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We have known for decades that n-acetylcysteine is an antidote for acetaminophen (paracetamol) overdose.  NAC is a benign chemical that repletes oxidized thiol equivalents in the liver that are destroyed in acetaminophen overdose. N-Acetylcysteine—a safe antidote for cysteine/glutathione deficiency.

IV treatment of acetaminophen poisoning usually offers a loading dose of 140 mg/ kg followed by 12 doses of 70 mg/kg every four hours. (ref) Note that this here blog does NOT offer professional dosing or recommendations for treatment.

In the referenced article, rats were poisoned with 300 mg/kg of acetaminophen (APAP) and then rescued with glutathione or NAC. The NAC group was given low-dose NAC at 0.65 mmol/kg NAC intravenously 1.5 hours after APAP (105mg/kg), or high-dose 1.95 mmol/kg NAC (h-NAC) (318 mg/kg).

The use of 1:3 NAC/APAP provides partial rescue of acetaminophen poisoning. The use of 1:1 NAC/APAP provides nearly complete rescue of acetaminophen poisoning.

Assuming someone ingests any certain amount of acetaminophen in overdose, an equimolar amount of NAC provides rescue. NAC is benign, available orally, and can be mixed with APAP. Research grade is available for 76¢ per gram in bulk. It’s probably available far cheaper for pharmaceutical production. It is freely orally absorbed.

Why not provide all acetaminophen OTC’s with at least 100mg of n-acetylcysteine compounded with the standard 325mg doses of acetaminophen? So, this New Year’s, when partiers top off a hangover with a few grams of acetaminophen, their livers might be rescued to drink another day. Say?

I got curious, and went to the Health Food Shoppe.  They have glutathione and NAC for sale, outrageous prices of course.  I tried one bottle of each, and took one capsule on one day, and the other on another day.  Pretty much nil.

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