Acetylcysteine
also known as N-acetylcysteine (NAC)
Type of Medication: Mucolytic
Indications: Oral: treatment of distal intestinal obstruction syndrome (DIOS) previously called meconium ileus equivalent. Nebulised: mucolytic. Given for the duration of the intravenous aminoglycoside treatment to prevention aminoglycoside induced ototoxicity.
Side Effects: Examples include nausea and vomiting, particularly with large oral doses. Bronchospasm has been noted in patients with asthma given acetylcysteine by inhalation (may need bronchodilator prior administration. Hypersensitivity reactions have also been reported.
Notes:
Route of administration: Adult (Nebulised)
Dose: 400mg TDS-QDS
Administration: Use 2ml of acetylcysteine 200mg/ml and mix with 2ml sodium chloride 0.9%. Oxygen should not be used as driving gas as it can lead to deactivation.
Route of administration: Adult (Oral) for DIOS
Dose:Acetylcysteine 200mg/ml injection generally 4 to 6 gm (20-30ml) as a single dose for treatment of DIOS. For the prevention of DIOS – acetylcysteine sachet (1g sachet contains 200mg acetylcysteine) one to two sachets two to three times a day.
Administration: Parvolex – Add to 120ml water, orange juice, blackcurrant juice or cola drink to mask the bitter taste
Route of administration: Adult (Oral) for prevention of ototoxicity in patients receiving IV aminoglycosides
Dose: ≥12 years: 600mg BD
Route of administration: Paediatric (Oral) DIOS
Dose: Treatment of DIOS One month to 2 years; 0.4 to 3gm (2ml to 15ml) as single dose. Two to seven years; 2 to 3gm as single dose (10ml to 15ml) Greater than 7 years see adult dose. Prevention of DIOS (sachet) One month to 2 years; 100mg to 200mg tds Two to seven years; 200mg tds Greater than 7 years see adult dose.
Administration: dilute to a concentration of 50mg/ml with water, orange juice, blackcurrant juice or cola drink to mask the bitter taste
Route of administration: Paediatric (Oral) for prevention of ototoxicity in patients receiving IV aminoglycosides
Dose: < 12 years of age – 300mg BD
Examples of Drug Interactions:
Drug information