N acetylcysteine inhalation. N-Acetylcysteine Inhalation: A Comprehensive Guide to Usage, Benefits, and Precautions
How does N-acetylcysteine inhalation work. What are the proper dosage instructions for N-acetylcysteine. Who can benefit from N-acetylcysteine inhalation therapy. What are the potential side effects of N-acetylcysteine inhalation. How should N-acetylcysteine be stored and handled. What precautions should be taken when using N-acetylcysteine inhalation.
Understanding N-Acetylcysteine Inhalation Therapy
N-acetylcysteine (NAC) inhalation is a powerful mucolytic agent used to treat various respiratory conditions. This medication works by breaking down thick mucus in the airways, making it easier for patients to breathe and expel secretions. But how exactly does it function in the body?
NAC belongs to a class of medications known as mucolytic agents. Its primary mechanism of action involves breaking disulfide bonds in mucus proteins, effectively thinning the mucus and reducing its viscosity. This process facilitates easier expectoration and helps clear the airways, providing relief to patients with respiratory issues.
Conditions Treated with N-Acetylcysteine Inhalation
NAC inhalation therapy is prescribed for a range of respiratory conditions characterized by thick or abnormal mucous secretions. These include:
- Asthma
- Emphysema
- Bronchitis
- Cystic fibrosis
In cystic fibrosis, a genetic disorder affecting the lungs and other organs, NAC plays a crucial role in managing respiratory symptoms. The medication helps liquefy the thick, sticky mucus that accumulates in the airways, allowing patients to breathe more easily and reduce the risk of infections.
Proper Administration of N-Acetylcysteine Inhalation
Administering NAC inhalation correctly is essential for achieving optimal therapeutic benefits. How should patients use this medication?
NAC is typically administered via a nebulizer, a device that converts the liquid medication into a fine mist for inhalation. The standard dosage regimen involves using the medication 3 to 4 times daily, but individual prescriptions may vary based on the patient’s condition and response to treatment.
Preparation and Usage Guidelines
To ensure proper use of NAC inhalation:
- Use the medication at consistent times each day to maintain its effectiveness.
- Follow the prescription label instructions carefully.
- Mix the concentrated solution with normal saline or sterile water as directed.
- Use the prepared solution within one hour of mixing.
- Clean the nebulizer thoroughly after each use to prevent clogging and ensure optimal delivery of the medication.
Is there a specific type of nebulizer required for NAC inhalation? Yes, NAC should only be used with nebulizers made of plastic or glass. It’s not recommended for use in hand-bulb operated nebulizers or directly in heated nebulizers.
Potential Side Effects and Precautions
While NAC inhalation is generally well-tolerated, it’s important to be aware of potential side effects. What adverse reactions should patients watch for?
Common side effects of NAC inhalation may include:
- Nausea and vomiting
- Fever
- Runny nose
- Swelling of the mouth interior
- Throat irritation
- Drowsiness
- Cool, moist skin
In rare cases, more serious side effects can occur. Patients should seek immediate medical attention if they experience:
- Chest tightness
- Wheezing
- Difficulty breathing or swallowing
- Coughing up blood
- Hives, rash, or itching
Special Precautions and Considerations
Before starting NAC inhalation therapy, patients should inform their healthcare provider about:
- Any allergies to medications or ingredients in NAC
- All current medications, including prescription, over-the-counter, and herbal supplements
- History of asthma
- Pregnancy or breastfeeding status
Can NAC inhalation interact with other medications? While specific drug interactions are not widely reported, it’s crucial to disclose all current medications to the prescribing physician to avoid potential complications.
Storage and Handling of N-Acetylcysteine
Proper storage and handling of NAC are essential for maintaining its efficacy and safety. How should this medication be stored?
Store NAC in its original container at room temperature, away from excessive heat and moisture. It’s important to note that an opened bottle of NAC may undergo a color change to light purple, but this does not affect its use or efficacy.
Disposal and Expiration Considerations
Dispose of unused or expired medication properly. Consult a pharmacist or local waste disposal company for guidelines on safe disposal methods. Do not flush medications down the toilet or pour them into drains unless instructed to do so.
Alternative Uses of N-Acetylcysteine
While primarily used as an inhalation therapy for respiratory conditions, NAC has other medical applications. Can NAC be used for purposes other than respiratory treatment?
