Acetylcysteine ​​for children

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Acetylcysteine

Acetylcysteine: instructions for use and reviews

Latin name: Acetylcysteine

ATX code: R05CB01

Active ingredient: acetylcysteine

Manufacturer: Marbiopharm (Russia)

Update of description and photo: 12/01/2017

Table of contents:

Prices in pharmacies: from 135 rubles.

Acetylcysteine ​​is a drug with a mucolytic effect used to treat cough.

Release form and composition

Forms of release of the drug:
  • Solution for inhalation (20%);
  • Solution for injection (10%);
  • Powder for the preparation of solution for oral administration.

The main active ingredient of the drug is acetylcysteine.

Pharmacological properties

Pharmacodynamics

Acetylcysteine ​​is a mucolytic drug that thins sputum, increases its volume and makes it easier to separate. Its action is due to the ability of unbound sulfhydryl groups of acetylcysteine ​​to break inter- and intramolecular disulfide bonds of acidic mucopolysaccharides contained in sputum. This causes depolymerization of mucoproteins and a decrease in sputum viscosity, which in some cases provokes a significant increase in sputum volume and requires aspiration of bronchial contents.

Acetylcysteine ​​remains active in diseases accompanied by purulent sputum and does not affect the immune system. The drug intensifies the production of less viscous sialomucins by goblet cells, reduces the adhesion of bacterial microorganisms on epithelial cells localized in the bronchial mucosa, and also activates bronchial mucosal cells that secrete a secretion that lyses fibrin. The effect of the drug on the secretions formed during diseases of the ENT organs of an inflammatory nature is identical.

The drug has an antioxidant effect associated with the presence of the SH group, which neutralizes electrophilic oxidative toxins.

Acetylcysteine ​​protects alpha1-antitrypsin, which is an elastase inhibitor, from the inactivating effects of the HOCI oxidant. The latter is produced by myeloperoxidase of active phagocytes.

The drug is also characterized by a certain anti-inflammatory effect due to inhibition of the formation of reactive oxygen-containing compounds and free radicals responsible for the development of the inflammatory process in the lung tissue.

Pharmacokinetics

Acetylcysteine ​​is highly absorbed. Its bioavailability is 10% due to the presence of a pronounced first-pass effect through the liver. The metabolic process involves deacetylation to form cysteine. The maximum concentration of the substance in plasma is achieved 1–3 hours after oral administration, and the degree of binding to plasma proteins is 50%.

The half-life of acetylcysteine ​​is about 1 hour (in patients with liver cirrhosis, this figure increases to 8 hours). It is excreted in the urine in the form of inactive metabolites (diacetylcysteine, inorganic sulfates). A small part of the administered dose is excreted unchanged in feces.

Acetylcysteine ​​crosses the placental barrier and accumulates in the amniotic fluid.

Indications for use

According to the instructions, Acetylcysteine ​​is used for respiratory diseases and conditions that are accompanied by the formation of mucopurulent and viscous sputum, including:

  • Acute and chronic bronchitis;
  • Tracheitis caused by a bacterial or viral infection;
  • Bronchiectasis;
  • Bronchial asthma;
  • Sinusitis (to facilitate the passage of secretions);
  • Cystic fibrosis (as part of combination therapy);
  • Pneumonia;
  • Atelectasis caused by blockage of the bronchi by a mucus plug.

The drug is also indicated for post-traumatic and postoperative conditions to remove viscous secretions from the respiratory tract.

Contraindications

  • Peptic ulcer of the stomach and duodenum in the acute phase;
  • Pulmonary hemorrhage;
  • Hemoptysis;
  • Hypersensitivity to the drug.

Instructions for use of Acetylcysteine: method and dosage

Acetylcysteine ​​is prescribed to adults and children over 6 years of age once a day (in 2-3 doses).

Children from 2 to 6 years old are recommended to take the drug pomg per day (in 2-3 divided doses), up to 2 years old - 200 mg daily (in 2 divided doses).

Acetylcysteine ​​in the form of an injection solution is administered intramuscularly once a day, for adults - 300 mg, for children - 150 mg.

The drug for inhalation is used in 2-5 ml doses over a period of minutes.

For colds, the drug is taken for 5-7 days. In severe cases of the disease, the duration of treatment is determined individually by the doctor. Treatment of bronchitis and cystic fibrosis requires longer-term use of the drug.

Side effects

Side effects are rare. In some cases, the following undesirable reactions are observed:

  • Heartburn, nausea, vomiting, diarrhea, feeling of a full stomach;
  • Nosebleeds and tinnitus;
  • Skin rash, itching, urticaria, bronchospasm.

When using the drug for inhalation, local irritation of the respiratory tract and reflex cough are possible, and much less often - stomatitis or rhinitis.

With shallow intramuscular injection of the drug, a slight burning sensation may occur.

Overdose

Symptoms of overdose: heartburn, stomach pain, nausea, vomiting, diarrhea. In this case, symptomatic therapy is recommended.

special instructions

The use of Acetylcysteine ​​during pregnancy and breastfeeding is possible only under strict indications.

For bronchial asthma and diseases of the adrenal glands, kidneys and liver, the drug should be used with extreme caution.

