Dosing & Uses
Dosage Forms & Strengths
nebulizer solution
- 10%
- 20%
Pulmonary Disease
Facilitation of expectoration via mucolysis
Solution (10 and 20%) may be used undiluted; 3-5 mL of 20% solution or 6-10 mL of 10% solution; administer 1 to 10 mL of 20% solution every 6-8 hours or 2 to 20 mL of 10% every 2 to 6 hours
Diagnostic Bronchography
1-2 mL of 20% solution or 2-4 mL of 10% solution administered 2-3 times by nebulization or by intratracheal instillation before procedure
Acetaminophen Overdose
See separate drug monograph, acetylcysteine (antidote)
Contrast Agent-Associated Nephrotoxicity (Off-label)
Prevention
600 mg PO q12hr for 2 days on day before and day of contrast agent administration
Keratoconjunctivitis Sicca (Off-label)
1 drop of 10% solution in eye(s) q6-8hr
Dosing Considerations
Direct instillation: 1-2 mL of 10% or 20% solution q1hr PRN
Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution q1-4hr by direct instillation into tracheotomy
Instillation into segment of bronchopulmonary tree via small plastic catheter into trachea (under local anesthesia and direct vision): 2-5 mL of 20% solution via syringe connected to catheter
Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution q1-4hr via syringe connected to catheter
Administration
Administer aerosolized bronchodilator 10-15 minutes before administering acetylcysteine via nebulization
Nebulizer solution may also be administered PO
Dosage Forms & Strengths
nebulizer solution
- 10%
- 20%
Pulmonary Disease
Facilitation of expectoration via mucolysis
1-11 months: 1-2 mL of 20% solution or 2-4 mL of 10% solution by nebulization q6-8hr PRN
>11 years: Solution (10 and 20%) may be used undiluted; 3-5 mL of 20% solution or 6-10 mL of 10% solution; administer 1 to 10 mL of 20% solution every 3 to 4 times/day or 2 to 20 mL of 10% every 2 to 6 hours
Acetaminophen Overdose
See separate drug monograph, acetylcysteine (antidote)
Ototoxicity Caused by Platinum-Based Chemotherapy (Orphan)
Prevention of ototoxicity caused by platinum-based chemotherapeutic agents used to treat pediatric cancers
Orphan sponsor
- Galephar Pharmaceutical Research, Inc, Road 198, No. 100 km. 14.7, Juncos Industrial Park, Juncos 00777-3873, Puerto Rico
Keratoconjunctivitis Sicca (Off-label)
1 drop of 10% solution in eye(s) q6-8hr
Dosing Considerations
Direct instillation: 1-2 mL of 10% or 20% solution q1hr PRN
Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution q1-4hr by direct instillation into tracheotomy
Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution q1-4hr via syringe connected to catheter
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (1)
- activated charcoal
activated charcoal decreases effects of acetylcysteine by Other (see comment). Use Caution/Monitor. Comment: Conflicting reports exist; however, charcoal administration does not preclude acetylcysteine administration for acetaminophen overdose .
Minor (7)
- nitroglycerin IV
acetylcysteine increases effects of nitroglycerin IV by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin PO
acetylcysteine increases effects of nitroglycerin PO by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin rectal
acetylcysteine increases effects of nitroglycerin rectal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin sublingual
acetylcysteine increases effects of nitroglycerin sublingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin topical
acetylcysteine increases effects of nitroglycerin topical by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin transdermal
acetylcysteine increases effects of nitroglycerin transdermal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
- nitroglycerin translingual
acetylcysteine increases effects of nitroglycerin translingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.
