Drug Index

Acetyl Cysteine

Synonym :

N-Acetyl Cysteine

Mechanism :

Acetylcysteine is the N-acetyl derivative of the naturally-occurring amino acid, cysteine. The compound is a white crystalline powder with the molecular formula C5H9NO3S5 a molecular weight of 163.2, and chemical name of N-acetyl-L-cysteine.
Acetylcysteine has mucolytic function which is related to the sulfhydryl group in the molecule. This group "opens" disulfide linkages in mucus thus lowering the viscosity.

Indication :

• Acetaminophen toxicity

• Post liver transplant

• Acute liver failure

• Adjunctive therapy in patients with abnormal or viscid mucous secretions in bronchopulmonary diseases, pulmonary complications of surgery, and cystic fibrosis.

• Meconium ileus

Contraindications :

In patients with a prior history of hypersensitivity to any of the ingredients. Also, in asthmatics and patients with history of bronchospasm.

Dosing :

Only the 72-hour oral and 21-hour IV regimens are FDA approved.

Paracetamol overdose: (ideally within 8-10 hours following ingestion)

IV: Loading dose of 150 mg/kg IV in D5W infused over 1 hour, followed by 50 mg/kg in D5W infused over 4 hours and then 100 mg/kg IV in D5W infused over 16 hours.

Oral: 75 mg/kg orally every 4 hours for next 2-3 days.

Acute liver failure:

IV: 100 mg/kg/d IV infusion upto 72 hours.


Administer aerosolized bronchodilator 10-15 minutes prior to acetylcysteine nebulization.

1-11 months: 1-2 mL of 20% or 2-4 mL of 10% solution by nebulizer every 6-8 hours as when required.

12 months-11 years: 3-5 mL of 20% or 6-10 mL of 10% solution by nebulizer every 6-8 hours.

>11 years: 6-10 ml of 10% solution or 3-5 ml of 20% solution by nebulizer every 6-8 hours.

Adverse Effect :

Anaphylaxis and hypersensitivity reactions causing flushing, urticaria, angioedema, nausea, vomiting, tachycardia, hypotension, bronchospasm, chest tightness, disagreeable odour, drowsiness, fever, hemoptysis, increased volume of bronchial secretions.

Interaction :

There are no significant drug interactions with acetylcysteine however caution must be taken while administering it with:

Auranofin, activated charcoal and Gold sodium thiomalate: May decrease the efficacy of acetylcysteine.

03/07/2020 02:58:14 Acetyl Cysteine
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