acetylcysteine

Action and Spectrum

Action and spectrum: 

Acetylcysteine is an N-acetylcysteine has multiple uses due to its diverse mechanisms of action. It acts as a mucolytic agent which breaks disulfide bonds in mucoproteins and reduces mucus viscosity. It is the standard treatment for acetaminophen overdose replenishing intracellular levels of glutathione and preventing liver damage. It neutralizes free radicals and reactive oxygen species. 

Drug Interaction

Adverse Reaction

Adverse drug reactions  

Frequency Not Defined  

Calmness  

Chest tightness  

Bronchoconstriction  

Disagreeable odor  

Drowsiness  

Bronchospasm  

Nausea  

Rhinorrhea  

Stomatitis  

Fever  

Hemoptysis  

Vomiting  

Black Box Warning

Blackbox warning: 

None 

Contraindication / Caution

Contraindication/caution: 

None 

Pregnancy / Lactation

Pregnancy warnings:   
AU TGA pregnancy category: B2
US FDA pregnancy category: B 

Lactation:  

Excreted into human milk is unknown  

Pregnancy Categories:        

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   
• Category B: there was no evidence of risk to the fetus in animal studies, and there were no enough studies on pregnant women.  
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    
• Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    
• Category N: There is no data available for the drug under this category  

Pharmacology

Pharmacology: 

Pharmacodynamics: 

Acetylcysteine breaks disulfide bonds in mucus glycoproteins that improves secretion clearance. It replenishes intracellular glutathione levels by protecting cells from oxidative damage especially in acetaminophen overdose. It also reduces pro-inflammatory cytokine production. 

Pharmacokinetics: 

Absorption: 

Bioavailability 6% to 10%. 

Distribution: 

Volume of Distribution is 0.47 L/kg. 

Metabolism: 

Metabolized into glutathione. 

Excretion: 

Elimination Half-Life is 5.6 hours, excreted through urine and small amount is excreted by feces. 

Adminstartion

Administration: 

It is available as solution nebulizer. 

Patient Information Leaflet

Patient Information Leaflet  

Generic Name: acetylcysteine 

Why do we use acetylcysteine?  

Acetylcysteine treats acetaminophen toxicity although it is not effective as hydration it may reduce COPD exacerbations. Also prevents nephrotoxicity in high-risk patients.