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If serum paracetamol levels exceed the treatment nomogram at any time point, treatment with antidote (NAC) is indicated; if time since ingestion is unknown or serum paracetamol concentration cannot be obtained within 8 hours of the overdose, it is recommended that treatment with antidote (NAC) should be initiated without waiting for serum paracetamol concentrations to be available; if NAC treatment has been initiated, it should be prolonged beyond the first 21-hour NAC course if paracetamol level remains above the limit of detection (or greater than 10 mg/L) or if ALT is increasing (greater than 100 U/L), and should be continued until paracetamol is below the limit of detection (or 10 mg/L) or panadol if ALT is falling below 100 U/L; antidote should be dosed as recommended by the local Poison Information Centre .
The Agency’s recommendations are based on a review of available data including a retrospective pharmacokinetic and clinical analysis of 53 cases of acute overdose with modified-release paracetamol by the Swedish Poison Information Centre,1 which found that the standard treatment protocol utilising panadol solely the Rumack-Matthew nomogram (or variations thereof) based on conventional paracetamol formulations may not be effective for overdoses with modified-release paracetamol formulations .
The maximum plasma concentration may occur later, and high concentrations, in particular after large doses, may overuse of panadol how long does panadol take to reduce fever panadol function baby panadol recall persist for several days .
The how long does it take for panadol to work how many grams of paracetamol in panadol panadol tablets usual protocols of sampling and treatment regimens used in the management of overdose with immediate-release formulations are therefore not adequate .

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