Yes, NAC is sometimes used in the treatment of acetaminophen overdose. In this context, it acts as an antidote by replenishing glutathione stores in the liver, helping to prevent liver damage caused by excessive acetaminophen.
Emerging Research and Potential Applications
Recent studies have explored the potential benefits of NAC in various other conditions:
- Psychiatric disorders, including obsessive-compulsive disorder and bipolar depression
- Substance use disorders
- Neurodegenerative diseases
- Cardiovascular health
While these applications are promising, more research is needed to establish NAC’s efficacy in these areas. Patients should only use NAC for approved indications under medical supervision.
Managing Missed Doses and Overdose Situations
Adherence to the prescribed dosing regimen is crucial for optimal therapeutic outcomes. However, mistakes can happen. How should patients handle missed doses of NAC inhalation?
If a dose is missed, it should be taken as soon as remembered. However, if it’s almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. It’s important not to double up on doses to make up for a missed one, as this could increase the risk of side effects.
Overdose Concerns and Emergency Measures
While overdose with NAC inhalation is rare, it’s essential to be aware of the signs and know how to respond. Symptoms of overdose may include:
- Severe nausea and vomiting
- Difficulty breathing
- Chest pain
- Rapid heartbeat
In case of suspected overdose, seek emergency medical attention immediately. Healthcare providers may need to monitor vital signs and provide supportive care as needed.
Long-Term Considerations and Follow-Up Care
For patients using NAC inhalation as part of their long-term respiratory management plan, regular follow-up with healthcare providers is essential. What should patients expect in terms of ongoing care?
Regular check-ups allow healthcare providers to assess the medication’s effectiveness, monitor for any side effects, and make necessary adjustments to the treatment plan. These visits may include:
- Pulmonary function tests to evaluate lung capacity and function
- Physical examinations to assess overall respiratory health
- Discussion of symptom management and quality of life
- Review of proper medication use and nebulizer maintenance
Lifestyle Modifications and Complementary Therapies
In addition to NAC inhalation, patients with respiratory conditions may benefit from various lifestyle modifications and complementary therapies. These may include:
- Smoking cessation programs
- Pulmonary rehabilitation exercises
- Nutrition counseling to support respiratory health
- Stress management techniques
Incorporating these strategies alongside NAC inhalation therapy can contribute to improved respiratory function and overall well-being.
Future Developments in N-Acetylcysteine Therapy
As medical research continues to advance, new developments in NAC therapy may emerge. What potential innovations might we see in the future of NAC treatment?
Ongoing research is exploring several areas of potential advancement:
- Improved delivery systems for more efficient inhalation therapy
- Combination therapies pairing NAC with other respiratory medications
- Extended-release formulations for longer-lasting effects
- Novel applications in other medical fields, such as neurology and cardiology
These developments hold promise for enhancing the therapeutic potential of NAC and expanding its applications in various medical contexts.
Personalized Medicine Approaches
The future of NAC therapy may also involve more personalized treatment approaches. Genetic testing and biomarker analysis could help identify patients who are most likely to benefit from NAC inhalation, allowing for more targeted and effective treatment strategies.
As research progresses, patients and healthcare providers should stay informed about new developments in NAC therapy to ensure optimal management of respiratory conditions and other potential applications.
Acetylcysteine Oral Inhalation: MedlinePlus Drug Information
pronounced as (a seet” il sis’ teen)
To use the sharing features on this page, please enable JavaScript.
Acetylcysteine inhalation is used along with other treatments to relieve chest congestion due to thick or abnormal mucous secretions in people with lung conditions including asthma, emphysema, bronchitis and cystic fibrosis (an inborn disease that causes problems with breathing, digestion, and reproduction). Acetylcysteine is in a class of medications called mucolytic agents. It works by thinning the mucus in the air passages to make it easier to cough up the mucus and clear the airways.
Acetylcysteine comes as a solution (liquid) and concentrated solution to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled). When using a nebulizer, it is usually used 3 to 4 times a day. When given by other methods, acetylcysteine should be used as directed. Use acetylcysteine at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use acetylcysteine exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Only mix acetylcysteine with other medications if instructed to do so by your doctor.
The concentrated solution of acetylcysteine should be mixed with normal saline or sterile water and used within an hour.
