VERIFIED CONTENTAuthor: Maria Konaszczuk, Master of Pharmacy

Acetylcysteine ​​is a mucolytic drug used in the case of a productive cough, the so-called wet. This drug has a high safety profile and is often prescribed by ENT and pulmonary specialists.

Acetylcysteine ​​ comes in the form of effervescent tablets, oral solution, powder for oral solution, capsules and inhalation solution. This substance is approved for the treatment of adults and children from the age of 3.

Acetylcysteine ​​action

Acetylcysteine ​​is a mucolytic drug. This means that it reduces the viscosity of the secretions in the respiratory system. The action of this substance is based on breaking disulfide bridges of peptides present in thick mucus.

The secretion in the airways becomes less sticky and thinner, which allows the patient to cough up more effectively. This substance acts on both sterile mucus and purulent mucus.

Additionally, acetylcysteine ​​reduces the secretion of mucus itself by cells infected with bacteria. It should also be emphasized that acetylcysteine ​​impairs the ability of bacteria to adhere to the epithelium.

Indications for the use of acetylcysteine ​​

This substance is indicated as a drug that reduces thick secretion in the respiratory tract and improves its expectoration. Acetylcysteine ​​is not only used for a productive cough, but also for sinusitis and otitis media.

In hospital treatment, acetylcysteine ​​is also given as a remedy for paracetamol poisoning. It binds the toxic metabolites of paracetamol and protects the liver from damage.

Acetylcysteine ​​dosage

  • Adults and adolescents from the age of 14: max 600 mg per day. The usual dose is 200 mg three times a day. However, there is a preparation for sale containing 600 mg of acetylcysteine, then you should take a single dose.
  • Children aged 7 to 14: the maximum daily dose is 400 mg. It is best to divide the daily dose into two.
  • Children from 3 to 6 years: the maximum daily dose is 300 mg. The daily dose should be divided into 2 or 3 administrations.

The Summary of Product Characteristics underlines that acetylcysteine ​​should not be usedmore than 5 days without a doctor's recommendation.

The drug should be taken after a meal. During therapy, the patient should drink plenty of water. The last planned dose of acetylcysteine ​​can be administered no later than 4 hours before bedtime.

Not suitable for children under 3 years of age.

Contraindications to the use of acetylcysteine ​​

Do not take the drug if the patient is hypersensitive to any substance in the preparation.

Acetylcysteine ​​is not recommended in patients with gastric or duodenal ulcer disease. Such a limitation results from the possibility of irritation of the gastric mucosa and exacerbation of peptic ulcer symptoms.

For the same reason, acetylcysteine ​​is not recommended for esophageal varices, asthmatic conditions or bronchial hyperreactivity. In an asthmatic patient, acetylcysteine ​​can cause bronchospasm, so it is the initiator of the asthmatic state.

The drug should not be administered to patients who are less able to cough up the secretions.

It cannot be used by pregnant and lactating women. This is due to the lack of studies on the safety of acetylcysteine ​​use during pregnancy or lactation.

Warnings and precautions during therapy

If acetylcysteine ​​is administered adjunct to oral antibiotic therapy, it is recommended to use at least two hours between the dose of the expectorant and the antibiotic.

A very rare and dangerous occurrence after the use of acetylcysteine ​​is the development of a skin reaction known as Stevens-Johnson syndrome or Lyell's syndrome. When skin lesions appear on the patient's body, he / she should immediately contact a doctor.

Acetylcysteine ​​affects the metabolism of histamine, which after long-term use may result in an intolerance reaction in patients sensitive to histamine. Symptoms to watch out for are:

  • headache,
  • pruritus,
  • rhinitis.

Acetylcysteine ​​in the form of effervescent tablets soluble in water contains 82.9 mg of sodium. This information is important for people with renal insufficiency and for patients on a low-sodium diet.

Interaction with other drugs

Ne should be used acetylcysteine, i.e. an expectorant with antitussive drugs. This can cause secretions to accumulate in the respiratory tract dangerously.

If you suffer from a cough so intense that you cannot sleep at night, contact your doctor who will consider adding a peripheral cough suppressant to your respiratory tract at night.

Concomitant use of acetylcysteine ​​and nitroglycerin or other drugs containing nitrates may lead to excessive vasodilation.

Side effects of acetylcysteine ​​

According to the summary of product characteristics and the observation of patients during clinical trials, the adverse reactions that may occur are headache, fever, allergic reactions including urticaria, eczema, pruritus, bronchospasm and edema.

Tachycardia and hypotension have been observed in rare cases.

The bronchospasm reaction after taking acetylcysteine ​​usually affects patients with bronchial asthma.

Tinnitus has been reported in some patients possibly related to variations in the patient's pressure.

The digestive system may cause inflammation of the oral mucosa, heartburn and nausea.

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