of known ingestion, acetadote should be administered immediately, regardless of the quanity reported to have been ingested.