AdultPediatricDosage Forms & Strengths nebulizer solution 10% 20% Pulmonary Disease Facilitation of expectoration via mucolysis Solution (10 and 20%) may be used undiluted; 3-5 mL of 20% solution or 6-10 mL of 10% solution; administer 1 to 10 mL of 20% solution every 6-8 hours or 2 to 20 mL of 10% every 2 to 6 hours Diagnostic Bronchography 1-2 mL of 20% solution or 2-4 mL of 10% solution administered 2-3 times by nebulization or by intratracheal instillation before procedure Acetaminophen Overdose See separate drug monograph, acetylcysteine (antidote) Contrast Agent-Associated Nephrotoxicity (Off-label) Prevention 600 mg PO q12hr for 2 days on day before and day of contrast agent administration Keratoconjunctivitis Sicca (Off-label) 1 drop of 10% solution in eye(s) q6-8hr Dosing Considerations Direct instillation: 1-2 mL of 10% or 20% solution q1hr PRN Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution q1-4hr by direct instillation into tracheotomy Instillation into segment of bronchopulmonary tree via small plastic catheter into trachea (under local anesthesia and direct vision): 2-5 mL of 20% solution via syringe connected to catheter Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution q1-4hr via syringe connected to catheter Administration Administer aerosolized bronchodilator 10-15 minutes before administering acetylcysteine via nebulization Nebulizer solution may also be administered PODosage Forms & Strengths nebulizer solution 10% 20% Pulmonary Disease Facilitation of expectoration via mucolysis 1-11 months: 1-2 mL of 20% solution or 2-4 mL of 10% solution by nebulization q6-8hr PRN >11 years: Solution (10 and 20%) may be used undiluted; 3-5 mL of 20% solution or 6-10 mL of 10% solution; administer 1 to 10 mL of 20% solution every 3 to 4 times/day or 2 to 20 mL of 10% every 2 to 6 hours Acetaminophen Overdose See separate drug monograph, acetylcysteine (antidote) Ototoxicity Caused by Platinum-Based Chemotherapy (Orphan) Prevention of ototoxicity caused by platinum-based chemotherapeutic agents used to treat pediatric cancers Orphan sponsor Galephar Pharmaceutical Research, Inc, Road 198, No. 100 km. 14.7, Juncos Industrial Park, Juncos 00777-3873, Puerto Rico Keratoconjunctivitis Sicca (Off-label) 1 drop of 10% solution in eye(s) q6-8hr Dosing Considerations Direct instillation: 1-2 mL of 10% or 20% solution q1hr PRN Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution q1-4hr by direct instillation into tracheotomy Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution q1-4hr via syringe connected to catheterInteraction CheckerEnter a drug name and acetylcysteineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (0)Monitor Closely (1)activated charcoalactivated charcoal decreases effects of acetylcysteine by Other (see comment). Use Caution/Monitor. Comment: Conflicting reports exist; however, charcoal administration does not preclude acetylcysteine administration for acetaminophen overdose .Minor (7)nitroglycerin IVacetylcysteine increases effects of nitroglycerin IV by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin POacetylcysteine increases effects of nitroglycerin PO by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin rectalacetylcysteine increases effects of nitroglycerin rectal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin sublingualacetylcysteine increases effects of nitroglycerin sublingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin topicalacetylcysteine increases effects of nitroglycerin topical by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin transdermalacetylcysteine increases effects of nitroglycerin transdermal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin translingualacetylcysteine increases effects of nitroglycerin translingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.activated charcoalMonitor Closely (1)activated charcoal decreases effects of acetylcysteine by Other (see comment). Use Caution/Monitor. Comment: Conflicting reports exist; however, charcoal administration does not preclude acetylcysteine administration for acetaminophen overdose .nitroglycerin IVMinor (1)acetylcysteine increases effects of nitroglycerin IV by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin POMinor (1)acetylcysteine increases effects of nitroglycerin PO by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin rectalMinor (1)acetylcysteine increases effects of nitroglycerin rectal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin sublingualMinor (1)acetylcysteine increases effects of nitroglycerin sublingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin topicalMinor (1)acetylcysteine increases effects of nitroglycerin topical by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin transdermalMinor (1)acetylcysteine increases effects of nitroglycerin transdermal by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin.nitroglycerin translingualMinor (1)acetylcysteine increases effects of nitroglycerin translingual by Other (see comment). Minor/Significance Unknown. Comment: Acetylcysteine may enhance vasodilatory effects of nitroglycerin. Frequency Not Defined Bronchoconstriction Bronchospasm Calmness Chest tightness Disagreeable odor Drowsiness Fever Hemoptysis Increased volume of bronchial secretions Irritation of tracheal or bronchial tract Nausea Rhinorrhea Stomatitis Vomiting Contraindications Acute asthma Documented hypersensitivity Cautions Volume of bronchial secretions may increase after administration; if cough response is inadequate, consider maintaining airway by mechanical suction if necessary; if airway block arises because of foreign body or local accumulation, clear by endotracheal aspiration, with or without bronchoscopy Not for injection Use with caution in patients with asthma or history of bronchospasm; these patients are at increased risk of hypersensitivity reactions In most instances, bronchospasm may be treated by prompt administration of bronchodilator via nebulization; if bronchospasm worsens, discontinue therapy immediately Slight disagreeable odor after administration (temporary) Face mask may produce sticky film on face after nebulization; remove with water Under certain conditions, opened bottle may cause slight purple color change as consequence of chemical reaction; this has no effect on drug safety or efficacy Keratoconjunctivitis: Remove contact lenses; do not coadminister with topical antibiotics Since increased bronchial secretions may occur after inhalation, postural drainage, inhalation percussion, and suctioning should follow; if bronchospasm occurs, administer a bronchodilator; discontinue therapy if bronchospasm progresses Pregnancy category: B Lactation: Unknown whether agent is excreted in milk; use with cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Exerts mucolytic activity through sulfhydryl group, which opens up disulfide bonds in mucoproteins and lowers mucous viscosity of pulmonary secretions Absorption Onset: 5-10 min Peak plasma time: 1-2 hr Distribution Duration: Variable (~1 hr) Protein bound: 80% Metabolism Metabolized in liver Elimination Excretion: Urine (primarily) BRAND FORM. UNIT PRICE PILL IMAGE acetylcysteine oral- 600 mg capsuleacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 100 mg/mL (10 %) vialacetylcysteine- 200 mg/mL (20 %) vialacetylcysteine- 100 mg/mL (10 %) vialN-A-C Sustain oral- 600 mg tabletNAC oral- 600 mg capsuleacetylcysteine intravenous- 200 mg/mL (20 %) vialacetylcysteine intravenous- 200 mg/mL (20 %) vialacetylcysteine intravenous- 200 mg/mL (20 %) vialacetylcysteine intravenous- 200 mg/mL (20 %) vialacetylcysteine intravenous- 200 mg/mL (20 %) vialAcetadote intravenous- 200 mg/mL (20 %) vialCopyright © 2010 First DataBank, Inc.Select a drug:acetylcysteine oralacetylcysteineacetylcysteine intravenousPrint Patient Educationacetylcysteine oral NO MONOGRAPH AVAILABLE AT THIS TIME USES: Consult your pharmacist. HOW TO USE: Consult your pharmacist. SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Consult your pharmacist. DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. NOTES: No monograph available at this time. MISSED DOSE: Consult your pharmacist. STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Information last revised July 2016. Copyright(c) 2023 First Databank, Inc. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. QL Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered. ST Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription. OR Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. 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