Cited by 128Drug-Induced Hepatotoxicity and ProtectionPoisoning and overdose treatmentsParaquat toxicity studies and treatments

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Risk factors in the development of adverse reactions to N‐acetylcysteine in patients with paracetamol poisoning

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Schmidt, L. E., Dalhoff, K·2001·British Journal of Clinical Pharmacology

DOI 10.1046/j.1365-2125.2001.01305.xPMC PMC2014432

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Abstract

Aims To identify risk factors in the development of side‐effects to N‐acetylcysteine (NAC) in patients with paracetamol poisoning. Methods A retrospective study was carried out based upon the hospital charts of 529 consecutive patients admitted with paracetamol poisoning, all treated with NAC, at the Department of Hepatology, Copenhagen University Hospital (the tertiary care centre of liver disease in Denmark). Results Forty‐five patients (8.5%; 95% confidence intervals (CI) 6.4, 11%) developed side‐effects to NAC and 18 patients (3.4%; 95% CI 2.1, 5.4%) developed systemic side‐effects. Asthmatics were 2.9 times (95% CI 2.1, 4.7) more likely to develop side‐effects (Chi‐square: P = 0.004). Side‐effects were of similar severity in asthmatics and nonasthmatics. A history of medical allergy was not a risk factor. Serum paracetamol was lower in patients with side‐effects than in those without (Mann–Whitney: P = 0.00006). Conclusions Asthma must be considered a risk factor in the development of side‐effects to NAC. However, the side‐effects are easily managed and there is no reason to withhold NAC from any patient with paracetamol poisoning. Paracetamol itself seems to offer some protection against the development of side‐effects to NAC.

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Authors: Schmidt, L. E., & Dalhoff, K.
Affiliations: Rigshospitalet (DK)
Corresponding author: Schmidt, L. E.
ORCID: Dalhoff, K
Venue: British Journal of Clinical Pharmacology
Publisher: Wiley
Published: 2001-01
Volume: 51
Issue: 1
Pages: 87-91
ISSN: 0306-5251 (ISSN-L)
1365-2125
DOI: 10.1046/j.1365-2125.2001.01305.x
PMC: PMC2014432
OpenAlex: W1597851562
Cited by: 127
References: 24
Citations by year: 2026: 1 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 1 · 2019: 5 · 2018: 6 · 2017: 3 · 2016: 5 · 2015: 12 · 2014: 6 · 2013: 9 · 2012: 7
FWCI: 4.87
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2744 d)
Locations: British Journal of Clinical Pharmacology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Paraquat toxicity studies and treatments
Keywords: N-acetylcysteine, acetaminophen toxicity, adverse drug reactions, asthma, risk factors, systemic side effects, drug hypersensitivity, hepatoprotection
MeSH terms: Acetaminophen, Acetylcysteine, Adolescent, Adult, Aged, Aged, 80 and over, Child, Denmark, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Poisoning, Prognosis, Risk Factors, Analgesics, Non-Narcotic, Drug Overdose

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Risk factors in the development of adverse reactions to N‐acetylcysteine in patients with paracetamol poisoning

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