There may be a slight unpleasant odor when you use acetylcysteine that goes away quickly. In an opened bottle of acetylcysteine, there may be a color change to a light purple, but it will not affect use.
Acetylcysteine should only be used with nebulizers made of plastic or glass. Acetylcysteine should not be routinely used in a hand bulb operated nebulizer or put directly into a heated nebulizer. Talk to your doctor or pharmacist about the correct nebulizer to use with acetylcysteine.
Clean your nebulizer immediately following each use. If you do not clean your nebulizer properly, the nebulizer may become clogged and may not allow medication to be inhaled. Follow the manufacturer’s directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your nebulizer.
Acetylcysteine is also sometimes used to treat people who have taken or received an overdose of acetaminophen (Tylenol, others). Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Before using acetylcysteine,
- tell your doctor and pharmacist if you are allergic to acetylcysteine, any other medications, or any of the ingredients in acetylcysteine inhalation. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
- tell your doctor if you have or have ever had asthma.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using acetylcysteine, call your doctor.
Unless your doctor tells you otherwise, continue your normal diet.
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
Acetylcysteine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- nausea
- vomiting
- fever
- runny nose
- swelling of the inside of the mouth
- throat irritation
- drowsiness
- cool, moist skin
Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:
- chest tightness
- wheezing
- difficulty breathing or swallowing
- coughing up blood
- hives
- rash
- itching
Acetylcysteine may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www. fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). After opening, keep this medication in the refrigerator, and dispose of any unused medication after 96 hours.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
- Mucomyst®¶
- N-Acetylcysteine
¶ This branded product is no longer on the market. Generic alternatives may be available.
Last Revised – 03/15/2017
Browse Drugs and Medicines
Acetylcysteine inhalation Uses, Side Effects & Warnings
Save
Generic name: acetylcysteine (inhalation) [ a-SEET-il-SIS-teen ]
Dosage form: inhalation solution (10%; 20%)
Drug classes: Antidotes, Mucolytics
Medically reviewed by Drugs. com on Nov 29, 2022. Written by Cerner Multum.
What is acetylcysteine inhalation?
Acetylcysteine inhalation is used to thin the mucus in people with certain lung conditions such as cystic fibrosis, emphysema, bronchitis, pneumonia, or tuberculosis. Acetylcysteine inhalation is also used during surgery or anesthesia, and to prepare the throat or lungs for a medical test.
Acetylcysteine inhalation may also be used for purposes not listed in this medication guide.
Warnings
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
Before taking this medicine
You should not use acetylcysteine if you are allergic to it.
Tell your doctor if you have asthma.
Tell your doctor if you are pregnant or breastfeeding.
How should I use acetylcysteine inhalation?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Do not use acetylcysteine inhalation at home if you do not fully understand all instructions that are specific to your use of acetylcysteine.
Acetylcysteine inhalation solution can be inhaled directly from the nebulizer or with a face mask, mouth piece, tent, or intermittent positive pressure breathing (IPPB) machine.
Use only the inhaler device provided with your medicine or you may not get the correct dose.
Do not place this medicine directly into a heated nebulizer medicine chamber.
Do not mix your dose of acetylcysteine inhalation until you are ready to use the medicine. Diluted acetylcysteine inhalation must be used within 1 hour of mixing.
Acetylcysteine inhalation liquid may change color once you have opened the bottle. This is caused by a chemical reaction and will not affect the medicine.
You may sense an unusual or unpleasant smell while using acetylcysteine inhalation. This effect should become less noticeable the longer you use the medicine.
Clean your nebulizer right after each use. The residue from acetylcysteine inhalation can clog the parts of the nebulizer.
Store an unopened vial (bottle) of acetylcysteine inhalation at room temperature, away from moisture and heat.
An opened acetylcysteine vial should be stored in a refrigerator, but you must use it within 96 hours (4 days) after opening. Do not allow the medicine to freeze.
What happens if I miss a dose?
Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while using acetylcysteine inhalation?
Do not mix other medicines in a nebulizer with acetylcysteine inhalation, unless your doctor has told you to.
Acetylcysteine inhalation side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Acetylcysteine inhalation may cause serious side effects. Stop using acetylcysteine inhalation and call your doctor at once if you have:
Common side effects of acetylcysteine may include:
sticky feeling around the nebulizer mask;
white patches or sores inside your mouth or on your lips;
nausea, vomiting;
fever, runny nose, sore throat;
drowsiness; or
cold and clammy skin.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect acetylcysteine inhalation?
