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Acetylcysteine Solution USP
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Acetylcysteine solution is a medication indicated for the treatment of acetaminophen overdose and respiratory conditions such as asthma, bronchitis, emphysema, and cystic fibrosis.
When inhaled through the mouth, the medication helps to dissolve and loosen thick mucus in the airways, making it easier to cough it up and breathe comfortably.
When administered by mouth, particularly in higher doses, Acetylcysteine is used to prevent or lessen hepatic injury after acetaminophen overdose (ingesting a dose exceeding 50 mg/kg or 12 g of acetaminophen).
How Does Acetylcysteine Work?
Acetylcysteine works in two ways, depending on the use.
In the treatment of respiratory conditions like pneumonia, chronic bronchitis, and cyst fibrosis, Acetylcysteine acts as a mucolytic agent. It helps in thinning and loosening the thick and sticky mucus in your airways by breaking disulfide bonds in the mucus protein. This reduces mucus viscosity and promotes expectoration hence making it easier to cough and clear the respiratory tract.
Acetylcysteine also works as an antidote for acetaminophen overdose by replenishing depleted glutathione in your liver. The increase in glutathione levels helps reduce or prevent liver damage caused by acetaminophen overdose.
Forms of Acetylcysteine
Acetylcysteine is available in three distinct formulations:
- Injectable Solution: This is in the form of a liquid usually administered intravenously. It delivers Acetylcysteine directly into the bloodstream via the vein.
- Inhalation Solution: The inhalation solution of Acetylcysteine is administered with a nebulizer which is targeted to treat respiratory ailments like COPD and pneumonia.
- Oral Tablets: These oral tablets are specifically designed to be dissolved in water to form an effervescent solution which is then consumed orally.
Acetylcysteine Precautions and Warnings
Encephalopathy: Encephalopathy may develop in some patients suffering from hepatic failure due to compromised liver function under acetylcysteine medication.
Urticaria: Taking acetylcysteine may cause you to develop urticaria. If you notice any signs of urticaria like itching, burning, or swelling of the skin, discontinue the medication immediately.
Allergic Reactions: Angioedema, an allergic reaction may arise as a result of taking acetylcysteine, therefore, disclosure of unknown allergic reaction or any of its components to your doctor is necessary.
Bleeding Complications: Bleeding complications in your esophagus and stomach may occur after taking Acetylcysteine. Therefore, inform your doctor if you experience severe vomiting after administration of Acetylcysteine.
Asthma and Acute Asthma: Do not take Acetylcysteine if you are suffering from asthma or acute asthma condition. Acetylcysteine can trigger bronchospasm in asthmatic patients if taken orally or if inhaled.
Hypersensitivity: After taking Acetylcysteine you may develop hypersensitivity or the condition could worsen in sensitive patients.
Side Effects of Acetylcysteine
Acetylcysteine has side effects that should be considered before taking it. Understanding the spectrum of side effects linked to the drug helps your healthcare provider optimize care and reduce the impact of adverse reactions on treatment outcomes.
Common Side Effects
- Coughing blood
- Dizziness
- Unpleasant odour
- Nausea
- Vomiting
- Drowsiness
- Wheezing
- Stuffy nose
Severe Side Effects
- Confusion
- Reddening of the skin around the ears
- Skin rash
- Difficulty breathing
- Mouth sores
- Bronchoconstriction
- Swelling of your face, feet, and hands
Drug Interactions with Acetylcysteine
As with any medication, acetylcysteine can interact with other drugs, affecting how your body processes these drugs. Before the administration of acetylcysteine, inform your healthcare provider if you are taking any other medication to prevent adverse side effects and to avoid altering the effectiveness of the drug.
| Drug | Interaction |
| Dextromethorphan | The interaction between Dextromethorphan and acetylcysteine may decrease the effectiveness of acetylcysteine in clearing and loosening mucus from the airways. |
| Furosemide | Combining acetylcysteine with furosemide enhances the ototoxic side effects of furosemide, increasing the risk of having tinnitus or hearing loss. |
| Nitroglycerine | Acetylcysteine and nitroglycerine combination can lead to increased hypertension and vasodilation, causing side effects such as fainting, dizziness, and lightheadedness. |
| Plavix (Clopidogrel) | Concurrent use of clopidogrel and acetylcysteine may cause an increase in gastrointestinal bleeding or hemorrhagic stroke. |
| Naproxen | The combination of naproxen and acetylcysteine can cause acute kidney injury or worsening of renal function, particularly in patients having pre-existing kidney conditions. |
| Heparin | Using heparin and acetylcysteine concurrently may cause prolonged bleeding signs such as easy bruising, blood in the stool or urine, and prolonged bleeding from cuts. |
Strengths and Dosages of Acetylcysteine
Acetylcysteine is typically administered by a doctor during a hospital stay to treat paracetamol overdose. Its efficacy is highest when administered promptly following an overdose. Delayed administration reduces its efficiency in safeguarding your liver from damage.
