A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose.
Oral and intravenous (IV) N-acetylcysteine (NAC) are used for the treatment of acetaminophen poisoning. The objective of this multicenter study was to compare the safety of these two routes of administration.


METHODS
We conducted a multicenter chart review of all patients treated with NAC for acetaminophen poisoning. The primary safety outcome was the percentage of patients with NAC-related adverse events.


RESULTS
A total of 503 subjects were included in the safety analysis (306 IV-only, 145 oral-only, and 52 both routes). There were no serious adverse events related to NAC for either route. Nausea and vomiting were the most common related adverse events and were more common with oral treatment (23 vs. 9%). Anaphylactoid reactions were more common with IV administration (6 vs. 2%).


CONCLUSIONS
IV and oral NAC are generally mild adverse drug reactions.
Bebarta
Vikhyat S
VS
Toxicology Investigator Network Authorship Group Wilford Hall Medical Center, USA.
Kao
Louise
L
Froberg
Blake
B
Clark
Richard F
RF
Lavonas
Eric
E
Qi
Ming
M
Delgado
Joao
J
McDonagh
John
J
Arnold
Tom
T
Odujebe
Oladapo
O
O'Malley
Gerry
G
Lares
Claudia
C
Aguilera
Elizabeth
E
Dart
Richard
R
Heard
Kennon
K
Stanford
Chriss
C
Kokko
Jamie
J
Bogdan
Greg
G
Mendoza
Carrie
C
Mlynarchek
Sara
S
Rhyee
Sean
S
Hoppe
Jason
J
Haur
William
W
Tan
Hock Heng
HH
Tran
Nguyen Nguyen
NN
Varney
Shawn
S
Zosel
Amy
A
Buchanan
Jennifer
J
Al-Helial
Mohammed
M
D000082:Acetaminophen / Q000506:poisoning*; D000111:Acetylcysteine / Q000008:administration & dosage* / Q000506:poisoning / Q000627:therapeutic use*; D000707:Anaphylaxis / Q000139:chemically induced; D004333:Drug Administration Routes; D062787:Drug Overdose / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy; D012449:Safety; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy
D000082:Acetaminophen; D000111:Acetylcysteine