Other drugs may affect acetylcysteine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
Popular FAQ
Fluimucil is a brand name for acetylcysteine sachets and tablets which may be used to clear phlegm and liquefy thick and viscous mucus secretions caused by respiratory conditions such as acute bronchitis, chronic bronchitis, cystic fibrosis, pneumonia, pulmonary emphysema, or bronchiectasis. It is a type of mucolytic. Fluimucil is available over the counter (without a prescription) in most countries that have it. Continue reading
NAC (N-acetyl cysteine) is a supplement that may be used to help people replenish glutathione – the most powerful antioxidant in the body. Levels of glutathione rapidly deplete during oxidative stress or after acetaminophen overdosage. NAC may also be used to help improve fertility, brain health, heart health, and long-term respiratory conditions (such as Asthma or COPD) and reduce the risk of developing certain cancers. In medicine, NAC has been used as an antidote to acetaminophen overdose since the 1960s and to treat those with acute liver failure. Continue reading
More about acetylcysteine
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (31)
- Side effects
- Dosage information
- During pregnancy
- Drug class: antidotes
- Breastfeeding
Patient resources
- Drug Information
- Acetylcysteine (Inhalation) (Advanced Reading)
- Acetylcysteine (Intravenous) (Advanced Reading)
- Acetylcysteine (Oral) (Advanced Reading)
- Acetylcysteine Effervescent Tablets
Other brands
NAC, Mucomyst, N-A-C Sustain, Acys-5, . .. +2 more
Professional resources
- Prescribing Information
Related treatment guides
- Acetaminophen Overdose
- Diagnostic Bronchograms
- Dietary Supplementation
- Expectoration
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medical Disclaimer
Copyright 1996-2023 Cerner Multum, Inc. Version: 3.01.
instructions for use, indications, composition
Per ampoule:
active substance: acetylcysteine - 1000.0 mg;
excipients: disodium edetate, sodium hydroxide 2 M solution, water for injection.
Cough and cold remedies. Mucolytics.
ATS code: K05CB01.
Mucolytic agent. Liquefies sputum, increases its volume, facilitates sputum separation, promotes expectoration. The action of the drug is associated with the ability of free sulfhydryl groups of acetylcysteine to break intra- and intermolecular disulfide bonds of sputum acid mucopolysaccharides, which leads to depolymerization of mucoproteins and a decrease in sputum viscosity (in some cases this leads to a significant increase in sputum volume, which requires aspiration of bronchial contents). The drug remains active in the presence of purulent sputum.
It has an antioxidant effect due to the presence of the SH group, which is able to interact and neutralize electrophilic oxidative toxins. Acetylcysteine promotes an increase in the synthesis of glutathione, which is an important antioxidant factor in intracellular protection and maintains the functional activity and morphological integrity of the cell.
Does not affect immunity. Increases the secretion of less viscous sialomucins by goblet cells, reduces the adhesion of bacteria to the epithelial cells of the bronchial mucosa. Stimulates the mucous cells of the bronchi, the secret of which lyses fibrin. It has a similar effect on the secret formed in inflammatory diseases of the upper respiratory tract. Protects alpha1-antitrypsin (an elastase inhibitor) from the inactivating effect of HOCI, an oxidizing agent produced by myeloperoxidase of active phagocytes. It also has some anti-inflammatory action (by suppressing the formation of free
radicals and active oxygen-containing substances responsible for the development of inflammation in the lung tissue).
Acute and chronic diseases of the respiratory system, accompanied by increased formation of a viscous secretion that is difficult to separate.
Adults: 3 ml 10% solution (300 mg acetylcysteine) 1-2 times a day.
Children (active participation age): 1.5 ml 10% solution (150 mg acetylcysteine) 1-2 times a day. Duration of treatment: 5-10 days.
For aerosol therapy of respiratory diseases, ultrasound devices and devices with a distribution valve can be used.
If the drug is well tolerated, the frequency of use and doses can be changed by the doctor, taking into account the clinical condition and therapeutic effect, without the need to differentiate doses for adults and children.
Acetylcysteine ampoule is opened before use.
