Normal Reference Ranges
Adult
Therapeutic: 10 - 30 mcg/mL
Pediatric
Therapeutic: 10 - 30 mcg/mL
Clinical Significance
Toxic levels (>150 mcg/mL at 4 hrs post-ingestion) can cause fatal centrilobular hepatic necrosis. Treated with N-acetylcysteine (NAC) based on the Rumack-Matthew nomogram.
Causes of High
- Intentional overdose
- Accidental toxicity (repeated high doses)
Causes of Low
- Subtherapeutic dosing