Possible Interaction: Acetaminophen and Acetylcysteine

“ Acetylcysteine prevents hepatic injury when administered soon after acetaminophen overdose.”

“…-C si … le vels in both treatments; however, there were several advantages with the combined therapy: AC enhanced the efficacy of N-AC according with the higher eliminatión … plus AC is more effective than N-AC alone in enhancing ACT elimination in overdosed patients and that it provided additional hepatoprotective benefit.”

“Hepatotoxicity (aspartate aminotransferase or alanine aminotransferase of more than 1,000 IU/L) … in 10% (five of 50) of patients at "probable risk" when IV NAC was started within … hours of acetaminophen ingestion and in 27.1% (23 of 85) when therapy was begun after ten to 24 hours.”

“BACKGROUND When administered early after an overdose of acetaminophen, intravenous acetylcysteine prevents hepatic necrosis by replenishing reduced stores of glutathione.”

“How acetylcysteine improves the survival of patients with established liver damage induced by acetaminophen , however, is unknown.”

“During the investigational use of oral N-acetylcysteine as an antidote for poisoning with acetaminophen , 11,195 cases of suspected acetaminophen overdose were reported.”

“Hepatotoxicity developed in 6.1 percent of patients at probable risk when N-acetylcysteine was started within 10 hours of acetaminophen ingestion and in 26.4 percent of such patients when therapy was begun 10 to 24 hours after ingestion.”

“When given within eight hours of acetaminophen ingestion, N-acetylcysteine was protective regardless of the initial plasma acetaminophen concentration.”

“In cultured hepatocytes, cell killing at 10 h after APAP decreased from 83% to 49%, 35% and 27%, respectively, by 1 h posttreatment with minocycline, NAC , and minocycline plus NAC.”

“In vivo, minocycline and minocycline plus NAC posttreatment after APAP protect at later time points than NAC alone, indicating that minocycline has a longer window of efficacy than NAC.”

“Prompt administration of NAC can prevent the deleterious actions of APAP in the liver.”

“The cytotoxicity caused by AAP plus CDDP was decreased by NAC , with the effectiveness being time-dependent.”

“Administration of N-acetylcysteine for a longer period might provide enhanced protection for patients in whom acetaminophen absorption or elimination is delayed.”

“Administration of N-acetylcysteine prevented inorganic sulfate depletion usually caused by acetaminophen and may have increased the formation of acetaminophen sulfate.”