خواص دارویی و گیاهی
2-Acetamido-3-sulfanylpropanoic acid[۱]
CC(=O)NC(CS)C(O)=O
قرص eff nac
InChI=1S/C5H9NO3S/c1-3(7)6-4(2-10)5(8)9/h4,10H,2H2,1H3,(H,6,7)(H,8,9) NKey: PWKSKIMOESPYIA-UHFFFAOYSA-N N
℞-only(US)
استیل سیستئین (به انگلیسی: ACETYLCYSTEINE) خلط‌آور است که به اشکال دارویی قرص و قرص جوشان مصرف می‌شود.
کاربرد اصلی این دارو در مسمومیت با استامینوفن و نیز جهت کمک به دفع خلط مجاری تنفسی بکار می‌رود.
سایر موارد کاربرد :
در درمان اعتیاد به کوکایین[۲] ـ ماری جوانا[۳]، سیگار کشیدن (کاهش استفاده) [۴] و قمار[۵]
افسردگی دوقطبی[۶]
روان گسیختی [۷]
درخودماندگی(اوتیسم)[۸]
وسواس کندن موها (تریکوتیلومانیا)[۹]
استیل سیستئین خوراکی همچنین برای پیشگیری از نوعی نارسایی حاد کلیه مورد استفاده قرار می‌گیرد.[۱۰]
در درمان مسمومیت با استامینوفن این دارو با احیای گلوتاتیون (گلوتاتیون متابولیت سمی استامینوفن به نام NAPQI را خنثی می‌کند) موجب کاهش آسیب کبدی استامینوفن و خنثی شدن آن می‌گردد.
عوارض این دارو خیلی شایع نیست ولی می‌توان به عوارض واکنش‌های حساسیتی،انقباض برونش و کاهش spo2 ،ادم صورت،بثورات جلدی اشاره نمود.
مصرف طولانی مدت مداوم آن منجر به اسیب ریه می‌شود.
Department of Clinical Toxicology and Forensic Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Ghaffari Avenue, Birjand, Iran
Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Letter to the Editor:
Acetaminophen (N-acetyl-p-aminophenol) or paracetamol is a widely used over-the-counter analgesic. Acetaminophen (AP) overdosage has caused acute liver failure in most countries. It was responsible for 50% of acute liver failure in the USA [1].
AP was the most common drug used in overdose, as it caused 48% of drug overdoses in Oxford. In the USA, the cost of treating patients with AP overdose was estimated at over $87 million every year [1].قرص eff nac
l-Methionine and cysteamine [2] were first used as antidotes for treatment of AP poisoning, but their side effects (vomiting, flushing, and misery) led researchers to find alternative treatments.
Several decades of experience have proven that N-acetylcysteine (NAC) is the antidote of choice for AP poisoning. Very few adverse effects are known for NAC such as nausea and vomiting and unpleasant smell and taste in high doses [3]. However, in a large study, only 5% of the cases required intravenous NAC because they did not tolerate oral administration [4]
Despite worldwide use of high doses of NAC for the treatment of AP poisoning, there is no evidence of toxicity of NAC in human beings [3, 5, 6].It has also been reported that even long-term high-dose NAC ingestion is safe [7].
The golden time for administration of NAC as a protective antidote is the first 8 h after overdose. Thus, NAC should be given as soon as possible after AP overdose. It is therefore recommended to formulate a tablet containing AP and NAC.
There have been two preparations of AP and methionine which are sold out for some time. They were removed from the market. However, NAC is safer and more effective than methionine.
Since NAC should be administered for 20 h and longer, a sustain release preparation of NAC is ideal for combination with AP. This of course requires experimental works both in vitro pharmaceutical investigations and animal experiments before making formulation for human administration. The main target for this new formulation of AP and NAC should be populations at high risk such as psychiatric patients particularly those with depression and personality disorders who may attempt suicide by AP.
We hope that our proposal for this formulation will be considered by the medical toxicologists, health authorities, pharmaceutical scientists, and pharmaceutical industries to work on this recommended formulation.
The authors wish to convey their appreciations to Professor Barry Rumack for his constructive comments.
National Center for
Biotechnology Information,
U.S. National Library of Medicine
8600 Rockville Pike, Bethesda
MD, 20894
USA
Generic Name: acetylcysteine
Medically reviewed by Drugs.com. Last updated on Feb 6, 2019.
Note: This document contains side effect information about acetylcysteine. Some of the dosage forms listed on this page may not apply to the brand name NAC.