An interval of at least 1-2 hours should be maintained between taking antibiotics and Acetylcysteine.

The drug should not be taken simultaneously with antitussives due to suppression of the cough reflex, which can lead to stagnation of sputum.

According to indications, the drug can be used in newborns under strict medical supervision.

Impact on the ability to drive vehicles and complex mechanisms

When driving vehicles and working with complex mechanisms that require increased concentration, the drug must be used with caution.

Use in childhood

When using acetylcysteine ​​in children with bronchial asthma, regular sputum drainage should be ensured. In newborns, it is used only for vital indications under the strict supervision of a specialist and in a dose not exceeding 10 mg/kg.

Drug interactions

Acetylcysteine ​​is pharmacologically incompatible with solutions of other drugs. When the substance comes into contact with metals and rubber, sulfides are formed, which have a characteristic odor.

When acetylcysteine ​​is combined with nitroglycerin, the vasodilator effect of the latter is enhanced. The drug also reduces the absorption of drugs belonging to the group of tetracyclines, cephalosporins or penicillins (they are recommended to be taken no earlier than 2 hours after taking acetylcysteine).

Analogs

Structural analogues of Acetylcysteine ​​are the drugs ACC, Acestin, Fluimucil, Mukonex, N-AC-ratiopharm, Vicks Active.

Storage conditions and periods

It is recommended to store the drug in a dry place at a temperature not exceeding 30 °C.

Shelf life – 3 years.

Conditions for dispensing from pharmacies

Available without a prescription.

Reviews of Acetylcysteine

There are a variety of reviews about Acetylcysteine. Many patients speak positively about it and confirm its effectiveness. However, negative opinions about the drug are also not uncommon: patients claim that the treatment did not help them at all, and they had to look for more effective means.

Price for Acetylcysteine ​​in pharmacies

The average price for Acetylcysteine ​​in powder form for the preparation of a solution for oral administration is 108‒195 rubles (dosage 200 mg, 20 sachets per package), 95‒146 rubles (600 mg dosage, 6‒10 sachets per package) or 103‒ 134 rubles (dosage 100 mg, package includes 20 sachets). Solution for inhalation and solution for injection are currently not commercially available.

Acetylcysteine ​​powder for solution 100 mg No. 20 sachets

Acetylcysteine ​​powder for solution 200 mg No. 20 sachets

Acetylcysteine ​​200 mg No. 24 effervescent tablets

Acetylcysteine ​​600 mg No. 12 effervescent tablets (lemon)

Education: First Moscow State Medical University named after I.M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes and does not replace official instructions. Self-medication is dangerous to health!

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Source: http://www.neboleem.net/acetilcistein.php

ACC for children

Among the mucolytic drugs prescribed for coughs, the drug ACC, produced by the Sandoz company, is in great demand. Can it be used in the treatment of children and at what age is it permissible to give ACC to children? Which dosage form is best to choose for children? How to dilute a tablet or granules? These and other questions about the use of such a medicine concern every mother if the doctor prescribed this drug to her coughing child.

Release form

The ACC drug is presented in the following forms:

  1. Effervescent tablets. They are distinguished by their flat round shape, blackberry scent and white color, and the active ingredient content of each soluble tablet is 100 or 200 mg. Tablets containing 600 mg of the active compound, called ACC Long, are also produced. One tube includes tablets.
  2. Syrup. The packaging of this ACC is a glass bottle filled with 100 ml of a clear, viscous, colorless liquid with a cherry aroma. 1 ml of syrup contains 20 mg of the active ingredient.
  3. Packets of granules. The weight of one bag is 3 grams, and one pack includes 20 bags, inside of which there is a white, homogeneous granular powder. The drink made from it may taste like orange or lemon with honey. The content of the active component in the package is 100 mg or 200 mg.
  4. Solution. This medicine, called ACC injection, is a clear liquid without any color, poured into 3 ml ampoules. One ampoule contains 300 mg of active substance. One package includes 5 ampoules.

Compound

The main ingredient of any form of ACC, which provides the drug with a therapeutic effect, is acetylcysteine. Excipients in different types of medicine differ:

  • Effervescent tablets contain citric and ascorbic acid, bicarbonate, saccharin, citrate and sodium carbonate. This form also contains milk sugar and mannitol, and blackberry flavoring gives the tablet and the solution prepared from it a pleasant smell.
  • The auxiliary ingredients of the ACC powder form are sucrose and ascorbic acid. This medicine also contains saccharin, and the presence of flavoring makes the drink made from granules orange or lemon-honey.
  • Additional substances in the syrup are represented by water, methyl parahydroxy benzoate, disodium edetate, as well as sodium hydroxide, carmellose, benzoate and saccharinate. The smell of this medicine is given by cherry flavoring.
  • In addition to the active substance, the ACC injection solution contains sterile water and disodium edetate. This liquid form also contains ascorbic acid and sodium hydroxide.

Operating principle

After entering the human body, acetylcysteine ​​begins to directly affect the sputum formed in the respiratory tract. In particular, this compound changes the rheology of mucus due to the destruction of bonds in mucopolysaccharides that are found in bronchial secretions. This thins the mucus and reduces its viscosity. The effectiveness of the product does not decrease, even if pus is mixed with the mucus.

