Saturday September 30, 2006


Q; You admitted a patient with acetaminophen (Tylenol) overdose and started on 21 hour regimen of IV acetylcysteine / mucomyst (Acetadote). After a while as passing through the bedside, you noticed the color of liquid in bottle is changed to pink. What would be your next step ?

A; Nothing


Acetadote changes color from colorless to light pink / purplish once the stopper is punctured. This is a benign and expected effect and doesn't require any intervention. Some hospital pharmacies prepare their own generic IV acetylcysteine and this color change may not be always apparent.

Caution: Keep IV benadryl and steroid handy as flushing, urticaria and angioedema are frequent side effects of IV acetylcysteine, mostly during first hour of loading and particular caution is advised in patients with asthma and bronchospasm.