In cases of intravenous paracetamol poisoning contact the National Poisons Information Service for advice on risk assessment and management.

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