Acetylcysteine ​​also has some antioxidant activity. It is noted that this substance stimulates the synthesis of glutathione and is also capable of neutralizing radicals formed during oxidative processes. This action of ACC strengthens the protection of cells in the respiratory tract mucosa and also helps reduce the inflammatory process.

Indications

The reason to use ACC is any disease of the respiratory system, in which too viscous secretions have accumulated inside the bronchial tree.

  • Laryngitis.
  • Bronchitis.
  • Pneumonia.
  • Laryngotracheitis.
  • Chronic pulmonary pathologies, including diseases occurring with obstruction.
  • Bronchiolitis.
  • Bronchiectasis.
  • Development of an abscess in the lung.

ENT doctors prescribe this medication for otitis media, rhinitis or sinusitis. ACC also helps with cystic fibrosis.

At what age can it be given?

The instructions for use allow the use of ACC for children over 2 years of age. For young patients aged from two to 5 years, a medicine called ACC 100 is intended, since the dosage of the active substance in it is the lowest. The drugs ACC 200 and ACC injection are prescribed to children six years of age and older. A medication with a maximum dosage of acetylcysteine ​​(ACC long) is recommended from the age of 14.

Contraindications

Annotation for ACC drugs prohibits their use in the following cases:

  • If a child is found to be intolerant to some component of the medication, for example, acetylcysteine ​​or lactose, which is included in the tablets.
  • If the lung disease is complicated by bleeding and traces of blood are found in the sputum.
  • If the patient has a peptic ulcer.
  • If the child suffers from a lack of certain enzymes (lactase, sucrase) or impaired carbohydrate metabolism.

Without consulting a doctor, ACC should not be given to children with bronchial asthma, arterial hypertension, kidney disease, liver pathologies, adrenal gland dysfunction, or diabetes mellitus. For such diseases, the pediatrician first evaluates the indications, and then selects the desired form of ACC and the correct dosage of the drug.

Side effects

Like many other medications, ACC can cause allergies. Taking this medication may cause hives, swelling of the skin, itching, rashes, and even anaphylactic shock.

Other side effects of ACC include:

  • Shortness of breath or the appearance of bronchospasm. This reaction of the child’s body to acetylcysteine ​​is often found in bronchial asthma. If your child's cough worsens after taking ACC, you should consult a doctor immediately.
  • Heartburn, loose stools, discomfort in the stomach and other symptoms called dyspepsia.
  • Increased body temperature, headache, noise in the ear, bleeding. Such negative effects of ACC treatment are very rare.

Instructions for use

How to use

  • The use of ACC is recommended after meals.
  • An effervescent tablet in the required dose should be placed in a glass of water, wait until it dissolves, and then offer the medicine to the child. For dissolution, use only water and glassware.
  • The contents of ACC portioned sachets are dissolved in half a glass of liquid. In this case, the granules can be diluted with water or another drink, for example, juice or cooled tea.
  • It is not advisable to leave the ACC suspension prepared from tablets or powder for a long time. If it is not possible to drink the medicinal solution immediately, storage at room temperature for no longer than two hours is permissible.
  • To dose the syrup, it is recommended to use a measuring cup or syringe, which is placed in the medicine package.
  • The last dose of ACC should not be later than 18 hours, since later use may adversely affect sleep.
  • In order for the therapeutic effect of the drug to occur faster, additional consumption of a large volume of liquid is recommended.
  • The doctor decides how many days to take the medicine individually for each child. In case of acute illness, the duration of use is most often 5-7 days.
  • ACC injections are given in the hospital 1-2 times a day. The drug is injected either deep into the muscle or slowly into a vein (over 5 minutes), mixing the contents of the ampoule with saline or glucose in a 1 to 1 ratio.

Dosage

The daily dose of ACC, regardless of the form of release, for a child of different ages will be as follows:

mg of active ingredient

mg of active substance

mg of active ingredient

This dose is divided into 2 doses for children under 14 years of age, and a child over 14 years of age can be given the drug either once a day or divided into 2-3 doses.

A single dose of various forms of ACC for a child over 2 years of age up to 6 years of age is usually 100 mg of acetylcysteine.

A child of this age is prescribed one of the following medications:

1 effervescent tablet ACC 100

1 package of granules with orange flavor ACC 100

Half a sachet of ACC 200

Half an effervescent tablet ACC 200

A single dosage for children over 6 years of age until 14 years of age will be mg of acetylcysteine. Often the drug is prescribed in a dosage of 200 mg per dose.

Depending on the form of ACC, this will be the following amount of medicine:

2 effervescent tablets ACC 100

2 packets of granules with orange flavor ACC 100

1 package of ACC 200 granules

1 effervescent tablet ACC 200

At the age of 14 years and older, the daily dose of ACC may be:

4-6 effervescent tablets ACC 100

4-6 packets of granules with orange flavor ACC 100

2-3 effervescent tablets ACC 200

2-3 bags of ACC 200 granules

1 tablet ACC long

A single dosage of the injectable form of ACC is half an ampoule for children 6-14 years old and a whole ampoule for a child over 14 years old. If there are vital indications, the drug can also be administered to children under 6 years of age at a dosage of 10 mg of the active substance per 1 kg of the child’s weight.