To obtain a 10% (100 mg/ml) solution, the initial 20% (200 mg/ml) solution of acetylcysteine is diluted with water for injection in a ratio of 1:1. When diluted, the solution may acquire a violet-pink color.
The opened ampoule and ready-made solution for inhalation can be stored at a temperature of 2 ° C to 8 ° C for 24 hours (see section “Shelf life”).
When acetylcysteine solution is mixed with bronchodilators or other drugs, it should be used as soon as possible and should not be stored.
Like all medicines, acetylcysteine can cause side effects, although not everyone gets them.
Stop taking acetylcysteine immediately and call your doctor if you experience any of the following side effects:
frequency unknown (frequency of occurrence cannot be determined from the available data): hypersensitivity reactions, bronchospasm, bronchial obstruction.
When using acetylcysteine, the following adverse reactions may also occur:
frequency unknown (based on the available data, the frequency of occurrence cannot be determined): rhinorrhea, stomatitis, nausea, vomiting, urticaria, rash, itching.
Adverse action report
If you experience side effects, tell your doctor. This also applies to any side effects not listed in this package insert. You can also report adverse reactions to the information base, data on adverse reactions (actions) to drugs, including reports of drug inefficiency, identified in the state (UE “Center for Expertise and Testing in Healthcare of the Ministry of Health of the Republic of Belarus”, rceth.by) . By reporting adverse reactions, you help to get more information about the safety of the drug.
– hypersensitivity to acetylcysteine or other components of the drug;
– peptic ulcer of the stomach and duodenum in the acute stage;
– hemoptysis, pulmonary bleeding;
– pregnancy, lactation;
– children’s age up to 6 years.
With caution: gastric ulcer and duodenal ulcer in remission, esophageal varicose veins, bronchial asthma, adrenal disease, liver and / or kidney failure, arterial hypertension.
Symptoms: high doses of the drug can initiate the release of a large amount of bronchopulmonary secretion, which can lead to airway obstruction.
Treatment: mechanical removal of mucus from the tracheobroncheal tree.
The concomitant use of acetylcysteine and antitussive drugs is not recommended. The simultaneous use of these drugs can lead, by inhibition of the cough reflex and physiological self-cleaning of the airways, to the accumulation of secretions with the risk of bronchospasm and upper respiratory tract infection.
The drug should be used with caution in patients with bronchial asthma. In the event of hypersensitivity reactions or bronchospasm, the drug should be stopped immediately and appropriate measures should be taken.
Acetylcysteine should be used with caution in patients with a history of peptic ulcer, especially in the case of concomitant use of other drugs that irritate the gastric mucosa.
The use of acetylcysteine, mainly at the beginning of therapy, can dilute the secret of the bronchial glands and increase its volume. If the patient is unable to effectively cough up sputum, postural drainage and bronchial aspiration should be performed.
When working with the drug, it is necessary to use glassware, avoid contact with metals and rubber (the formation of sulfides with a characteristic odor is possible), easily oxidizing substances.
The faint sulfuric odor of the solution is the characteristic odor of the active substance. The use of acetylcysteine may change the results of the quantitative determination of salicylates by the colorimetric method and the results of the determination of ketones in urine.
Pregnancy
Limited data on the use of the drug during pregnancy did not show an adverse effect on the course of pregnancy or on the health of the fetus or newborn. There is no experience of epidemiological studies.
Animal studies have not revealed direct or indirect toxic effects on pregnancy, embryonic development, fetal development and / or postnatal development. Use during pregnancy is contraindicated.
Lactation
Data on the intake of acetylcysteine in breast milk are not available. Acetylcysteine should not be used during breastfeeding.
There is no evidence of an effect on the reaction rate.
Interaction studies of acetylcysteine with other drugs have only been performed in adults.
The simultaneous use of acetylcysteine and antitussives can lead to the accumulation of bronchial secretions due to the suppression of the cough reflex, so the combined use of these drugs is not recommended.
It is also recommended to avoid the simultaneous use of mucolytics and other substances that inhibit secretion (for example, anticholinergics).
Acetylcysteine can be used together with bronchodilators and vasoconstrictors.
There are literature data on the in vitro interaction of N-acetylcysteine and a number of antibiotics, which indicate a decrease in the activity of antibiotics. In particular, due to the presence of a thiol group (-SH), N-acetylcysteine can react chemically with various penicillins, tetracyclines, cephalosporins, aminoglycosides, macrolides and amphotericin B if these substances are mixed in the same solution. Therefore, as a precaution, it is not recommended to mix the solution of N-acetylcysteine and antibiotics.
