Paracetamol overdose emergency department leaflet

• Paracetamol is a common painkiller and is present in many cold and flu preparations and often combined with other painkillers. It can cause harm when taken in amounts above the recommended daily dose.

• Taking too much paracetamol is known as an overdose and needs medical attention.

• When too much paracetamol is taken, you can overwhelm your body’s defences against one of the breakdown products of paracetamol. This leads to damage to your liver and kidneys.

• The damage to your liver can cause you to become jaundiced. This is a yellow discoloration to your skin. This often comes with severe itch. The damage can be severe enough to need a liver transplantation. If you are unable to get a transplant in time you could die. You may become more likely to have liver disease. Liver disease can lead to bruising easily, bleeding and swelling of your tummy. It can also lead to death.

• You may feel sick, vomit or have abdominal (tummy) pain after taking too much paracetamol, but often there are no obvious symptoms at first. It is important to seek medical advice if you have a suspected paracetamol overdose, even if you feel well initially.

• When you arrive in hospital, we collect information about what happened, including what tablets you took, when and if you took any other tablets or substances along with the paracetamol. We also ask about your general medical health.

• We take blood tests and perform observations to guide our management of your overdose. To assess the risk to you from this overdose we need to know when you took the medication.

• If you have taken too much medication and it is likely to damage your liver we will start treatment.

• Once your treatment has finished we will check your blood tests again and should there be abnormalities then you may need further treatment.

• If your bloods tests do not show that you need treatment then depending on the reason for the overdose we may ask the Mental Health Liaison team to come and see you to provide you with support.

• Paracetamol overdose is treated with a vitamin infusion known as Parvolex. This is given to you for at least twenty one hours after an overdose to prevent the damage to your liver.

• Parvolex provides you with gluthathione which your body uses to break down paracetamol and other medications.

• Parvolex does not cause an allergic reaction but can cause itching, rashes and wheeze.

• If you have had problems with this medication before or develop any of these symptoms during your treatment, please let us know and we will give you other medications to prevent the side effects. In addition, we will give you the medication at a slower rate which means you may have to stay in hospital for a bit longer.

If you develop any of the following symptoms, you must seek medical advice immediately.

• Abdominal (stomach) pain, nausea, vomiting (sickness).
• Yellow discoloration of the skin or whites of the eyes (jaundice).
• Severe headache, confusion or drowsiness.
• Passing no urine at all for the past eight hours.

For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.

• The NHS website provides online health information and guidance.

• NHS 111 phone line offers medical help and advice from trained advisers supported by nurses and paramedics. Available 24 hours a day. Calls are free from landlines and mobile phones.

• There are walk-in and urgent treatment services at Brighton Station, in Crawley and at Lewes Victoria Hospital.

• Patient Advice and Liaison Service (PALS) can be contacted with your comments and concerns, and to provide general support.

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this article is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.