Repeated supratherapeutic ingestion of >100 mg/kg/day.
Hepatic failure and death are uncommon outcomes, but paracetamol remains the most important single cause of acute fulminant hepatic failure in Western countries.
It is involved in a large proportion of accidental paediatric exposures and deliberate self-poisonings and is the leading pharmaceutical agent prompting calls to poisons information centres across Australia and New Zealand.
Paracetamol is the most widely used over-the-counter analgesic in the world.
Complicated overdoses involving longer-acting forms of paracetamol (eg Panadol Osteo) or staggered ingestions should be discussed with a toxicologistįor 24 hour advice, contact the Poisons Information Centre 13 11 26 Background.
Stated timing and dose of paracetamol ingestion are often unreliable and this needs to be taken into consideration.
Time to NAC is crucial in protecting the liver from significant toxicity
N-acetylcystine (NAC) is a safe and effective antidote.
Suspect paracetamol poisoning in all deliberate adolescent self-poisonings.