Revised IV acetylcysteine (NAC) protocol launching April 1, 2026

The revised protocol will go live on April 1 at 0700 EST.
We recognize that implementation timelines may vary by site. As poison specialists (SPIs) do not have visibility into local transition timing, health care providers are encouraged to share their transition status during consultations to ensure recommendations align with local practice. OPC is committed to supporting safe NAC administration and will work collaboratively with health care providers throughout this transition.

• Letter to Health Care Providers (PDF)
• Health Care Provider Education Sessions (PDF)
• OPC Webinar: Acetaminophen and Revised IV NAC Protocol
• *March & April 2026 Frontline Provider Sessions (PDF)

Patient Care Resources: Effective April 1, 2026

• IV NAC dosing

  • Combined 1-bag + 2-bag
  • 1-bag
  • 2-bag
• IV NAC preparation
• Bloodwork
• Stopping criteria
• NAAR management (anaphylactoid reaction)
• Oral NAC for acetaminophen poisoning
• Fomepizole for acetaminophen poisoning

For more information, contact Katie.Orr@sickkids.ca