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While toxicity depends on many factors, including prior damage to the liver, and co-ingestants, there is a great deal of experience that can help predict whether a level is likely verus unlikely to cause damage. Most of this data applies only to a single ingestion (not a series of doses over time) and one must be certain of the time of ingestion. The product must be the immediate release variety.
If these caveats are met, one can draw a blood level (at least 4 hours after ingestion) and plot it on the Rumack/Matthew nomogram. At 4 hours, a level below 70 ug/ml is definitely safe, and below 140 ug/ml is probably safe (and thus likely does not warrant treatment). Levels above 140 ug/ml - AT 4 HOURS POST- INGESTION - need treatment. The nomogram allows extrapolation to times later than 4 hours post-ingestion.
Thus, the short answer would be, a level > 140 ug/ml on a specimen drawn 4 hours post-ingestion, would be considered potentially toxic.
In general, the dose needed to achieve this level is about 140mg/kg, or about 10 times the usual dose. This dose estimate also must be considered in light of underlying health issues of the patient, including how sure one can be of the exact amount taken.
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