Second Dose: 5,000 mg in 500 mL diluent, infused over 4 hours Loading Dose: 15,000 mg in 200 mL diluent, infused over 1 hour Third Dose: 100 mg/kg in 1,000 mL diluent, infused over 16 hours Second Dose: 50 mg/kg in 500 mL diluent, infused over 4 hours Loading Dose: 150 mg/kg in 200 mL diluent, infused over 1 hour Third Dose: 100 mg/kg in 500 mL diluent, infused over 16 hours Second Dose: 50 mg/kg in 250 mL diluent, infused over 4 hours Loading Dose: 150 mg/kg in 100 mL diluent, infused over 1 hour Third Dose: 100 mg/kg in 14 mL/kg diluent, infused over 16 hours Second Dose: 50 mg/kg in 7 mL/kg diluent, infused over 4 hours Loading Dose: 150 mg/kg in 3 mL/kg diluent, infused over 1 hour

The total dose is 300 mg/kg, given as 3 separate doses, administered over a total of 21 hrs. Either there is full resolution of hepatotoxicity or fulminant liver failure progresses to multiorgan failure and death.Usual Adult Dose for Acetaminophen Overdose Stage 4 (>96 hours): Survival or death.Liver function tests peak, and clinical signs and symptoms of liver failure are evident, including jaundice, vomiting and gastrointestinal pain, coagulopathy, encephalopathy, metabolic acidosis, and possibly acute renal failure and/or pancreatitis. Stage 3 (72–96 hours): Hepatic failure with encephalopathy.If injury is severe, then coagulopathy studies (PT, PTT, INR) may increase. AST and ALT begin to rise, and possibly bilirubin. Patients may begin to develop RUQ pain, although sometimes they are clinically asymptomatic. Stage 2 (24–72 hours): Hepatic injury (hepatotoxicity).The vague, nonspecific symptoms of this stage might include nausea and vomiting, diffuse abdominal pain, and general malaise. Stage 1 (0–24 hours): Preclinical toxic effects with minimal signs and symptoms, possibly asymptomatic, and often normal liver function tests.

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