A precursor of antioxidant glutathione.
Trade name Mucomyst,
Utilized by oral , intravenous injection, and inhalation administration techniques.
Has an oral bioavailability of only 4-10%.
Has protein binding of 80-83%.
Metabolism is hepatic and has a half-life of 5.6 hours.
Excretion by renal (22%), and fecal (3%) route.
Used primarily as a mucolytic agent and in the management of acetaminophen overdose.
Can be used as a sulfate repletion therapy in conditions, such as autism, where cysteine and related sulfur amino acids may be depleted.
A derivative of cysteine; an acetyl group that is attached to the nitrogen atom.
The thio group in N-acetylcysteine is able to reduce levels of free radicals.
A dietary supplement sold for possible antioxidant and liver protecting effects.
Breaks disulfide bonds in mucus and liquefies it, making it easier to cough up phlegm..
Useful in thinning thick mucus in cystic and pulmonary fibrosis patients.
Intravenous acetylcysteine is indicated for the treatment of acetaminophen overdose.
Acetylcysteine acts to augment the glutathione reserves in the body and, together with glutathione, directly bind to toxic metabolites, protecting hepatocytes in the liver from NAPQI toxicity.
Has been successful for the treatment of liver injury in DRESS syndrome and other non-acetaminophen induced acute liver injuries.
Oral administration is poorly tolerated because high oral doses are required due to low oral bioavailability,
Oral acetylcysteine associated with foul taste and odor, and nausea and vomiting.
3% to 6% of people given intravenous acetylcysteine have an anaphylaxis-like allergic reaction, which may bronchospasm, hypotension, rash, angioedema, and sometimes nausea and vomiting.
Repeated intravenous acetylcysteine cause allergic reactions to progressively worsen.
Inhaled acetylcysteine is indicated for mucolytic therapy as an adjuvant in respiratory conditions with excessive or thick mucus production.
Oral acetylcysteine may also be used as a mucolytic reducing mucus viscosity by splitting disulfide bonds linking proteins present in the mucus
Oral acetylcysteine has been used for the prevention of radiocontrast-induced nephropathy, and some studies suggesting that prior administration of acetylcysteine markedly decreases radiocontrast induced nephropathy, whereas other studies show no such benefit.
Despite the above controversy acetylcysteine continues to be commonly used in individuals with renal impairment to prevent the precipitation of acute renal failure.
Can be used for cyclophosphamide-induced hemorrhagic cystitis, although it can diminish the effectiveness of the drug.
Has been used in the treatment of interstitial lung disease to prevent disease progression, for the treatment of schizophrenia, depression, mania, bipolar disorder, drug addiction, gambling addiction,
trichotillomania, autism, and obsessive-compulsive disorder.
Use in Polycystic ovary syndrome, a small prospective trial comparing acetylcysteine to metformin both treatments resulted in equal efficacy.
Is a prodrug to L-cysteine which is a precursor to the biologic antioxidant, glutathione.
Use 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.
Increases glutamate release into the extracellular space.
Possesses some anti-inflammatory effects via inhibiting NF-κB and modulating cytokine synthesis.
Can facilitate dopamine release in certain brain areas.
Is the N-acetyl derivative of the amino acid L-cysteine.
A precursor in the formation of the antioxidant glutathione in the body.
The thiol group confers antioxidant effects and is able to reduce free radicals.
Solution for inhalation can be inhaled for mucolytic therapy
Oral ingestion for nephroprotective effect.
IV injection of the drug for the treatment of acetaminophen overdose.
Available as an oral solution, effervescent tablets (200 mg, 900 mg), and ocular solution.
It reduce the incidence of chronic obstructive pulmonary disease (COPD) exacerbations.
Cause an increase in immunological functions and plasma albumin concentrations in treated AIDS patients.
Studies suggest use may decrease viral influenza symptoms.
Taken together with vitamin C and B1 can be used to prevent and relieve symptoms of hangover following alcohol consumption.
May be of benefit in blepharitis.
The combination of acetylcysteine with prednisolone decreased mortality significantly in alcohol
hepatitis at one month compared to a prednisolone-only group, but the improvement was not as significant at 3 months or 6 months.
Improves the clinical efficacy of B vitamins in patients with raised homocysteine and memory disorders, including dementia.
Prevents hepatic injury from acetaminophen by restoring hepatic glutathione.
Increases the production of glutathione because it crosses cell membranes readily and can be converted to cysteine.
Given at 1800 mg daily restores depleted pulmonary glutathione levels and improves lung function in fibrosing alveolitis.
Reduces risk of radiographic contrast-induced renal insufficiency in high-risk patients.
A pharmaceutical drug and nutritional supplement used primarily as a mucolytic agent and in the management of acetaminophen overdose.
Intravenous acetylcysteine is indicated for the treatment of acetaminophen overdose, by augmenting the glutathione reserves and with glutathione, binds to toxic metabolites to protect the hepatocytes from NAPQI toxicity.
Oral administration is poorly tolerated because high oral doses are required due to low oral bioavailability, has an unpleasant taste and odor, and because of adverse effects, particularly nausea and vomiting.
3% to 6% of people given intravenous acetylcysteine show a severe, anaphylaxis-like allergic reaction.
Indicated for mucolytic therapy in respiratory conditions with excessive and/or thick mucus production including: emphysema, bronchitis,, bronchiectasis,, pneumonia, cystic fibrosis and COPD.
Oral acetylcysteine is used for the prevention of radiocontrast-induced nephropathy, although its efficacy has been questioned.
Acetylcysteine offers no benefit in preserving FVC in patients with idiopathic pulmonary fibrosis with mild-moderate impairment in lung function.