The ACC solution in ampoules can also be used for inhalation in a nebulizer. For one procedure, take 3 ml of medication and mix it with 3 ml of saline solution. This manipulation is allowed for coughs in children over 12 years of age.

Overdose

Taking too much ACC may cause vomiting, severe nausea, or loose stools. To help with an overdose, the doctor prescribes symptomatic treatment.

Interaction with other drugs

  • It is not recommended to mix ACC and any other drugs in one glass.
  • The use of sorbents, for example, activated carbon, will reduce the effectiveness of acetylcysteine ​​treatment.
  • It is strictly forbidden to give children ACC and medications that suppress the cough reflex. This combination of medications can cause stagnation of mucus in the respiratory tract.
  • If you combine ACC and medications from the bronchodilator group, the treatment of cough will be more effective.
  • Acetylcysteine ​​may worsen the effect of antibiotic therapy if cephalosporins or penicillin drugs are used, and therefore a break of 2 hours or more should be allowed between such drugs.
  • The simultaneous administration of ACC and vasodilating drugs leads to greater vasodilation.

Terms of sale

To purchase any form of ACC, except for injection, you do not need to present a prescription. To purchase ACC injection, you will need a prescription from a doctor.

On average, the cost of a pack of 20 ACC 100 tablets or one bottle of syrup is about 240 rubles. The price of ACC in bags is approximately rubles per package. For ten tablets of ACC Long you need to pay about 300 rubles.

Storage conditions and shelf life

Keep ampoules, granules or tablets in a dry place out of reach of a small child. Storage temperature should not exceed 25 degrees Celsius. When removing the tablet from the tube, the packaging must be immediately closed tightly.

The shelf life of the drug, depending on the form, is:

  • For tablets - 3 years.
  • For bags of granules – 4 years.
  • For syrup – 2 years (unopened).
  • For ampoules with solution – 3 years.

Once the bottle of ACC syrup has been opened, the medicine should be stored for no longer than 18 days.

Reviews

There are mostly positive reviews about the use of ACC for wet cough in children. Mothers confirm that the drug is very effective in liquefying very viscous secretions and helping to cough up, thereby speeding up recovery. Side effects from ACC are rarely noted, and most children consider the taste of the finished medicine to be pleasant.

Analogs

Any analogue that also contains acetylcysteine ​​can replace ACC. Such a drug may be Fluimucil, N-AC-Ratiopharm, Acetylcysteine ​​or Acestine. For a runny nose, you can use the drug Rinofluimucil, which also contains acetylcysteine. The medicine is released in the form of a spray, which is convenient for administering the medicine into the nose.

Also, instead of ACC, the doctor may recommend a remedy with a similar effect, which will be no less effective in treating cough, for example:

  • Lazolvan. The active ingredient of this expectorant is ambroxol. The advantages of Lazolvan are a wide variety of dosage forms and the possibility of use from birth.
  • Erespal. The basis of this drug is fenspiride, which has an antihistamine effect. Taking Erespal relieves bronchospasm and helps fight inflammation, so this medicine is in demand for dry and barking cough. It is prescribed in syrup from the age of two, and in tablets - no earlier than 18 years.
  • Fluditek. This mucolytic contains carbocisteine ​​and is available in syrup with two dosages. The smaller one (20 mg/ml) allows you to use the medicine from the age of 2, and the larger one (50 mg/ml) is allowed from the age of 15.
  • Gedelix. This plant-based product has an expectorant effect. The drug is made from ivy leaves in syrup and drops. It can be given to children over 2 years of age.
  • Mukaltin. This expectorant medicine in tablets is prescribed to children over one year of age.
  • Ascoril. This multicomponent drug contains salbutamol and bromhexine, which are supplemented with guaifenesin. Taking it dilutes bronchial secretions and has an expectorant effect. This medicine in syrup is prescribed to children from 1 year old, and tablet form - from six years old.

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Source: http://www.o-krohe.ru/otharkivayushchie-preparaty/acc/

Acetylcysteine ​​in the treatment of cough in children

Published in the magazine:

EAT. Kamaltynova, Associate Professor, Department of Faculty Pediatrics, Siberian State Medical University, Roszdrav

Mucolytics take first place among antitussive drugs used in pediatric practice, since the main pathogenetic factor in the development of a cough reaction, especially in young children, is the high viscosity of secretions and the child’s inability to cough up thick, difficult-to-clean sputum.

Mechanism of action of mucolytics

Mucolytics break down the disulfide bonds of acidic mucopolysaccharides. This leads to a decrease in the polarization of sputum mucoproteins, the gel layer of the secretion of goblet cells of the mucous membranes becomes more liquid, the adhesiveness of sputum decreases, which ensures its easier sliding and excretion along the bronchial tract; accelerates mucociliary clearance.

