Acetaminophen overdose: treatment line and acetylcysteine dose
Rumack-Matthew treatment threshold for a single acute ingestion, with the IV acetylcysteine regimen.
Inputs
0 of 3Actual (total) body weight
h
Patient values are shared with every calculator.
When to use
- Single acute ingestion with a known time, level drawn 4 to 24 hours after.
Pearls and pitfalls
- Not valid for repeated supratherapeutic ingestion, unknown time, or extended-release products (repeat the level).
- 2023 consensus: very large ingestions (level above the 300 line) may need higher NAC doses; contact poison control (1-800-222-1222).
Why use
Treatment threshold and NAC dose together.
Treatment line (µg/mL) = 150 × 2^(−(hours − 4) ÷ 4), 4–24 h; IV NAC 150 mg/kg over 1 h, 50 mg/kg over 4 h, 100 mg/kg over 16 h (weight capped at 100 kg)