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New recommendation for N-acetylcystiene dosing may reduce incidence of adverse effects
  1. R Duncan,
  2. G Cantlay,
  3. B Paterson
  1. Accident and Emergency, Ninewells Hospital, Dundee, DD1 9SY
  1. Correspondence to:
 Russell Duncan
 Accident and Emergency, Ninewells Hospital, Dundee DD1 9SY; russell.a.duncan{at}

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National Poisons Information Service (NPIS) guidelines for the treatment of paracetamol overdose recommend the use of intravenous N-acetylcysteine (NAC) in a dose calculated according to body weight (kg). Available on Toxbase ( We recently treated a 180 kg patient who had overdosed on paracetamol, prompting us to question this guidance.

Paracetamol overdose is the most common method of deliberate self-poisoning in the UK. …

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  • RD made the initial query and wrote the letter. GC made the formal enquiries leading to the change in guidelines. BP has edited the letter and acts as guarantor.

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