Applies to acetylcysteine: oral capsule, oral powder, oral solution, oral tablet effervescent
Other dosage forms:
قرص eff nac
Along with its needed effects, acetylcysteine (the active ingredient contained in NAC) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking acetylcysteine:
Some side effects of acetylcysteine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Applies to acetylcysteine: compounding powder, inhalation solution, intravenous solution, oral capsule, oral tablet, oral tablet effervescent
The most common adverse events were anaphylactoid reaction, nausea, vomiting, flushing, and skin rash.[Ref]
Anaphylactoid symptoms include airway obstruction (bronchospasm), angioedema, dyspnea, hypotension, shock, tachycardia, urticaria, and injection site reaction (including rash). These are most common either during, or at the end of the loading dose infusion, and may be dose related. Careful monitoring is recommended.[Ref]
Very common (10% or more): Anaphylactoid reaction (18%)
Uncommon (0.1% to 1%): Anaphylaxis
Rare (less than 0.1%): Acquired sensitization
Frequency not reported: Dermal eruptions[Ref]
Very common (10% or more): Vomiting NOS (12%)
Common (1% to 10%): Nausea
Frequency not reported: Stomatitis[Ref]
Common (1% to 10%): Respiratory symptoms, pharyngitis, rhinorrhea, rhonchi, throat tightness
Frequency not reported: Bronchoconstriction, bronchospasm, irritation to tracheal and bronchial tract (inhalation route), hemoptysis, dyspnea, respiratory arrest, coughing, stridor[Ref]
Respiratory symptoms were defined as presence of any of the following: cough, wheezing, stridor, shortness of breath, chest tightness, respiratory distress, or bronchospasm.[Ref]
Common (1% to 10%): Tachycardia
Uncommon (0.1% to 1%): Hypotension
Frequency not reported: Cyanosis, tachycardia, bradycardia, cardiac arrest, extrasystoles, flushing, hypertension, vasodilation, ECG changes[Ref]
Common (1% to 10%): Urticaria/facial flushing, rash NOS, pruritus, flushing
Frequency not reported: Angioedema, sweating, edema periorbital, clamminess[Ref]
Common (1% to 10%): Edema
Frequency not reported: Acidosis, hypokalemia[Ref]
Rare (less than 0.1%): Death
Frequency not reported: Fever, malaise, rigors, chest pain, facial pain, facial edema, raised temperature[Ref]
Frequency not reported: Syncope, generalized seizure, drowsiness[Ref]
Frequency not reported: Injection site reaction[Ref]
Frequency not reported: Arthralgia, arthropathy[Ref]
Frequency not reported: Deterioration of liver function[Ref]
Frequency not reported: Thrombocytopenia[Ref]
Frequency not reported: Blurred vision, eye pain, puffy eyes, itching/redness/irritation in eyes (ophthalmic formulation)[Ref]
Frequency not reported: Anxiety[Ref]
1. Cerner Multum, Inc. “Australian Product Information.” O 0
2. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0
قرص eff nac
3. “Product Information. Acetadote (acetylcysteine).” Cumberland-Swan Inc, Smyrna, TN.
4. “Product Information. Acetylcysteine (acetylcysteine).” American Regent Laboratories Inc, Shirley, NY.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
Medical Disclaimer
Other brands: Mucomyst, Cetylev, Acetadote, Mucomyst-10, Acys-5
acetylcysteine, Mucinex DM, Robitussin Cough + Chest Congestion DM, Mucomyst, dextromethorphan / guaifenesin, Tussin DM, Cetylev, Acetadote, Mucomyst-10
NAC reviews
The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Available for Android and iOS devices.
Subscribe to Drugs.com newsletters for the latest medication news, alerts, new drug approvals and more.
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 Aug 2019), Cerner Multum™ (updated 1 Aug 2019), Wolters Kluwer™ (updated 31 July 2019) and others.
Third Party Advertising
We comply with the HONcode standard for trustworthy health information – verify here
Copyright © 2000-2019 Drugs.com. All rights reserved.
Acetylcysteine (also known as N-acetylcysteine or N-acetyl-L-cysteine or NAC) is primarily used as a mucolytic agent and in the management of acetaminophen poisoning. It is a derivative of cysteine with an acetyl group attached to the amino group of cysteine. NAC is essentially a prodrug that is converted to cysteine (in the intestine by the enzyme aminoacylase 1) and absorbed in the intestine into the blood stream. Cysteine is a key constituent to glutathione and hence administration of acetylcysteine replenishes glutathione stores. Acetylcysteine can also be used as a general antioxidant which can help mitigate symptoms for a variety of diseases exacerbated by reactive oxygen species (ROS). For instance, acetylcysteine is commonly used in individuals with renal impairment to prevent the precipitation of acute renal failure. Acetylcysteine has been shown to have efficacy in treating mild to moderate traumatic brain injury including ischemic brain injury, particularly in reducing neuronal losses, and also reducing cognitive and neurological symptoms when administered promptly after injury. N-acetylcysteine is now widely used in the treatment of HIV, and it has reported efficacy in chronic obstructive pulmonary disease and contrast-induced nephropathy. Acetylcysteine is also being successfully used to treat a variety of neuropsychiatric and neurodegenerative disorders including cocaine, cannabis, and smoking addictions, Alzheimer’s and Parkinson’s diseases, autism, compulsive and grooming disorders, schizophrenia, depression, and bipolar disorder. Recent data also shows that N-acetylcysteine inhibits muscle fatigue and can be used to enhance performance in endurance events and in exercise and endurance training.