Acetylcysteine ​​(ACC) is a derivative of the amino acid cysteine. This determines the high safety of the drug, and due to the presence of a free sulfhydryl group, the main mucolytic effect is ensured. Acetylcysteine ​​has a direct effect on the structure of sputum, helping to reduce viscosity, liquefy it and facilitate removal from the bronchial tract, without significantly increasing the volume of sputum. While ambroxol affects sputum more indirectly, first activating hydrolyzing enzymes and enhancing the release of lysosomes from Clark cells, which leads to a decrease in sputum viscosity. Due to its direct action, the mucolytic effect of acetylcysteine ​​is pronounced and rapid.

A distinctive feature of acetylcysteine ​​is its ability to dilute sputum of any type, from mucous to purulent, with its subsequent evacuation from the respiratory tract. The effectiveness of acetylcysteine ​​against any type of sputum is especially important for bacterial infections, when the viscosity of sputum with purulent inclusions must be quickly reduced to allow it to be evacuated from the respiratory tract and prevent the spread of infection, which makes acetylcysteine ​​(ACC) the drug of choice in the treatment of respiratory tract infections as viral and bacterial etiology. Over the past few years, many large studies have been conducted on the possibility of using acetylcysteine ​​in a variety of areas of medicine.

ACC, as an acetylcysteine ​​preparation, is safe for young children. The safety of acetylcysteine ​​in pediatric practice has been confirmed by clinical studies. To evaluate the safety of acetylcysteine, 20 studies were conducted involving 1080 patients aged 2 months to 13 years. Of the nine controlled studies, acetylcysteine ​​was administered orally in eight and intramuscularly in one. Patients in the comparison groups took placebo. Antibiotics were prescribed if necessary. Diagnostic studies included blood tests and monitoring of liver and kidney function, chest x-ray, and pulmonary function. All controlled trials have shown high clinical safety of acetylcysteine ​​for children.

In a study at the Russian State Medical University, it was found that in children with acute bronchitis the best clinical effect was achieved using ACC (Zaitseva O.V. RMZh No. 18, 2009). During this study, 259 children with acute and chronic bronchopulmonary pathology aged from the first days of life to 15 years were observed. The children were divided into three groups: the 1st group of children (92 people) received ACC, the 2nd group of children (117 people) received ambroxol, the 3rd comparison group (50 people) received bromhexine or mucaltin.

According to short-term studies (lasting up to 2 weeks), the use of acetylcysteine ​​at a dose of 100–300 mg per day in children [Biscatti G. et al., 1972; Bellomo G. et al., 1973] and 200 mg 3 times a day in adults [Verstraeten JM, 1979; Brocard H. et al., 1980] in combination with antibiotics helps to reduce the viscosity of sputum, the intensity of cough, facilitates coughing, and also improves auscultation of the lungs, significantly reducing the days of illness compared to groups receiving only antibiotic therapy.

ACC does not cause lung swamping syndrome, since it does not increase the volume of bronchial secretions, but makes it less viscous, thereby improving evacuation. The use of ACC in combination with medications that suppress the cough reflex is not recommended. When using mucolytics, conditions for adequate removal of sputum must be provided (postural drainage, vibration massage, etc.), it is necessary to explain to the child’s relatives the rules for taking this drug: ACC should not be taken immediately before the child’s daytime or night sleep (like other mucolytics), as as its effect begins within 30 minutes, accordingly the sputum becomes liquefied, and the child, being in a horizontal position and in a state of sleep, cannot adequately remove it (cough up). Humidifying the ambient air is also useful, especially in winter in a room with central heating radiators.

Antioxidant effect of ACC

Studies of the antioxidant properties of acetylcysteine ​​have revealed its nonspecific activity in neutralizing various free radical groups. This happens in two ways: by direct binding of free radicals and indirectly - as a result of the delivery of the amino acid cysteine ​​into cells, from which glutathione is synthesized - the main antioxidant of cells in the human body. Of course, this has an additional therapeutic effect in pathological processes in the bronchopulmonary tree. In inflammatory diseases of the lungs and bronchial tract, the activity of oxidative processes sharply increases, causing damage to lung tissue cells. There is a significant decrease in glutathione content in cells, which, in turn, leads to an increase in the formation of inflammatory mediators. Acetylcysteine, being a donor of thiol (sulfhydryl) groups, increases the intracellular concentration of glutathione, activates the antioxidant system of the lungs and interrupts free radical oxidation reactions characteristic of inflammatory processes. This provides an additional advantage when using ACC in the treatment of inflammatory processes of the respiratory system.

Dosage forms and dosage regimen of ACC

A variety of dosage forms of ACC for children: granules for preparing a solution, effervescent tablets, granules for preparing syrup. ACC has a specially designed form for use in young children - granules for making syrup. This form of ACC can be recommended for children under 2 years of age. In addition, it has pleasant organoleptic properties and does not contain sugar or alcohol, which corresponds to a high level of safety. One package of ACC granules for making syrup is designed for a full course of treatment.

The list of references is in the editorial office

Source: http://medi.ru/info/2069/

ACC for children. Instructions for use

When the cold season comes, the number of colds increases - with all their unpleasant symptoms - fever, runny nose, sore throat. A particularly unpleasant manifestation of acute respiratory infections is cough. And it is especially difficult for children to bear it. Fortunately, modern pharmaceuticals have developed many cough medications suitable for use in children. One of these drugs is ACC.

Operating principle

The active ingredient in ACC is acetylcysteine. The drug was developed by Italian pharmacists in the mid-20th century, and since then has repeatedly proven its effectiveness in treating cough.

It should be borne in mind that coughing is a normal protective reaction of the body during colds and associated respiratory tract lesions. There are two main types of cough - wet and dry. Acetylcysteine ​​is only suitable for relieving wet coughs.

A wet cough is a cough that is accompanied by the release of a special bronchial secretion - sputum. This secretion binds pathogenic organisms, and coughing is designed to remove it from the bronchi. However, when too much mucus is produced, it may be difficult to remove it from the bronchi. It is especially difficult to remove sputum in children due to the narrowness of their respiratory passages. As a result, the child suffers, trying for a long time and unsuccessfully to cough up sputum. This complicates his condition and makes recovery difficult, leading to insomnia.

Acetylcysteine ​​makes this task easier. It is similar in structure to the amino acid cysteine, which is capable of breaking down mucopolysaccharides that form the basis of bronchial sputum. The sputum becomes much less viscous and can freely leave the body. Acetylcysteine ​​is also often prescribed for purulent otitis media and sinusitis.

Although ACC is used in the treatment of cough in children and has earned a good reputation, nevertheless, it is not a purely children's drug and can be used with equal success to relieve cough in patients of all ages. Upon entering the body, acetylcysteine ​​ends up in the liver, where it is metabolized to cysteine ​​and in this form passes into the systemic circulation.

The ACC drug is produced by the Slovenian company Sandoz or the German Hexal AG.

Composition and dosage forms

There are several forms of medication. It is available in tablets, in the form of granulated powder in bags for preparing a solution (suspension), syrup in a bottle, 20% solution for inhalation and solution for injection.

Effervescent tablets ACC have a dosage of 100 and 200 mg, a version of the drug ACC Long - 600 mg. The sachets may also contain 100 or 200 mg of acetylcysteine. One milliliter of syrup contains approximately 20 mg of the active substance, the bottle has a volume of 100 ml. The bottles are equipped with a measuring syringe and a cup, so the desired dosage can be easily measured.

The tablets contain, in addition to acetylcysteine, ascorbic and citric acids, mannitol, lactose, saccharin, bicarbonate, citrate and sodium carbonate.

The syrup includes the following components:

  • methyl parahydroxybenzoate
  • caramelose
  • edetate disodium
  • saccharinate and sodium benzoate
  • cherry flavor

Composition of granules for preparing the solution:

  • ascorbic acid
  • lemon honey or orange flavoring
  • sucrose
  • saccharin

The price for ACC granules in bags is around 150 rubles, for effervescent tablets – 300 rubles.

Indications

ACC is most often prescribed for inflammatory diseases of the lower respiratory tract. However, the scope of its application may extend beyond this scope.

In what cases is ACC indicated:

  • Bronchitis
  • Bronchiolitis
  • Pneumonia
  • Tracheitis
  • Bronchiectasis (dilation of the bronchi)
  • Cystic fibrosis
  • Laryngitis
  • Otitis
  • Sinusitis
  • Pulmonary abscess
  • Prevention of complications after respiratory surgery
  • Treatment of paracetamol poisoning

Contraindications

The drug has a number of contraindications. It is strictly contraindicated in case of exacerbation of gastric and duodenal ulcers. Outside the period of exacerbations, the drug is taken with caution. The drug should be prescribed with caution to infants and children under two years of age. Treatment in this case should be carried out under the supervision of a doctor.

This type of drug, ACC Long, is intended only for adults and should not be given to children under 14 years of age. Parenteral administration of the drug is allowed only after six years.

You should also take the drug with caution in the following conditions:

  • hemoptysis
  • bronchial asthma
  • renal failure
  • liver failure
  • adrenal diseases
  • pregnancy and lactation

Side effects

Some side effects may occur when using ACC. However, if the instructions and dosage are followed, they are rare. These include:

  • Noise in ears
  • Headache
  • Hives
  • Stomatitis

Patients with diabetes should take into account that the drug contains sucrose.

Photo: Madhourse / Shutterstock.com

Interaction with other drugs

It is forbidden to take simultaneously with antitussive drugs that suppress the cough reflex, as this leads to the accumulation of sputum. Caution should be taken when taking the drug simultaneously with antibiotics, as it is incompatible with many of them. Only drugs of the cyclosporine, tetracycline and penicillin series are suitable for use together with ACC, however, at least 2 hours must pass between their administration and the administration of the drug.

Nitroglycerin enhances the effect of the drug.

Instructions for use

According to the instructions for use of the drug, ACC should be taken after meals, the last dose should be no later than six o'clock in the evening. Additional fluid intake enhances the effect of the drug.

To prepare the solution, pour a packet of granules into one glass of water at room temperature. You can also simply drop the tablets into a glass of warm water and they will dissolve there. Instead of water, you can use other liquids, such as juice, compote or tea. The syrup is supplied ready-to-use. A full measuring cup of syrup contains 400 mg of acetylcysteine, and a syringe filled with syrup contains 100 mg. It is convenient to use a syringe to take the medicine directly from the bottle and inject it directly into the mouth of a small child.

The prepared solution should be consumed no later than three hours after preparation, but it is better to do it immediately. In no case should you dilute the medicine in a metal container, as this releases substances hazardous to health. Only ceramic or glass dishes are suitable for this purpose.

Approximate dosage for syrup:

  • 2-6 years – 5 ml 2-3 times a day
  • 6-14 children – 5 ml 3-4 times a day
  • over 14 years old – 10 ml 2-3 times a day

Approximate dosage for suspension from bags:

  • 2-6 years – 1 packet 100 mg 2-3 times a day
  • 6-14 years – 2 packets of 100 mg 2 times a day
  • over 14 years old – 2 packets of 100 mg 3 times a day

Approximate dosage for tablets:

  • 2-6 years – 1 tablet 100 mg 2-3 times a day
  • 6-14 years ¬– 2 tablets 100 mg 2 times a day
  • over 14 years old – 2 tablets 100 mg 3 times a day

In general, you need to adhere to a daily dosage such that the mass of the active substance does not exceed the following values:

  • 2-6 years – mg
  • 6-14 years ¬–mg
  • over 14 years – mg

Thus, if ACC 200 tablets or packets are used instead of ACC 100, the dose should be halved.

The inhalation solution is recommended to be used 3 times a day. For one inhalation, 2-5 ml of solution is taken, the duration of inhalation is minutes.

A typical course of treatment for children with granules, syrup and tablets is 5-7 days, a course of inhalations is 5-10 days. If necessary, the duration of treatment can be extended by the pediatrician. The dosage of all dosage forms of ACC for children under 2 years of age can only be prescribed by the attending physician on an individual basis.

Intravenous administration of the solution is carried out only in a hospital, the approximate dosage is 10 mg per kg of weight.

Analogs

On the market you can find several drugs with the active substance - acetylcysteine. First of all, these are the Italian drug Fluimicil and the German Acestad, the drugs Mukobene, Acestine, Acetylcysteine, VixActiv. The cost of analogues approximately corresponds to the cost of ACC.

Indirect analogues include other mucolytic drugs, such as Bromhexine and Ambroxol, but their action and contraindications are somewhat different from those characteristic of ACC.

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ACC or Acetylcysteine ​​- a detailed description of the legendary drug, facts and misconceptions.

ACC (Acetylcysteine) promotes liquefaction and abundant secretion of sputum, as a result of which the cough is softened, and sputum is easier to expectorate and is removed from the body, freeing the lungs and bronchi. This effect of Acetylcysteine ​​is a consequence of its destructive (mucolytic) effect on the structure of mucopolysaccharides responsible for the viscosity of sputum.

Before you continue reading: If you are looking for an effective method of getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to look at this section of the site after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

In addition, Acetylcysteine ​​is characterized by a mild antiseptic effect, immunomodulatory and hepatoprotective (restoring the structure of liver cells) activity.

Recently, Acetylcysteine ​​solution is often prescribed for the treatment of mental illness: the drug is believed to have a mild psychotropic effect.

Indications. For what diseases is Acetylcysteine ​​used?

Acetylcysteine, which is no less known as ACC, is actively used for inhalation and injection in adults and children. Indications for prescribing the medicine:

  • Acute bronchitis
  • Chronic bronchitis, including obstructive
  • Bronchiectasis
  • Bronchial asthma complicated by irreversible bronchial obstruction
  • Cystic fibrosis
  • Pneumonia (lung inflammation)
  • Other respiratory diseases in which coughing is difficult due to increased viscosity of sputum

Help with coughs with sticky sputum. Inhalations and injections

Cough is the body’s protective reaction to irritation of the mucous membrane of the upper respiratory tract. This irritation can be caused by foreign objects, e.g. a person coughs because he has choked. We also cough, inhaling suffocating gases and toxic fumes.

However, the most common causes of cough, for which the administration of Acetylcysteine ​​inhalations to children and adults (and its ingestion) is indicated, are allergic and infectious diseases, as a result of which an inflammatory process develops in the mucous membrane of the larynx, trachea, bronchi and lungs, accompanied by the release of mucus - sputum.

PS For effective inhalations you need a good inhaler. How to choose the right inhaler for inhalation? - a very useful article, don’t be lazy to read! This article also explains how to do inhalations and many other important and interesting nuances.

Sputum during bronchitis can vary in nature, composition and consistency. Transparent liquid sputum is usually easily coughed up, but bronchitis is often accompanied by the release of viscous sputum, which clogs the lungs and bronchi and leads to worsening of the disease.

In this case, the cough becomes painful and the sputum becomes purulent, which is a bad prognostic sign. If bronchitis is complicated by bronchiectasis (dilation of sections of the bronchi), in which viscous purulent sputum accumulates in large quantities, a solution (Acetylcysteine) can be prescribed by injection - intramuscular or intravenous.

In addition, a solution for parenteral administration is prescribed for cystic fibrosis, a severe hereditary lung disease accompanied by a violation of their physiological state and breathing problems.

