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Therapeutic Drug Levels

Acetaminophen Level

Normal range 10–30 (therapeutic) µg/mL (66–199 µmol/L SI). Specimen: Serum (timed after ingestion).

Also known as: paracetamol level, APAP.

10–30 (therapeutic) µg/mLCritical: read below

Reference range

Conventionalµg/mL
1030
SIµmol/L
66199
SpecimenSerum (timed after ingestion)
Conventional range10–30 (therapeutic) µg/mL
SI range66–199 µmol/L
Conversion factor×6.62 (conventional → SI)
Critical value> 150 µg/mL at 4 h post-ingestion risks hepatotoxicity
PanelTherapeutic Drug Levels

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What is the normal range for Acetaminophen Level?

The standard teaching reference range for Acetaminophen Level is 10–30 (therapeutic) µg/mL in conventional units, or 66–199 µmol/L in SI units. This value is measured in serum (timed after ingestion).

A commonly taught critical (panic) value is > 150 µg/mL at 4 h post-ingestion risks hepatotoxicity. Critical results are reported to the provider immediately under your facility's policy.

Source: Adult reference values compiled from Pagana & Pagana, Mosby's Diagnostic and Laboratory Test Reference, and Fischbach & Dunning, A Manual of Laboratory and Diagnostic Tests. Reference ranges vary by laboratory, method, age, sex, and population — always use the range printed on the actual result.

Above the range

Common causes of a high Acetaminophen Level

  • Overdose (intentional or unintentional)
  • Chronic excess with alcohol use

At the bedside

Nursing considerations

  • Plot the 4-hour level on the Rumack–Matthew nomogram to guide treatment.
  • N-acetylcysteine is the antidote and is most effective early.

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