Acetylcysteine ​​- instructions for use, analogs, reviews and release forms (effervescent tablets, 100 mg powder, 200 mg and 600 mg, inhalation and washing solution) cough medicines for sputum in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Acetylcysteine. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Acetylcysteine ​​in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Acetylcysteine ​​in the presence of existing structural analogs.Use for the treatment of bronchitis, pneumonia and other diseases accompanied by cough with phlegm in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Acetylcysteine mucolytic agent, is a derivative of the amino acid cysteine. It has a mucolytic effect, facilitates the escape of sputum due to a direct effect on the rheological properties of sputum. The effect is due to the ability to rupture the disulfide bonds of the mucopolysaccharide chains and cause the depolymerization of sputum mucoproteins, which leads to a decrease in the viscosity of the sputum. The drug remains active in the presence of purulent sputum.

Has an antioxidant effect due to the ability of its reactive sulfhydryl groups (SH-groups) to bind to oxidative radicals and, thus, to neutralize them.

In addition, acetylcysteine ​​promotes the synthesis of glutathione, an important component of the antioxidant system and chemical detoxification of the body. The antioxidant effect of acetylcysteine ​​increases the protection of cells from the damaging effect of free radical oxidation, which is characteristic of an intensive inflammatory reaction.

With the preventive use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations in patients with chronic bronchitis and cystic fibrosis.

Composition

Acetylcysteine ​​+ excipients.

Pharmacokinetics

When ingestion is well absorbed from the digestive tract. It is largely exposed to the effect of the first passage through the liver, which leads to a decrease in bioavailability. Binding to plasma proteins up to 50% (4 hours after ingestion). Metabolised in the liver and, possibly, in the intestinal wall. In plasma is determined in unchanged form, as well as in the form of metabolites - N-acetylcysteine, N, N-diacetylcysteine ​​and cysteine ​​ester. Kidney clearance is 30% of the total clearance.

Indications

Diseases of the respiratory system and condition, accompanied by the formation of viscous and mucopurulent sputum:

• acute and chronic bronchitis;
• tracheitis due to bacterial and / or viral infection;
• pneumonia;
• bronchiectatic disease;
• bronchial asthma;
• atelectasis due to congestion of the bronchi by a mucous plug;
• sinusitis (to facilitate the departure of secretions);
• cystic fibrosis (as part of combination therapy).

Removal of a viscous secretion from the respiratory tract in post-traumatic and postoperative conditions.

Overdose of paracetamol.

Forms of release

The effervescent tablets are 200 mg and 600 mg.

Powder for the preparation of the solution for oral administration of 100 mg and 200 mg.

Solution for inhalation.

Instructions for use and dosing regimen

Inside. Adults - 200 mg 2-3 times per day in the form of granules, tablets or capsules.

Children 2-6 years - 200 mg 2 times a day or 100 mg 3 times a day in the form of a water-soluble granulate; younger than 2 years - 100 mg 2 times a day; 6-14 years - 200 mg 2 times a day.

For chronic diseases for several weeks: adults - 400-600 mg per day in 1-2 divided doses; children 2-14 years - 100 mg 3 times a day; with cystic fibrosis - children from 10 days to 2 years - 50 mg 3 times a day, 2-6 years - 100 mg 4 times a day, over 6 years - 200 mg 3 times a day in the form of water-soluble granules, effervescent tablets or capsules .

Inhalation. For aerosol therapy in ultrasound devices, spray 20 ml of a 10% solution or 2-5 ml of a 20% solution, in devices with a control valve - 6 ml of a 10% solution. The duration of inhalation is 15-20 minutes; multiplicity - 2-4 times a day. In the treatment of acute conditions, the average duration of therapy is 5-10 days; with prolonged therapy of chronic conditions treatment course - up to 6 months.In the case of a strong secretolytic action, the secretion is aspirated, and the frequency of inhalations and the daily dose are reduced.

Intratracheal. To wash the bronchial tree with therapeutic bronchoscopies use a 5-10% solution.

Locally. Burden in the nasal passages of 150-300 mg (per 1 procedure).

Parenteral. Enter intravenously (preferably drip or slow struino - for 5 minutes) or intramuscularly. Adults - 300 mg 1-2 times a day.

Children from 6 to 14 years - 150 mg 1-2 times a day. Children under the age of 6 years are preferred oral intake, children under 1 year of intravenous injection of acetylcysteine ​​is possible only for vital indications in a hospital. In the event that there are still indications for parenteral therapy, the daily dose for children under 6 years of age should be 10 mg / kg of body weight.

For intravenous administration, the solution is further diluted with 0.9% NaCl solution or 5% Dextrose solution in a 1: 1 ratio.

The duration of therapy is determined individually (no more than 10 days). In patients older than 65 years - use the lowest effective dose.

Side effect

• heartburn;
• nausea, vomiting;
• diarrhea;
• sensation of stomach overflow;
• skin rash;
• itching;
• hives;
• bronchospasm;
• with a shallow intramuscular introduction and in the presence of hypersensitivity, there may appear a light and rapidly burning sensation, and therefore it is recommended to inject the drug deep into the muscle;
• reflex cough;
• local irritation of the respiratory tract;
• stomatitis;
• rhinitis;
• nasal bleeding;
• noise in ears;
• reduction of prothrombin time against the appointment of large doses of acetylcysteine ​​(monitoring the condition of the blood coagulation system is necessary);
• change in the results of the quantitative determination test for salicylates (colorimetric test) and the ketone quantification test (sodium nitroprusside test).

Contraindications

• peptic ulcer of the stomach and duodenum in the phase of exacerbation;
• hemoptysis;
• pulmonary hemorrhage;
• pregnancy;
• lactation period (breastfeeding);
• hypersensitivity to acetylcysteine.

Application in pregnancy and lactation

Contraindicated the use of acetylcysteine ​​during pregnancy and lactation (breastfeeding).

Use in children

When using acetylcysteine ​​in patients with bronchial asthma, it is necessary to provide sputum drainage. In newborn infants are used only for vital indications in a dose of 10 mg / kg under the strict supervision of a doctor.

Inside children over 6 years - 200 mg 2-3 times a day; children aged 2 to 6 years - 200 mg 2 times a day or 100 mg 3 times a day, up to 2 years - 100 mg 2 times a day.

special instructions

With caution apply acetylcysteine ​​in patients with bronchial asthma, diseases of the liver, kidneys, adrenals.

Between admission of acetylcysteine ​​and antibiotics should be observed 1-2 hour interval.

Acetylcysteine ​​reacts with certain materials, such as iron, copper and rubber, used in the spraying device. In the places of possible contact with the solution of acetylcysteine, parts made of the following materials should be used: glass, plastic, aluminum, chrome-plated metal, tantalum, silver of the sample or stainless steel. After contact, silver may fade, but this does not affect the effectiveness of acetylcysteine ​​and does not harm the patient.

Drug Interactions

Simultaneous use of acetylcysteine ​​with antitussive agentsmay increase sputum stasis due to suppression of the cough reflex.

When used simultaneously with antibiotics (including tetracycline, ampicillin, amphotericin B), they may interact with the thiol group of acetylcysteine.

With the simultaneous administration of acetylcysteine ​​and nitroglycerin, the vasodilator and antiplatelet effect of the latter may be enhanced.

Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

Pharmaceutically incompatible with solutions of other drugs. Upon contact with metals, rubber forms sulphides with a characteristic odor.

Analogues of the drug Acetylcysteine

Structural analogs for the active substance:

• N-AC-ratopharm;
• N-acetylcysteine;
• Acestin;
• Acetylcysteine ​​Canon;
• Acetylcysteine ​​Teva;
• Acetylcysteine ​​solution for inhalation 20%;
• Acetylcysteine ​​injection 10%;
• Acetylcysteine ​​FS;
• ATSTS;
• ATSTS inject;
• ATSTS Long;
• AC-FS;
• Wicks Active Expectomed;
• Mukobene;
• The mukonist;
• Mukonakes;
• Fluimucil;
• Exomuk 200;
• Espa-Nat.

Analogues on the pharmacological group (secretolitics):

• Althae Syrup;
• Ambrogen;
• Ambroxol;
• Ambrosan;
• Ambrosol;
• Ascoril;
• Bromhexine;
• Bronchicum;
• Bronchicum inhalate;
• Bronchicum cough lozenges;
• Bronchicum cough syrup;
• Bronchipret;
• Bronchostop;
• Bronchotil;
• Gedelix;
• Hexapneumine;
• GeloMirtol;
• Herbion syrup of primrose;
• Herbion syrup of plantain;
• Glycyrs;
• Chest fee;
• Thoracic elixir;
• Josette;
• Doctor IOM;
• Dr. Thysse syrup with plantain;
• Zedex;
• Insty;
• Carbocysteine;
• Cough;
• Kodelak Broncho;
• Broncho's Witchcraft;
• Coldrex bronchus;
• Lazolvan;
• Libexin Muko;
• Linkas;
• Mukaltin;
• Mucosol;
• Expectorant collection;
• Pectosol;
• Pectusin;
• Pertussin;
• Prospan;
• Rinicold Bronho;
• Sinupret;
• Mixture for inhalation;
• Licorice syrup;
• Solutan;
• Stoptussin;
• Pills for cough;
• Terpin hydrate;
• Travisil;
• Tussamag;
• Tussin;
• Tussin plus;
• Fervex from coughing;
• Flavamed;
• Flavamed forte;
• Fluviert;
• Fluidite;
• Haliksol;
• Erdosteine.

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