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At a glance

Acetylcysteine is a mucolytic agent that thins thick mucus in the airways, making it easier to cough out. It is used in respiratory diseases like bronchitis, asthma, and COPD, and also as an antidote for paracetamol overdose.

Indications

Respiratory diseases (chronic bronchopulmonary diseases such as COPD, emphysema with bronchitis, chronic asthmatic bronchitis, bronchiectasis; acute bronchopulmonary diseases such as asthma, bronchitis, bronchopneumonia, tracheobronchitis, bronchiolitis, pulmonary complications of cystic fibrosis, surgery-related pulmonary complications), paracetamol overdose (antidote).

Pharmacology

Acetylcysteine reduces the viscosity of secretions by splitting disulphide bonds in mucoproteins and provides antisecretory effects. It has antioxidant properties by reacting with free radicals and serving as a precursor to glutathione. In paracetamol overdose, it detoxifies the toxic intermediate metabolite N-acetyl-p-benzoquinone imine (NAPQI) to prevent liver damage.

Dosage

Effervescent/Dispersible Tablet (Adults & children >6 years): 600 mg once daily (evening), 5-10 days (acute) or long-term (chronic).

Effervescent Granules:

  • Adults & children >6 years: 200 mg 2-3 times/day OR 100 mg 2 sachets 2-3 times/day
  • Children 2-6 years: 100 mg 2-4 times/day (age-dependent)

Nebuliser Solution:

  • Adults: 5-10 mL of 10% or 20% solution every 6-8 hours
  • Infants 1-11 months: 1-2 mL of 20% or 2-4 mL of 10% solution every 6-8 hours
  • Children 12 months-11 years: 3-5 mL of 20% or 6-10 mL of 10% solution every 6-8 hours

Paracetamol Overdose (Oral): Loading dose: 140 mg/kg, then maintenance: 70 mg/kg every 4 hours (total 17 doses).

Side effects

Common side effects: Headache, nausea, vomiting, abdominal pain, diarrhea, fever, rash, stomatitis, pruritus, urticaria, tachycardia, hypotension, tinnitus.

Serious side effects (rare): Anaphylactic shock, severe skin reactions, dyspnea, bronchospasm (especially in asthma patients).

Use in pregnancy

Generally considered safe during pregnancy (Pregnancy Category: B). Animal studies have shown low or no adverse effects on the fetus; human studies are limited.

Pregnancy Category: B — always consult a doctor before taking during pregnancy.

Precautions & warnings

Bronchial asthma: Strict monitoring required during therapy; discontinue if bronchospasm occurs.

Peptic ulcer: Caution in patients with history.

Sodium-controlled diet: Each dose contains sodium (156.9 mg).

Pregnancy & lactation: Use under medical advice.

Sulfurous odor: Characteristic of the drug, not a sign of deterioration.

Overdose effects

Overdose symptoms: nausea, vomiting, diarrhea.

Storage conditions

Store in a cool and dry place, protected from light.

Acetylcysteine — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.