Tier 1 — highest

Reduction of adverse effects from intravenous acetylcysteine treatment for paracetamol poisoning: a randomised controlled trial

D Nicholas Bateman, James W Dear, H K Ruben Thanacoody, Simon H L Thomas, Michael Eddleston, Euan A Sandilands, Judy Coyle, Jamie G Cooper, Aryelly Rodriguez, Isabella Butcher, Steff C Lewis, A D Bastiaan Vliegenthart, Aravindan Veiraiah, David J Webb, Alasdair Gray
Lancet 2014 383(9918):697-704

Bibliography

PubMed
PMID 24290406
DOI
10.1016/S0140-6736(13)62062-0
Funding
Funding disclosure was not located in the indexed record reviewed; consult the source publication for the full funding statement.
Competing interests
Competing-interest disclosure was not located in the indexed record reviewed; consult the source publication for the full declaration.

Study snapshot

DesignDouble-blind randomized factorial trial
ModelHuman
Sample222 randomized; 217 assessable at 2 hours
InterventionStandard 20.25-hour IV NAC versus modified 12-hour regimen, with or without ondansetron
Duration12-20.25 hours
EndpointsVomiting/retching; Anaphylactoid reactions; Treatment interruption; ALT rise

What the study showed, in plain terms

Key trial testing whether a shorter, modified IV NAC regimen reduces treatment toxicity in paracetamol poisoning.

Key findings

The modified 12-hour protocol substantially reduced vomiting and severe anaphylactoid reactions, but the trial was not powered to prove noninferior antidote efficacy.

What this study can and cannot tell us

Hospital overdose regimen; cannot be extrapolated to oral supplement dosing.

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology