acetylcysteine
Acetylcysteine is an inhalation solution that's breathed in through a nebulizer to help clear mucus from the lungs. It benefits people with certain lung conditions, such as cystic fibrosis (CF) or emphysema. Acetylcysteine used to be sold under the brand name Mucomyst which is no longer available. Some side effects of acetylcysteine include sores in the mouth, nausea, runny nose, and drowsiness. The oral and injectable versions of this medication can be prescribed by providers as an antidote for acetaminophen (Tylenol) overdose.
What is Acetylcysteine?
What is Acetylcysteine used for?
Mucus buildup caused by lung problems like emphysema, infection, or cystic fibrosis
How Acetylcysteine works
Acetylcysteine is a mucolytic. It makes the mucus in your lungs less sticky and thinner so that it's easier to cough it out.
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What are the side effects of Acetylcysteine?
Common Side Effects
- Coughing
- Sore throat
Other Side Effects
- Irritation of the mouth or lips (stomatitis)
- Nausea
- Vomiting
- Fever
- Runny nose
- Drowsiness
- Clamminess
- Chest tightness
Serious Side Effects
- Tightening of the airways: trouble breathing, wheezing
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine 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 as soon as possible if any of the following side effects occur:
Rare
Skin rash or other irritation
Some side effects 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:
Less common
Clammy skin
increase in amount of mucus in lungs
irritation or soreness of mouth, throat, or lungs
nausea or vomiting
For patients using a face mask for inhalation of acetylcysteine: the mask may leave a stickiness on your face. This can be removed with water.
When you use acetylcysteine, you may notice that the medicine has an unpleasant odor at first. However, this smell will go away soon after you use the medicine.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Acetylcysteine
Pros
Helps you cough up mucus that's stuck in your airway
Dose can be easily adjusted to your needs by your provider
Available as a lower-cost generic
Cons
Might smell bad when you first start the nebulizing treatment
Can make your face sticky if you use a face mask, but you can easily wash it off with water
Usually need to use multiple times a day
Pharmacist tips for Acetylcysteine
If you're using the 10% version of acetylcysteine, you don't have to dilute it (mix it together with another liquid). If you are using the 20% version, your provider will ask you to dilute it using sterile saline or sterile water. Ask your provider or pharmacist about the right way to dilute this medication.
Unopened vials of acetylcysteine can be stored at room temperature. But once you've opened a vial, any medication still left in the vial must be stored in the refrigerator and used within 4 days. Acetylcysteine doesn't contain any preservatives, so there's a chance that microbes, like bacteria or mold, can start to grow in the solution after this time.
If you've prepared any diluted acetylcysteine, the diluted solutions must be used within an hour. Otherwise, you'll need to discard the solution.
The acetylcysteine solution in the vial might change colors to a light purple after you open the bottle. This is normal and shouldn't affect how well the medication works or its safety.
Some medications work less well if you mix them together with the acetylcysteine nebulizing solution. If you need to take other nebulized medications around the same time as acetylcysteine, check with your provider or pharmacist to see if it's safe to mix them together.
You might notice that your face mask becoming sticky after you use the nebulizer with acetylcysteine. If so, you can remove the stickiness by washing the mask with water.
Make sure to clean your nebulizing equipment after each dose of acetylcysteine to prevent blockage or corrosion of parts.
Frequently asked questions about Acetylcysteine
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What are the risks and warnings for Acetylcysteine?
Acetylcysteine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
More mucus in the lungs
Acetylcysteine might make you have more liquid mucus in your airway, which can be hard to get rid of. If you have asthma, this might start an attack, so always have your rescue inhaler nearby when you take acetylcysteine.
Acetylcysteine dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4ml of 10% nebulizer solution | 25 vials | $50.89 | $2.04 |
| 10ml of 10% nebulizer solution | 3 vials | $21.65 | $7.22 |
| 30ml of 10% nebulizer solution | 12 vials | $82.36 | $6.86 |
| 4ml of 20% nebulizer solution | 25 vials | $85.63 | $3.43 |
| 10ml of 20% nebulizer solution | 3 vials | $23.38 | $7.79 |
| 30ml of 20% nebulizer solution | 3 vials | $36.46 | $12.15 |
Typical dosing for Acetylcysteine
The typical dose is 3 mL to 5 mL of the 20% solution or 6 mL to 10 mL of the 10% solution inhaled via a nebulizer 3 to 4 times a day. Your provider will decide how much you need and how often you should take it based on your symptoms and response to the medication. Your dose might differ if you're receiving this medication in the hospital.
Interactions between Acetylcysteine and other drugs
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Acetylcysteine cost?
What are alternatives to Acetylcysteine?
Mucus buildup caused by lung problems like emphysema, infection, or cystic fibrosis
Improve lung function in children and adults with cystic fibrosis
Acetylcysteine images
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References
Best studies we foundAmerican Lung Association. (2023). How to use a nebulizer. Â
Fresenius Kabi USA, LLC. (2022). ACETYLCYSTEINE solution [package insert].
MedlinePlus. (2022). How to use a nebulizer.
Tenório, M. C. D. S., et al. (2021). N-Acetylcysteine (NAC): Impacts on human health. Antioxidants.Â
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