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GENERAL PEDIATRICS DRUG INFORMATION
Acetylcysteine
Mucolytic, acetaminophen overdose treatment
Acetaminophen overdose
IV:
60 mg/kg/h for 4 hours (maximum: 6 000 mg/h)
then: 6 - 12 mg/kg/h (maximum: 1 200 mg/h)
IV therapy preferred. In general, reassess every 12 hours. Duration of therapy will depend on clinical course.
PO:
140 mg/kg
then: 70 mg/kg Q4H
Mucolytic
NEB:
Infants: 1 - 2 mL of 20% solution Q6-8H
Children: 3 - 5 mL of 20% solution Q6-8H
Adolescents: 5 - 10 mL of 20% solution Q6-8H
Pretreatment with a bronchodilator is usually recommended prior to inhaled therapy. Use 20% (200 mg/mL) solution.
For acetaminophen overdose: IV therapy preferred. If symptoms of histamine release and bronchospasm occur, hold infusion, give anti-histamines +/-corticosteroids and bronchodilators, then restart infusion.
Administration: For oral administration dilute injection solution in three times the volume (or as little volume as tolerated) of juice or cola to mask taste.
Availability: Injection: 20% solution (200 mg/mL) vials of 2 g (10 mL) and 6 g (30 mL)
Pharmacology: Mucolytic agent: can reduce the viscosity of pulmonary secretions. When used for acetaminophen overdose it maintains concentration of reduced glutathione which is needed to inactivate a hepatotoxic metabolite of acetaminophen. In meconium ileus loosens and softens meconium plugs by breaking disulphide bonds.
Updated: 12/24/2025
Disclaimer: This document has been created specifically for Hamilton Health Sciences (HHS) to use for its own patients and the information contained herein may not be applicable or relevant to other health care organizations. This document is for informational purposes only and is not intended to be a substitute for medical or clinical advice from a qualified health care professional. HHS makes no representations or warranties as to the accuracy of the information. This material is current only to the date listed. This material is the intellectual property of HHS and may not be shared, duplicated, or distributed further without the consent of HHS. HHS assumes no liability for the use of this information by the recipient.
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