Cimetidine as an alternative to N-acetylcysteine in patients with paracetamol poisoning

A 20 year old woman attended the emergency department of Wollongong Hospital 11 hours after a toxic ingestion of paracetamol. After developing a significant anaphylactoid reaction to N-acetylcysteine (NAC), she was treated with cimetidine 40mg/kg intravenously as an alternative. This therapy may be an option when NAC cannot be used.