The combined use of acetylcysteine and nitroglycerin may enhance the vasodilating and antiplatelet effects of the latter. If the combined use of nitroglycerin and N-acetylcysteine is necessary, blood pressure should be monitored in patients. Patients should be warned about the possibility of lowering blood pressure, which can be severe and accompanied by headache.
Incompatible
Acetylcysteine is incompatible with most metals and is inactivated by oxidizing agents. Therefore, if possible, devices with glass or plastic parts (but not rubber) should be used when using the drug.
If devices with metal or rubber parts are used, rinse immediately with water after use.
Acetylcysteine should not be used in conjunction with other drugs, in particular antibiotics, in the same solution or in the same kit due to lack of compatibility data.
Store in a dark place at a temperature not exceeding 25 °C.
Keep out of the reach of children.
4 years.
Do not use after the expiry date stated on the package.
The opened ampoule and ready-made solution for inhalation can be stored at a temperature of 2 ° C to 8 ° C for 24 hours.
Clear, colorless solution with a characteristic odour. When opening the ampoules, the solution may acquire a violet-pink color.
5 ml glass ampoules. 10 ampoules, together with instructions for use, are placed in a cardboard box. 5 ampoules are placed in a blister pack made of polyvinyl chloride film and aluminum foil, 1 or 2 blister packs, together with instructions for use, are placed in a cardboard pack.
On prescription.
Manufacturer:
RUE “Belmedpreparaty”,
Republic of Belarus, 220007, Minsk, st. Fabritsiusa, 30, phone/fax: (+37517) 220 3716, e-mail: [email protected]
The use of N-acetylcysteine in children: current data and new opportunities | Drones
1. Suddarth S.B. Acetylcysteine, a new and effective mucolytic agent. Bull. Geisinger. 1963; 15:65–69.
2. Geppe N.A., Malakhov A.B. Mucolytic and antitussive drugs in pediatric practice (lecture). Children’s doctor. 1999; (4): 42–45
3. Morozova T.E., Andrushishina T.B. Acetylcysteine in clinical practice. Doctor. 2007; (12): 37–38.
4. Chalumeau M., Duijvestijn Y.C. Acetylcysteine and carbocysteine for acute upper and lower respiratory tract infections in pediatric patients without chronic broncho-pulmonary disease. Cochrane Database Syst. Rev. 2013; (5): CD003124. DOI: 10.1002/14651858.CD003124.pub4.
5. Chikina S.Yu., Chuchalin A.G. N-acetylcysteine: are we using all the possibilities? Atmosphere. Pulmonology and Allergology. 2013; (1): 20–26.
6. Aruoma O. I., Halliwell B., Hoey B.M., Butler J. The antioxidant action of N-acetylcysteine: its reaction with hydrogen peroxide, hydroxyl radical, superoxide, and hypochlorous acid. Free radical. Biol. Med. 1989; 6(6):593-597. DOI: 10.1016/0891-5849(89)
-X.
7. Barnes P.J. chronic obstructive pulmonary disease. N. Engl. J. Med. 2000; 343(4):269-280. DOI: 10.1056/NEJM200007273430407
8. Yoon E., Babar A., Choudhary M. et al. Acetaminophen-induced hepatotoxicity: a comprehensive update. J.Clin. Transl. Hepatol. 2016; 4(2): 131–142. DOI: 10.14218/JCTH.2015.00052.
9. Savyuk F., Danel V., Zobnin Yu.V. Acute paracetamol poisoning: emergency care. Siberian Medical Journal. 2008; (6): 107–111.
10. Jaeschke H. Acetaminophen: dose-dependent drug hepatotoxicity and acute liver failure in patients. Dig. Dis. 2015; 33(4): 464–471. DOI: 10.1159/000374090.
11. American Academy of Pediatrics. Committee on Drugs. Acetaminophen toxicity in children. Pediatrics. 2001; 108(4): 1020–1024. DOI: 10.1542/peds.108.4.1020.
12. Heard K.J. Acetylcysteine for acetaminophen poisoning. N. Engl. J. Med. 2008; 359(3): 285–292. DOI: 10.1056/NEJMct0708278.