Synonyms and name variations

Persistent cough requires complex drug treatment, one of the components of which is drugs from the group of mucolytics. It is to this group of drugs that Acetylcysteine ​​belongs (synonyms for the drug name N-Acetylcysteine, N-acetyl-L-cysteine, the abbreviated form of the name is ACC).

Synonyms of the drug also include commercial names of drugs such as Inspir, Acetein, Broncholysin, Airbron, Broncholysin, Fluimucil, Mucosolvin, Mucoluticum, Mucomyst, Racomex, etc. Some of these drugs include excipients, but each of them contains N -Acetylcysteine ​​is the main active component.

Antibiotic Acetylcysteine: a myth that has no relation to reality

If you are offered to buy the antibiotic Acetylcysteine ​​“at a reasonable price”, do not do this for two reasons.

Firstly, you can only buy any medicine at a pharmacy, public or private (licensed).

Secondly, the antibiotic Acetylcysteine ​​is a non-existent drug, because the drug is not an antibiotic in its structure and mode of action, and does not have a bactericidal effect.

Acetylcysteine ​​alone can cure an infectious disease without an antibiotic. However, in case of viscous purulent sputum, when prescribing an antibacterial agent, the doctor will definitely prescribe Acetylcysteine ​​or another mucolytic in combination with an antimicrobial drug in order to speed up its action and enhance the effect.

N-Acetylcysteine ​​in combination with tuaminoheptane: actions and indications

Among the most effective complex preparations with a mucolytic effect, which includes ACC, is a spray for irrigation of the nose and throat acetylcysteine ​​+ tuaminoheptane.

In combination with acetylcysteine, tuaminoheptane is used to treat inflammatory diseases of the upper respiratory tract, as well as for inhalation for bronchitis and pneumonia.

Once in the lungs, these substances act in combination: acetylcysteine ​​thins sputum, tuaminoheptane has a vasoconstrictor effect and reduces the formation of mucus.

It should be borne in mind that tuaminoheptane is a beta blocker, and therefore its action may cause undesirable effects in some patients. Therefore, in some cases, the drug Acetylcysteine ​​for inhalation is used in isolation.

If the dosage, frequency of procedures and duration of treatment are observed, the drug in its pure form does not cause any significant side effects.

Acetylcysteine ​​is available for inhalation in ampoules. After opening the ampoule, the solution may change color, which is normal.

Is Acetylcysteine ​​prescribed for children with bronchitis?

Acetylcysteine ​​is prescribed to children, and very actively, due to its safety and high effectiveness. As a rule, for children over three years of age the drug is prescribed by inhalation. For children under 3 years of age, the injection option is more recommended.

The fact is that a small child is not always able to expectorate on his own, and after inhalation this must be done. Otherwise, the baby may simply choke on the abundant phlegm.

Which is better: Acetylcysteine ​​or Ambroxol?

It is difficult to answer this question. Acetylcysteine, Ambroxol and other mucolytics, acting on one principle or another, reduce the amount of mucopolysaccharides in the secretion, as a result of which the sputum becomes liquid and abundant, it is easier to cough up and the lungs are freed from purulent contents.

Moreover, each medicine has additional effects, based on which the doctor prescribes this or that drug for the treatment of bronchitis, its complications, as well as other diseases of the upper respiratory tract accompanied by cough.

One of the advantages of Ambroxol is its low price compared to the price of Acetylcysteine. At the same time, although Ambroxol is much cheaper, anyone can also afford to buy Acetylcysteine: this highly effective medicine is far from the most expensive.

The price is quite affordable

Despite the unique capabilities, the cost of the drug Acetylcysteine ​​is low. However, there are cheaper medications with similar effects.

So, if price is a determining factor for you when purchasing Acetylcysteine, you can discuss with your doctor the possibility of replacing it, for example, with Ambroxol.

However, remember that such a replacement is not always indicated, and carefully study the instructions for Acetylcysteine ​​and the instructions for another drug from the mucolytic group if you are offered to buy it at a pharmacy in the absence of the first one.

If Acetylcysteine ​​is affordable for you, it is not recommended to change your doctor’s prescriptions on your own or experiment with medications.

The average price of the drug is rubles.

The article above and comments written by readers are for informational purposes only and do not encourage self-medication. Consult a specialist regarding your own symptoms and illnesses. When taking any medicine, you should always use the instructions that come with the medicine and your doctor's advice as a guide.

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Do you want to get rid of your nose, throat, lung and cold diseases? Then be sure to check it out here.

It is also worth paying attention to other drugs for bronchitis and cough:

ACC powder is sold in pharmacies in sachets, to which the seller does not attach an annotation. And it says that this drug is incompatible with antibiotics, other antitussives, and nitroglycerin. After ACC, ANY medications can be taken no earlier than 2 hours later.

2. The fact that even a child cannot drink all medications in one slide is clear; the drugs interact with each other, so the interval between doses is at least 2 hours!

3. ACC is a mucolytic (it thins sputum and weakly removes it!), and antitussives inhibit the cough center, i.e., they are used when there is pathologically NO sputum - this begs the question: why combine them?

I have bronchitis, is it possible to combine ACC with Berodual *n?

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