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Although acetylcysteine is most effective if given early, it still has beneficial effects if given as late as 48 hours after ingestion.[48] In clinical practice, if the patient presents more than eight hours after the paracetamol overdose, then activated carbon is probably not useful, and acetylcysteine is started immediately

[DOI] [PubMed] [Google Scholar] Reagan-Shaw S, Nihal M, Ahmad N

Cysteine starvation or xCT blockade confers the opposite result and increases cellular NADPH pools

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The PRISMA 2020 statement: An updated guideline for reporting systematic reviews