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How to treat acetaminophen poisoning

Nov 25, 2025 Source: Cainiu Health
Dr. Wang Lei
Introduction
Treatment for acetaminophen poisoning includes prompt emesis and catharsis, administration of specific antidotes, intravenous fluid support, symptomatic management of complications, and monitoring of liver and kidney function. Staged and standardized treatment is required to avoid delays in care. Immediate medical attention is recommended in cases of accidental overdose or if symptoms such as nausea, abdominal pain, or jaundice occur. If within 4 hours of ingestion and the patient is conscious,

Rescue measures for acetaminophen poisoning include timely emesis and catharsis, administration of specific antidotes, intravenous fluid support, symptomatic management of complications, and monitoring of liver and kidney function. Treatment should be carried out in a staged and standardized manner to avoid delays in care. Immediate medical attention is recommended if an overdose is ingested or symptoms such as nausea, abdominal pain, or jaundice occur.

1. Timely emesis and catharsis: For patients who are conscious and within 4 hours of ingestion, vomiting can be induced by stimulating the pharynx, or laxatives may be used to promote the elimination of unabsorbed drug, thereby reducing gastrointestinal absorption.

2. Administration of specific antidote: N-acetylcysteine should be administered as early as possible. It replenishes glutathione in the body, preventing hepatotoxic metabolites from damaging the liver. The best efficacy is achieved when given within 12 hours of poisoning, and the dose must be calculated based on body weight.

3. Intravenous fluid support: Infusion of glucose solutions and electrolytes via intravenous route helps maintain water and electrolyte balance, promotes renal excretion of drug metabolites, and reduces the metabolic burden on the liver.

4. Symptomatic management of complications: Hepatoprotective drugs should be given in case of liver injury; coagulation factors should be supplemented if coagulopathy occurs; and renal support therapy should be initiated when necessary for abnormal kidney function.

5. Monitoring of liver and kidney function: Continuously monitor transaminases, bilirubin, creatinine, and other indicators during treatment to dynamically assess organ function and adjust therapeutic strategies according to changes in these parameters, thus preventing disease progression.

After symptom relief, a light diet is recommended—avoiding greasy and spicy foods that may increase liver burden. Sufficient rest should be ensured, with avoidance of physical exertion. After gradual recovery, high-quality protein intake may be appropriately increased. Regular follow-up tests of liver and kidney function are essential to confirm full recovery.

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