Acetylcysteine is also undergoing clinical trials as RK-0202, an oral rinse for the prevention and treatment of mucositis. It is comprised of acetylcysteine in a polymer matrix.
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.قرص eff nac
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
Acetylcysteine is used mainly as a mucolytic and in the management of paracetamol (acetaminophen) overdose.
Acetylcysteine has been shown to reduce the extent of liver injury following acetaminophen overdose. It is most effective when given early, with benefit seen principally in patients treated within 8-10 hours of the overdose. Acetylcysteine likely protects the liver by maintaining or restoring the glutathione levels, or by acting as an alternate substrate for conjugation with, and thus detoxification of, the reactive metabolite.
Acetylcysteine protects against acetaminophen overdose-induced hepatotoxicity by maintaining or restoring hepatic concentrations of glutathione. It does this by producing the glutathione precursor L-cysteine. Glutathione is required to inactivate an intermediate metabolite (N-acetyl-p-benzoquinoneimine or NAPQI) of acetaminophen that is thought to be hepatotoxic. In acetaminophen overdose cases, excessive quantities of this metabolite are formed because the primary metabolic (glucuronide and sulfate conjugation) pathways become saturated. Acetylcysteine may act by reducing the metabolite to the parent compound and/or by providing sulfhydryl for conjugation of the metabolite. Experimental evidence also suggests that a sulfhydryl-containing compound such as acetylcysteine may also directly inactivate the metabolite. The mechanisms of action for acetylcysteine’s well-known mucolytic effects are different. In particular, when inhaled, acetylcysteine (and its metabolic byproduct cysteine) exerts its mucolytic action through its free sulfhydryl group, which reduces the disulfide bonds in the mucus matrix and lowers mucus viscosity. This action increases with increasing pH and is most significant at pH 7 to 9. The mucolytic action of acetylcysteine is not affected by the presence of DNA. Acetylcysteine is also an antioxidant and reduces oxidative stress. Acetylcysteine serves as a prodrug to L-cysteine which is a precursor to the biologic antioxidant, glutathione and hence administration of acetylcysteine replenishes glutathione stores. L-cysteine also serves as a precursor to cystine which in turn serves as a substrate for the cystine-glutamate antiporter on astrocytes hence increasing glutamate release into the extracellular space. This glutamate in turn acts on mGluR2/3 receptors, and at higher doses of acetylcysteine, mGluR5. Glutathione also modulates the NMDA receptor by acting at the redox site. These effects on glutamate and NMDA signaling appear to explain some of the positive neuropsychotropic effects associated with NAC. Acetylcysteine also possesses some anti-inflammatory effects possibly via inhibiting NF-κB through redox activation of the nuclear factor kappa kinases thereby modulating cytokine synthesis.
Comprehensive structured data on known drug adverse effects with statistical prevalence. MedDRA and ICD10 ids are provided for adverse effect conditions and symptoms.
Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.
Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.
Bioavailability is 6–10% following oral administration and less than 3% following topical administration.
83%
Hepatic. Deacetylated by the liver to cysteine and subsequently metabolized.
5.6 hours (adults), 11 hours (neonates)
Single intravenous doses of acetylcysteine at 1000 mg/kg in mice, 2445 mg/kg in rats, 1500 mg/kg in guinea pigs, 1200 mg/kg in rabbits and 500 mg/kg in dogs were lethal. Symptoms of acute toxicity were ataxia, hypoactivity, labored respiration, cyanosis, loss of righting reflex and convulsions.
Extended description of the mechanism of action and particular properties of each drug interaction.
A severity rating for each drug interaction, from minor to major.
A rating for the strength of the evidence supporting each drug interaction.
An effect category for each drug interaction. Know how this interaction affects the subject drug.
Rolf-Dieter Juch, Gerd Birrenbach, Christian Pflugshaupt, “Solid, fast-soluble pharmaceutical preparation containing S-(carboxymethyl)-L-cysteine and/or N-acetylcysteine.” U.S. Patent US5401514, issued November, 1990.
The date on which a patent was filed with the relevant government.
There is additional data available for commercial users including Adverse Effects, Contraindications, and Blackbox Warnings. Contact us to learn more about these and other features.
Drug created on January 15, 2008 09:45 / Updated on August 20, 2019 16:12
