Acetylcysteine: Indications, dosage and side effects

Article by Pharmacist Nguyen Thu Giang - Faculty of Pharmacy, Vinmec Times City International General Hospital.

Acetylcysteine is a drug used quite commonly to treat cough with phlegm and is easily purchased without a prescription in pharmacies with many different brand names, many different forms of use, suitable for subjects from children to children. children to adults. However, that does not mean that you can abuse the drug.

1. Designation

The drug is recommended by the manufacturer to be used in the following cases:
Clear mucus in some respiratory diseases with increased mucus secretion due to cutting disulfide bonds in mucoproteins (components of mucus) so it reduces the viscosity of the mucus. slime of mucus. From there, the mucus is more easily expelled from the airways by coughing, postural drainage or by mechanical means. In addition, acetylcysteine is also used as an antidote to paracetamol overdose and to reduce the nephrotoxicity of contrast agents.

2. Dosage form

The drug has many different dosage forms suitable for different indications:
Common oral route includes 200mg tablets, 100mg powder packs, 200mg Oral solution, drops into the trachea and 100mg oral medicine/ mL, 200mg/mL Concentrate for injection: 200mg/mL for solution for infusion. In Vietnam, the majority of cases use acetylcysteine in the form of tablets or powder packs to dissolve phlegm.

Acetylcystein là thuốc được sử dụng khá phổ biến để điều trị ho có đờm

3. Dosage

According to the Vietnam National Pharmacopoeia 2015, the dose for the indications for sputum expectoration is as follows:
Adults and children over 7 years old: 200mg/time x 3 times/day. The maximum dose should not exceed 600mg/day Children from 2-7 years old: 200mg/time x 2 times/day. Children < 2 years old: 50mg/time x 2-3 times/day. However, especially for children under 2 years old, use the drug with extreme caution because it is difficult for this subject to expel sputum actively, there is a higher risk of unwanted reactions, especially the risk of respiratory failure. Therefore, most manufacturers recommend not using this product for children < 2 years old.

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4. Side effects

Possible side effects when using the product include:
Common with incidence > 1% include: nausea, vomiting, facial flushing, edema, heart palpitations Uncommon with an incidence from 0.1% - 1% include: drowsiness, headache, tinnitus, stomatitis, runny nose, day rales, rash, urticaria Rare but serious include: bronchospasm causing difficulty breathing, respiratory failure respiratory, systemic anaphylaxis, fever, chills.

5. Note when using

When taking acetylcysteine, it should be noted:
To reduce the possibility of vomiting due to the drug can be diluted oral solution (if mixed with powder package) or drink a lot of water (if taking tablets) Do not use concurrently with other cough medicines or any drug that reduces sputum secretion. If you have a history of asthma, tell your doctor or pharmacist for close monitoring. If before using the medicine, you have decreased ability or have difficulty coughing, then after taking the medicine, you may need to have sputum aspirated. Read the ingredients carefully (including excipients) because some products contain sorbitol, be careful if you can't use sugar Source: Vietnam National Pharmacopoeia 2015, Medicines.org.uk

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