Conclusion
The time has come to use a higher dose of NAC in patients presenting with high-dose overdose, over 500mg/kg body weight, or with evidence of developing hepatic damage while a standard 12 h does of NAC is being used. The animal and human data show that the earlier NAC is used the better the outcome, and it would be illogical not to assume the same in larger paracetamol overdose, further justifying an earlier intensification of NAC and supporting early assessment of response that is facilitated by the shorter SNAP NAC regimen.8