Adverse Effects
Frequency Not Defined
Bronchoconstriction
Bronchospasm
Calmness
Chest tightness
Disagreeable odor
Drowsiness
Fever
Hemoptysis
Increased volume of bronchial secretions
Irritation of tracheal or bronchial tract
Nausea
Rhinorrhea
Stomatitis
Vomiting
Warnings
Contraindications
Acute asthma
Documented hypersensitivity
Cautions
Volume of bronchial secretions may increase after administration; if cough response is inadequate, consider maintaining airway by mechanical suction if necessary; if airway block arises because of foreign body or local accumulation, clear by endotracheal aspiration, with or without bronchoscopy
Not for injection
Use with caution in patients with asthma or history of bronchospasm; these patients are at increased risk of hypersensitivity reactions
In most instances, bronchospasm may be treated by prompt administration of bronchodilator via nebulization; if bronchospasm worsens, discontinue therapy immediately
Slight disagreeable odor after administration (temporary)
Face mask may produce sticky film on face after nebulization; remove with water
Under certain conditions, opened bottle may cause slight purple color change as consequence of chemical reaction; this has no effect on drug safety or efficacy
Keratoconjunctivitis: Remove contact lenses; do not coadminister with topical antibiotics
Since increased bronchial secretions may occur after inhalation, postural drainage, inhalation percussion, and suctioning should follow; if bronchospasm occurs, administer a bronchodilator; discontinue therapy if bronchospasm progresses
Pregnancy & Lactation
Pregnancy category: B
Lactation: Unknown whether agent is excreted in milk; use with caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Exerts mucolytic activity through sulfhydryl group, which opens up disulfide bonds in mucoproteins and lowers mucous viscosity of pulmonary secretions
Absorption
Onset: 5-10 min
Peak plasma time: 1-2 hr
Distribution
Duration: Variable (~1 hr)
Protein bound: 80%
Metabolism
Metabolized in liver
Elimination
Excretion: Urine (primarily)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine - | 100 mg/mL (10 %) vial |  | |
| acetylcysteine oral - | 600 mg capsule |  | |
| NAC oral - | 600 mg capsule |  | |
| N-A-C Sustain oral - | 600 mg tablet |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| acetylcysteine intravenous - | 200 mg/mL (20 %) vial |  | |
| Acetadote intravenous - | 200 mg/mL (20 %) vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
acetylcysteine
ACETYLCYSTEINE - ORAL INHALATION/ORAL
(a-SEET-il-SIS-teen)
COMMON BRAND NAME(S): Mucomyst
USES: When inhaled by mouth, acetylcysteine is used to help thin and loosen mucus in the airways due to certain lung diseases (such as emphysema, bronchitis, cystic fibrosis, pneumonia). This effect helps you to clear the mucus from your lungs so that you can breathe easier.When taken by mouth, acetylcysteine is used to prevent liver damage from acetaminophen overdose.
HOW TO USE: If you are using this medication to treat lung disease, inhale this medication by mouth as directed by your doctor. A health care professional will show you the proper way to use this medication. Learn all preparation and usage instructions.You may notice a slight odor when you first breathe in the medication. This odor will quickly go away. If you are using a face mask to breathe in the medication, there may be some stickiness on your face after use. Wash your face with water to remove the stickiness.Do not mix acetylcysteine with other inhaled medications unless directed by the doctor or pharmacist.If you are taking this medication by mouth, take it as directed by your doctor. The solution is usually mixed with another liquid (such as cola) to decrease nausea and vomiting. Drink the medication within 1 hour of mixing.Tell your doctor if you vomit within 1 hour after taking your medication. You may need to take another dose.The dosage is based on your medical condition and response to treatment. For acetaminophen overdose, the dosage is also be based on your weight.Tell your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: Nausea and vomiting may occur. Mouth sores and runny nose may also occur if you are inhaling this medication by mouth. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.If you are taking this medication by mouth, tell your doctor right away if any of these unlikely but serious side effects occur: severe stomach/abdominal pain, black stools, vomit that looks like coffee grounds.If you are inhaling this medication by mouth, seek immediate medical attention if any of these rare but very serious side effects occur: chest pain/tightness, trouble breathing.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using acetylcysteine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, stomach/intestinal ulcer.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.This medication may interfere with certain laboratory tests (including urine ketone test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.For acetaminophen overdose, laboratory and/or medical tests (such as liver/kidney function test, acetaminophen drug levels, blood mineral levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
MISSED DOSE: If you are using this medication to treat lung disease and miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.If you are using this medication to treat acetaminophen overdose, it is important to take each dose as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.
STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light. After opening the vial, store in the refrigerator between 35-46 degrees F (2-8 degrees C) and use within 96 hours (4 days). The solution may change to a light purple color. This is normal and will not affect how the drug works. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised December 2021. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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