Acetylcysteine ((r) -2-acetamide-3-mercaptopropanoic acid) is a bronchosecretory, mucolytic and expectorant agent with moderate anti-inflammatory activity. acetylcysteine thins phlegm, increases its volume, facilitates excretion, promotes expectoration. the mechanism of action is due to the ability of its sulfhydryl groups to break the disulfide bonds of acidic mucopolysaccharides of sputum, which leads to a decrease in the viscosity of mucus. exhibits a stimulating effect on mucosal cells, the secretion of which lyses fibrin. the preparation also has anti-inflammatory activity due to the inhibition of free radical processes, which is a pathogenetic link in the development of acute and chronic inflammation in the tissues of the respiratory tract. acetylcysteine promotes the synthesis of glutathione - the most important link in the intracellular antioxidant defense system, and also promotes detoxification processes.
When taken orally, it is well absorbed in the digestive tract. During the initial passage through the liver, it is deacetylated with the formation of cysteine, which leads to a relatively low bioavailability of acetylcysteine (about 10%). The maximum concentration in blood plasma is reached within 1-3 hours after administration. Plasma protein binding is about 50%. Penetrates the placental barrier. The half-life from blood plasma is 1 hour, with cirrhosis of the liver, its duration increases to 8 hours. It is metabolized in the liver. It is excreted from the body mainly by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine), a small part is eliminated unchanged through the intestines.
Diseases of the respiratory system and conditions accompanied by the formation of a viscous secretion: acute and chronic bronchitis, tracheitis due to bacterial or viral infection, pneumonia, bronchiectasis, BA, atelectasis due to bronchial obstruction by a mucous plug, cystic fibrosis (as part of combination therapy), rhinitis, sinusitis. also used to remove viscous secretions from the respiratory tract in patients after injuries and surgical interventions. as an antidote for paracetamol poisoning.
The preparation is taken orally after meals. the contents of one package are dissolved in half a glass (approximately 100 ml) of drinking water immediately before taking.
For acute and chronic respiratory diseases: adults and adolescents over the age of 14 years - 200 mg of acetylcysteine 3 times a day or 600 mg 1 time a day; children aged 6-14 years - 200 mg 2 times a day or 100 mg 3 times a day; children 2-5 years old - 100 mg 2-3 times a day; children under 2 years of age and newborns (from the 10th day of life) - 50 mg 2-3 times a day.
For cystic fibrosis: patients weighing more than 30 kg - up to 800 mg / day, children over 6 years old - 200 mg 3 times a day, children 2-6 years old - 100 mg 4 times a day, children aged 2 weeks up to 2 months - 50 mg 2-3 times a day.
The course of treatment, as a rule, ranges from 5-7 days (for acute diseases) to several weeks (for chronic diseases).
Peptic ulcer of the stomach and duodenum in the acute phase, hemoptysis, pulmonary hemorrhage, liver disease, pregnancy, hypersensitivity to the components of the preparation.
Heartburn, nausea, vomiting, diarrhea, full stomach, urticaria.
The use of the preparation in newborns and children under the age of 1 year is possible only under medical supervision. with caution prescribed for BA, kidney and adrenal gland diseases. when used in persons with ba, it is necessary to ensure drainage of sputum.
The mucolytic effect is enhanced by additional fluid intake.
Application for purulent bronchitis and cystic fibrosis must be combined with active sputum evacuation, with obstructive bronchitis (with caution) - with the use of bronchodilators.
Acetylcysteine passes into breast milk, and therefore its use during breastfeeding is possible only in cases where the intended benefit to the mother outweighs the potential risk to the baby.
Combined use with preparations that suppress the cough center is not recommended due to the possible risk of sputum stagnation due to suppression of the cough reflex. the preparation enhances (mutually) the effect of bronchodilators.
Reduces the absorption of penicillins, cephalosporins, tetracyclines (the interval between doses should be at least 2 hours).
The preparation can enhance the vasodilating effect of nitroglycerin. Reduces the hepatotoxicity of paracetamol, phenacetin.
Severe and dangerous side effects in case of preparation overdose have not been identified.
In a dry, dark place at a temperature of 15-25 ° C.
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