See Emergency treatment of poisoning for advice on the treatment of patients who have taken an overdosage of paracetamol; paracetamol poisoning calculator can be used for patients who present between 4 and 24 hours of poisoning, but those who present after 24 hours may still be treated.

Patients at high-risk of liver damage include those:

• taking liver enzyme-inducing drugs (e.g. carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, rifabutin, efavirenz, nevirapine, alcohol, St John's wort);
• who are malnourished (e.g. in anorexia, or bulimia, cystic fibrosis, hepatitis C, in underweight children with 'failure to thrive', in alcoholism, or those who are HIV-positive);
• who have a febrile illness;
• who have not eaten for a few days.

Is the patient at high-risk of liver damage?

Yes
No