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.
Toxicology Investigator Network Authorship Group Wilford Hall Medical Center, USA.
Vikhyat S
VS
Bebarta
Louise
L
Kao
Blake
B
Froberg
Richard F
RF
Clark
Eric
E
Lavonas
Ming
M
Qi
Joao
J
Delgado
John
J
McDonagh
Tom
T
Arnold
Oladapo
O
Odujebe
Gerry
G
O'Malley
Claudia
C
Lares
Elizabeth
E
Aguilera
Richard
R
Dart
Kennon
K
Heard
Chriss
C
Stanford
Jamie
J
Kokko
Greg
G
Bogdan
Carrie
C
Mendoza
Sara
S
Mlynarchek
Sean
S
Rhyee
Jason
J
Hoppe
William
W
Haur
Hock Heng
HH
Tan
Nguyen Nguyen
NN
Tran
Shawn
S
Varney
Amy
A
Zosel
Jennifer
J
Buchanan
Mohammed
M
Al-Helial
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