Acetylcysteine

Effervescent tab: Should be taken with food. Dissolve in 1/2 glass of water before taking.

For mucolytic use (oral): Children <2 years.

Patient with asthma, history of bronchospasm, atopy; decreased cough reflex (e.g. frail patient), predisposition to gastrointestinal haemorrhage [e.g. oesophageal varices, peptic ulcer] (oral). Patient requiring fluid restriction or who weighs ≤40 kg (IV). Acetylcysteine is available in multiple dosage forms, refer to detailed product guidelines for specific recommendations. Children. Pregnancy and lactation. Patient Counselling Ophthalmic: This drug may cause blurred vision after use, if affected, do not drive or operate machinery. Remove contact lenses before administration and allow a 15-minute interval before reinserting lenses. Monitoring Parameters Monitor pulmonary function and response to treatment. For paracetamol poisoning: Monitor serum paracetamol concentrations, AST, ALT, bilirubin, prothrombin time, INR, serum creatinine, BUN, serum glucose, Hb, haematocrit, and electrolytes; re-assess LFTs 4-6 hourly for possible hepatotoxicity. Observe for anaphylactoid reactions (particularly with IV use).

Significant: Increased risk of upper gastrointestinal haemorrhage (oral), small increase in prothrombin time (IV). Rarely, bronchospasm; serious skin reactions (e.g. Stevens-Johnson syndrome, Lyell's syndrome), generalised urticaria (oral). Blood and lymphatic system disorders: Thrombocytopenia (IV). Cardiac disorders: Tachycardia; cardiac arrest (IV). Ear and labyrinth disorders: Tinnitus (oral). Eye disorders: Eye irritation, pain or swelling, blurred vision. Gastrointestinal disorders: Nausea, vomiting, stomatitis; diarrhoea, abdominal pain (oral). General disorders and administration site conditions: Pyrexia, chest tightness; malaise, facial pain (IV). Metabolism and nutrition disorders: Acidosis (IV). Musculoskeletal and connective tissue disorders: Arthralgia, arthropathy (IV). Nervous system disorders: Headache (oral); drowsiness (inhalation/endotracheal). Psychiatric disorders: Anxiety (IV). Respiratory, thoracic and mediastinal disorders: Rhinorrhoea; throat tightness, pharyngitis, rhonchi, cough, stridor (IV); tracheal and bronchial tracts irritation (inhalation/endotracheal). Skin and subcutaneous tissue disorders: Pruritus, rash, angioedema; exanthema (oral); hyperhidrosis (IV). Vascular disorders: Hypotension; flushing, vasodilation, syncope, cyanosis (IV).
Potentially Fatal: Fluid overload resulting in hyponatraemia and seizures (IV). Rarely, anaphylactoid reactions (particularly with IV use).

Concomitant use with antitussives may lead to a build-up of secretions due to suppressed cough reflex; avoid concurrent use. May increase the vasodilatory and platelet aggregation-inhibiting effect of glyceryl trinitrate.

Antidotes, Detoxifying Agents & Drugs Used in Substance Dependence / Cough & Cold Preparations / Other Eye Preparations

S01XA08 - acetylcysteine ; Belongs to the class of other ophthalmologicals.
V03AB23 - acetylcysteine ; Belongs to the class of antidotes. Used to neutralize paracetamol overdose.
R05CB01 - acetylcysteine ; Belongs to the class of mucolytics. Used in the treatment of wet cough.