Dosing & Uses
Dosage Forms & Strengths
nebulizer solution
- 10%
- 20%
Pulmonary Disease
Facilitation of expectoration via mucolysis
Solution (10 and 20%) may be used undiluted; 3-5 mL of 20% solution or 6-10 mL of 10% solution; administer 1 to 10 mL of 20% solution every 6-8 hours or 2 to 20 mL of 10% every 2 to 6 hours
Diagnostic Bronchography
1-2 mL of 20% solution or 2-4 mL of 10% solution administered 2-3 times by nebulization or by intratracheal instillation before procedure
Acetaminophen Overdose
See separate drug monograph, acetylcysteine (antidote)
Contrast Agent-Associated Nephrotoxicity (Off-label)
Prevention
600 mg PO q12hr for 2 days on day before and day of contrast agent administration
Keratoconjunctivitis Sicca (Off-label)
1 drop of 10% solution in eye(s) q6-8hr
Dosing Considerations
Direct instillation: 1-2 mL of 10% or 20% solution q1hr PRN
Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution q1-4hr by direct instillation into tracheotomy
Instillation into segment of bronchopulmonary tree via small plastic catheter into trachea (under local anesthesia and direct vision): 2-5 mL of 20% solution via syringe connected to catheter
Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution q1-4hr via syringe connected to catheter
Administration
Administer aerosolized bronchodilator 10-15 minutes before administering acetylcysteine via nebulization
Nebulizer solution may also be administered PO
Dosage Forms & Strengths
nebulizer solution
- 10%
- 20%
Pulmonary Disease
Facilitation of expectoration via mucolysis
1-11 months: 1-2 mL of 20% solution or 2-4 mL of 10% solution by nebulization q6-8hr PRN
>11 years: Solution (10 and 20%) may be used undiluted; 3-5 mL of 20% solution or 6-10 mL of 10% solution; administer 1 to 10 mL of 20% solution every 3 to 4 times/day or 2 to 20 mL of 10% every 2 to 6 hours
Acetaminophen Overdose
See separate drug monograph, acetylcysteine (antidote)
Ototoxicity Caused by Platinum-Based Chemotherapy (Orphan)
Prevention of ototoxicity caused by platinum-based chemotherapeutic agents used to treat pediatric cancers
Orphan sponsor
- Galephar Pharmaceutical Research, Inc, Road 198, No. 100 km. 14.7, Juncos Industrial Park, Juncos 00777-3873, Puerto Rico
Keratoconjunctivitis Sicca (Off-label)
1 drop of 10% solution in eye(s) q6-8hr
Dosing Considerations
Direct instillation: 1-2 mL of 10% or 20% solution q1hr PRN
Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution q1-4hr by direct instillation into tracheotomy
Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution q1-4hr via syringe connected to catheter
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (1)
- activated charcoal
activated charcoal decreases effects of acetylcysteine by Other (see comment). Use Caution/Monitor. Comment: Conflicting reports exist; however, charcoal administration does not preclude acetylcysteine administration for acetaminophen overdose .
Minor (7)
- nitroglycerin IV
acetylcysteine increases effects of nitroglycerin IV by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin PO
acetylcysteine increases effects of nitroglycerin PO by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin rectal
acetylcysteine increases effects of nitroglycerin rectal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin sublingual
acetylcysteine increases effects of nitroglycerin sublingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin topical
acetylcysteine increases effects of nitroglycerin topical by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin transdermal
acetylcysteine increases effects of nitroglycerin transdermal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin translingual
acetylcysteine increases effects of nitroglycerin translingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
Adverse Effects
Frequency Not Defined
Bronchoconstriction
Bronchospasm
Calmness
Chest tightness
Disagreeable odor
Drowsiness
Fever
Hemoptysis
Increased volume of bronchial secretions
Irritation of tracheal or bronchial tract
Nausea
Rhinorrhea
Stomatitis
Vomiting
Warnings
Contraindications
Acute asthma
Documented hypersensitivity
Cautions
Volume of bronchial secretions may increase after administration; if cough response is inadequate, consider maintaining airway by mechanical suction if necessary; if airway block arises because of foreign body or local accumulation, clear by endotracheal aspiration, with or without bronchoscopy
Not for injection
Use with caution in patients with asthma or history of bronchospasm; these patients are at increased risk of hypersensitivity reactions
In most instances, bronchospasm may be treated by prompt administration of bronchodilator via nebulization; if bronchospasm worsens, discontinue therapy immediately
Slight disagreeable odor after administration (temporary)
Face mask may produce sticky film on face after nebulization; remove with water
Under certain conditions, opened bottle may cause slight purple color change as consequence of chemical reaction; this has no effect on drug safety or efficacy
Keratoconjunctivitis: Remove contact lenses; do not coadminister with topical antibiotics
Since increased bronchial secretions may occur after inhalation, postural drainage, inhalation percussion, and suctioning should follow; if bronchospasm occurs, administer a bronchodilator; discontinue therapy if bronchospasm progresses
Pregnancy & Lactation
Pregnancy category: B
Lactation: Unknown whether agent is excreted in milk; use with caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Exerts mucolytic activity through sulfhydryl group, which opens up disulfide bonds in mucoproteins and lowers mucous viscosity of pulmonary secretions
Absorption
Onset: 5-10 min
Peak plasma time: 1-2 hr
Distribution
Duration: Variable (~1 hr)
Protein bound: 80%
Metabolism
Metabolized in liver
Elimination
Excretion: Urine (primarily)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| acetylcysteine oral - | 600 mg capsule |  | |
| N-A-C Sustain oral - | 600 mg tablet |  | |
| NAC oral - | 600 mg capsule |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| Acetadote intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
acetylcysteine oral
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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