What is the daily dose of N-Acetylcysteine (NAC)?

From the Guidelines

The daily dose of N-Acetylcysteine (NAC) for acetaminophen hepatotoxicity is not explicitly stated in the provided evidence, but based on the context, it is implied that a specific dosage is used in the management of acute liver failure, particularly for acetaminophen poisoning, as mentioned in the study by 1.

Key Considerations

• The management of acetaminophen hepatotoxicity involves the use of NAC as an antidote, with the goal of reducing liver injury and preventing acute liver failure.
• The study by 1 highlights the importance of prompt treatment with NAC in cases of suspected acetaminophen overdose, but does not specify the exact daily dose.
• In clinical practice, the dosage of NAC may vary depending on the specific clinical scenario and the patient's individual needs, but a common dosage range is typically between 600-1,800 mg per day, as seen in other contexts.

Dosage and Administration

• While the exact daily dose of NAC for acetaminophen hepatotoxicity is not specified in the provided evidence, it is essential to follow established treatment protocols and guidelines for the management of acute liver failure.
• The administration of NAC should be guided by a healthcare professional, taking into account the patient's medical history, current condition, and potential interactions with other medications.
• As noted in the study by 1, the use of activated charcoal for gastrointestinal decontamination may be beneficial in cases of acetaminophen overdose, but it does not reduce the effect of NAC when administered concurrently.

From the FDA Drug Label

DOSAGE GUIDE AND PREPARATION Doses in relation to body weight are: Loading Dose of Acetylcysteine ** Body Weight Grams of Acetylcysteine mL of 20% Acetylcysteine mL of Diluent Total mL of 5% Solution (kg) (lb) ... Maintenance Dose** (kg) (lb) ...

The daily dose of N-Acetylcysteine (NAC) is based on body weight.

• The loading dose is 140 mg/kg for patients weighing less than 20 kg, and varies for patients weighing more than 20 kg, with a range of 15-4 grams of Acetylcysteine.
• The maintenance dose is 70 mg/kg for patients weighing less than 20 kg, and varies for patients weighing more than 20 kg, with a range of 7.5-2 grams of Acetylcysteine 2.

From the Research

Daily Dose of N-Acetylcysteine (NAC)

• The daily dose of N-Acetylcysteine (NAC) varies depending on the condition being treated.
• For acetaminophen overdose, a three-bag NAC regimen was initiated, followed by a regimen of 3 g q8h 3.
• In patients with obstructive jaundice, intravenous NAC was administered at a dose of 200 mg/kg per hour in the first 8 hours, followed by 100 mg/kg per hour for another 16 hours, and the same dose for another 24 hours 4.
• The optimal daily dose of NAC for other conditions, such as non-acetaminophen-induced acute liver failure, is not well established, but studies suggest that it may be beneficial in improving transplant-free survival and overall survival 5, 6.

Administration and Monitoring

• NAC can be administered intravenously or orally, depending on the condition being treated and the severity of the patient's condition.
• Monitoring of liver and kidney function tests is recommended during NAC administration, as well as assessment of the patient's clinical condition and adverse events 4, 5.

Efficacy and Safety

• NAC has been shown to be effective in improving liver function and reducing the risk of liver failure in patients with acetaminophen overdose and non-acetaminophen-induced acute liver failure 3, 5, 6.
• NAC has also been shown to be safe and well-tolerated, with minimal side effects reported in most studies 4, 5, 7.
• However, the evidence for the use of NAC in other conditions, such as chronic diseases, is emerging and requires further study 7.