Keywords: acetylcysteine, NAC, INR, PT, prothrombin time (PubMed Search)
In the treatment of acetaminophen poisoning with N-acetylcysteine (NAC), the PT/INR can be slightly elevated even in the absence of hepatotoxicity. Considering Prothombin Time (PT) is one of the criteria used to assess severity of liver damage in this setting, it is important to know how much the PT/INR can be affected by NAC and if it has an actual effect on coagulation factor levels.
Clinical Practice Pearls
1. Pizon AF, et al. The in vitro effect of n-acetylcysteine on prothrombin time in plasma samples from healthy subjects. Acad Emerg Med 2011;18:351-4. [PMID 21496136]
2. Jang DH, et al. In vitro study of n-acetylcysteine on coagulation factors in plasma samples from healthy subjects. J Med Tox 2013;9:49-53. [PMID 22733602]
Follow me on Twitter (@PharmERToxGuy)