13. Smilkstein M.J., Knapp G.L., Kulig K.W., Rumack B.H. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985). N. Engl. J. Med. 1988; 319(24): 1557–1562. DOI: 10.1056/NEJM198812153192401.
14. Brok J., Buckley N., Gluud C. Interventions for paracetamol (acetaminophen) overdose. Cochrane Database Syst. Rev. 2006; (2): CD003328. DOI: 10.1002/14651858.CD003328.pub2.
15. Mehrpour O., Ballali-Mood M. Why not formulate an acetaminophen tablet containing N-acetylcysteine to prevent poisoning? J. Med. Toxicol. 2011; 7(1): 95–96. DOI: 10.1007/s13181-010-0126-2.
16. El-Ebiary A.A., Elsharkawy R.E., Soliman N.A. et al. N-acetylcysteine in acute organophosphorus pesticide poisoning: a randomized, clinical trial. basic. Clin. Pharmacol. Toxicol. 2016; 119(2): 222–227. DOI: 10.1111/bcpt.12554.
17. Tehrani H., Halvaie Z., Shadnia S. et al. Protective effects of N-acetylcysteine on aluminum phosphide-induced oxidative stress in acute human poisoning. Clin. Toxicol. (Phil.). 2013; 51(1):23–28. DOI: 10.3109/15563650.2012.743029.
18. Montanini S., Sinardi D., Praticò C. et al. Use of acetylcysteine as the life-saving antidote in Amanita phalloides (death cap) poisoning. Case report on 11 patients. Arzneimittelforschung. 1999; 49(12): 1044–1047.
19. Kasperczyk S., Dobrakowski M., Kasperczyk A. et al. Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers. Toxicol. Ind. health. 2016; 32(9): 1607–1618. DOI: 10.1177/0748233715571152.
20. Baniasadi S., Eftekhari P., Tabarsi P. et al. Protective effect of N-acetylcysteine on antituberculosis drug-induced hepatotoxicity. Eur. J. Gastroenterol. Hepatol. 2010; 22(10): 1235–1238. DOI: 10.1097/MEG.0b013e32833aa11b.
21. Karimzadeh I., Khalili H., Sagheb M.M., Farsaei S. A double-blinded, placebo-controlled, multicenter clinical trial of N-acetylcysteine for preventing amphotericin B-induced nephrotoxicity. Expert Opin. drug metab. Toxicol. 2015; 11(9): 1345–1355. DOI: 10.1517/17425255.2015.1042363.
22. Kocyigit I., Vural A., Unal A. et al. Preventing amikacin related ototoxicity with N-acetylcysteine in patients undergoing peritoneal dialysis. Eur. Arch. Otorhinolaryngol. 2015; 272(10): 2611–2620. DOI: 10.1007/s00405-014-3207-z.
23. Feldman L., Efrati S., Eviatar E. et al. Gentamicin-induced ototoxicity in hemodialysis patients is ameliorated by N-acetylcysteine. Kidney Int. 2007; 72(3): 359–363. DOI: 10.1038/sj.ki.5002295.
24. Blasi F., Page C., Rossolini G.M. et al. The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections. Respir. Med. 2016; 117:190–197. DOI: 10.1016/j.rmed.2016.06.015.
25. Domenech M., Garcia E. N-acetyl-cysteine and cysteamine as new strategies against mixed biofilms of nonencapsulated Streptococcus pneumoniae and nontypeable Haemophilus influenza. Antimicrob. Agents Chemother. 2017; 61(2): e01992-16. DOI: 10.1128/AAC.01992-16.
26. Dinicola S., De Grazia S., Carlomagno G., Pintucci J.P. N-acetylcysteine as a powerful molecule to destroy bacterial biofilms. A systematic review. Eur. Rev. Med. Pharmacol. sci. 2014; 18(19): 2942–2948.
27. Leite B, Gomes F, Teixeira P. et al. Staphylococcus epidermidis biofilms control by N-acetylcysteine and rifampicin. Am. J. Ther. 2013; 20(4): 322–328. DOI: 10.1097/MJT.0b013e318209e17b.
28. Macchi A., Ardito F., Marchese A. et al. Efficacy of N-acetyl-cysteine in combination with thiamphenicol in sequential (intramuscular/aerosol) therapy of upper respiratory tract infections even when sustained by bacterial biofilms.