If you are taking an Acetylcysteine tablet, dissolve the effervescent tablet in water before ingestion, and take the mixed solution within 2 hours of preparation.
For the oral liquid, mix the solution with a caffeine-free diet sodas, or alternative diet soft drink, and consume it within one hour.
The total dose of Acetylcysteine is 17 doses, spaced approximately four hours apart. In case you vomit within 1 hour of ingestion, you should take another dose to compensate for the vomited one.
| Weight (kg) | Dosage | Infusion Time | |
| Loading dose | 150mg in 3ml diluent | Infused over 1 hour | |
| Children weighing from 5 to 20 kg | Second dose | 50mg in 7ml diluent | Infused over 4 hours |
| Third dose | 100mg in 14ml diluent | Infused over 16 hours | |
| Loading dose | 150mg in 100ml diluent | Infused over 1 hour | |
| Children weighing from 21 to 40 kg | Second dose | 50mg in 250ml diluent | Infused over 4 hours |
| Third dose | 100mg in 500ml diluent | Infused over 16 hours | |
| Loading dose | 150mg in 200ml diluent | Infused over 1 hour | |
| Adults weighing from 41 to 100kg | Second dose | 50mg in 500ml diluent | Infused over 4 hours |
| Third dose | 100mg to 1000ml diluent | Infused over 16 hours | |
| Loading dose | 15000mg in 200ml diluent | Infused over 1 hour | |
| Adults weighing over 100kg | Second dose | 5000mg in 500ml diluent | Infused over 4 hours |
| Third dose | 10000mg in 1000ml diluent | Infused over 16 hours | |
Compatible diluents include 5% Dextrose in Water, Sterile Water for Injection, or 0.45% Sodium Chloride Injection.
Acetylcysteine Alternatives
Several medications can be used in place of acetylcysteine offering clinicians and patients additional options for treatment of respiratory conditions like pneumonia, cyst fibrosis, and chronic bronchitis. The alternatives include:
- Guaifenesin: It is an expectorant that works by decreasing viscosity and increasing the volume of respiratory tract secretions hence preventing cough. It is often used to treat chest congestion associated with colds, bronchitis, and other respiratory infections.
- Mucomyst: Mucomyst breaks down mucus in the respiratory tract. It helps in treating conditions such as cyst fibrosis, pneumonia, and chronic bronchitis.
- Bromhexine: This medication works by loosening and thinning mucus in the airways, which makes it easier to cough up. The drug is commonly used to treat respiratory conditions such as chronic obstructive pulmonary disease (COPD).
- Mucinex
- Tussin
- Delsym
Acetylcysteine FAQs
What is Acetylcysteine?
It is a type of drug commonly used in the treatment of paracetamol overdose and helps loosen thick mucus in patients suffering from pneumonia, chronic bronchitis, and cyst fibrosis.
How does Acetylcysteine work?
The medication works as an antidote for paracetamol overdose. It replenishes glutathione levels in your liver, which helps in preventing liver damage. Acetylcysteine also acts as a mucolytic agent that helps in loosening and thinning mucus in respiratory conditions like pneumonia and chronic bronchitis helping to clear mucus.
What are the side effects of Acetylcysteine?
The side effects of acetylcysteine include nausea, difficulty breathing and swallowing, heart conditions, blurred vision, fever, runny nose, and chest tightness.
When should Acetylcysteinenot be used?
Avoid using acetylcysteine if you are suffering from an asthmatic condition because the medication may induce bronchospasm if ingested or inhaled.
What is the best time to take Acetylcysteine?
Take acetylcysteine as soon as possible after taking the overdose. The longer you wait after taking an overdose, the less effective acetylcysteine will be safe for your liver.
Can I take acetylcysteine on an empty stomach?
Yes. Acetylcysteine is most effective when taken on an empty stomach.
What is the duration of Acetylcysteine treatment?
The treatment duration of orally administered acetylcysteine is 72 hours.
How long does Acetylcysteine last in your body?
400 mg of Acetylcysteine has a half-life of 6.25 hours when taken orally and 5.58 hours when administered intravenously.
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IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.
