Paracetamol poisoning treatment

Paracetamol is a common painkiller that is normally safe. If you take more than the recommended amount (an overdose), it can harm the liver and rarely the kidneys.

The medical team have assessed you. Based on the information that you gave them and the results of your blood tests, you need treatment to stop damage to your liver.

The treatment is a medicine called acetylcysteine. We give it to you through a thin, plastic tube that's inserted into a vein in your arm. This is called a drip or intravenous infusion.

Having treatment

In our hospital, patients who need the acetylcysteine medicine are treated in a certain way (protocol). The protocol is called the Scottish and Newcastle Acetylcysteine Protocol (SNAP).

The Medicines and Healthcare products Regulatory Agency (MHRA) have not yet officially approved (licensed) the protocol. However, we follow SNAP because:

  • it uses the same amount of medicine, but with fewer infusions (a way of putting the medicine into your bloodstream) through a drip (2 instead of 3)
  • you are likely to be on a drip for less time (12 instead of 21 hours)
  • side effects, such as itching and being sick, are less common
  • it's likely to be as effective at preventing liver damage

Making sure you are not at risk

Checking your blood

We check your blood after you have the acetylcysteine medicine to make sure that you are not at risk of liver problems. We take the blood tests at the end of the second acetylcysteine infusion and might repeat them. This is so that we have results from a blood test taken at least 24 hours after you last had paracetamol.

If there are any problems with these blood tests, we discuss the results with you and you might need more treatment. 

Leaving hospital

It is only safe for you to leave hospital when your blood tests show that you are not at risk of liver problems. It's important that you give us accurate information about the tablets that you took. We use this information to assess you and your risk of liver damage. 

Are you certain:

  • when you took the tablets?
  • how many tablets you took?
  • if you took the tablets all at once or over more than an hour?

If you forget to give us this information or think something you told us might not be correct, tell a doctor or nurse immediately before you leave.

After you leave hospital

You only leave the hospital when the team looking after you feel that your risk of liver damage is very low. 

Go to A&E if:

  • you have stomach pain
  • you feel sick (nausea) or are being sick (vomiting)
  • your skin or eyes look yellow (jaundice)
  • you have a very bad headache
  • you feel confused or drowsy (sleepy)
  • you do not pee for 8 hours

Resource number: 3770/VER3
Last reviewed: October 2020
Next review: October 2023

Contact us

If you have questions or concerns about your treatment, contact the clinical toxicology team.

Phone: 020 7188 5848 Monday to Friday, 9am to 5pm.

Out of hours, contact NHS 111 or an out of hours GP service. 

Email: [email protected]

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Contact our Patient Advice and Liaison Service (PALS)

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