Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: PO Mucolytic As powder for oral solution: 200 mg tid. Max: 600 mg/day. As effervescent tab: 600 mg once daily. Paracetamol poisoning As effervescent tab: Initial: 140 mg/kg; followed by 17 maintenance doses of 70 mg/kg given 4 hourly. Inhalation Mucolytic As 10% solution: 6-10 mL 3-4 times/day or 2-20 mL 2-6 hourly as necessary. As 20% solution: 3-5 mL 3-4 times/day, or 1-10 mL 2-6 hourly as necessary. Endotracheal Mucolytic As 10% or 20% solution: 1-2 mL every hour. Ophth Dry eye associated with abnormal mucus production As 5% solution: Instill 1 or 2 drops into the affected eye(s) 3 or 4 times/day. IV Paracetamol poisoning Initial: 150 mg/kg in 200 mL diluent over 60 minutes, followed by 50 mg/kg in 500 mL diluent over the next 4 hours, then 100 mg/kg in 1 L diluent over the next 16 hours.
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Contraindications
Use of oral powder for solution and effervescent tab in children below 2 years of age.
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Special Precautions
Patient with known or history of atopy and asthma, history of bronchospasm, history of. peptic ulcer disease, esophageal varices. Children. Pregnancy and lactation. Patient Counselling Ophthalmic: This drug may cause blurred vision, if affected, do not drive or operate machinery. Should not be used in patients who wear soft contact lenses. Monitoring Parameters Paracetamol poisoning: Monitor serum paracetamol levels, AST, ALT, bilirubin, prothrombin time, INR, serum creatinine, BUN, serum glucose, Hb, haematocrit and electrolytes.
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Adverse Reactions
Significant: Hypersensitivity reactions (e.g. urticaria, rash, hypotension, wheezing, dyspnoea); fluid overload resulting in hyponatraemia and seizures, decreased prothrombin time, acute flushing, skin erythema (IV); risk of upper gastrointestinal haemorrhage (oral); haemoptysis, rhinorrhoea, stomatitis (inhalation).
Cardiac disorders: Cardiac arrest.
Eye disorders: Ophthalmic: Itching, redness, eye irritation, blurred vision.
Gastrointestinal disorders: Nausea, vomiting.
General disorders and administration site conditions: Fever, sweating.
Investigations: Liver function disturbances.
Metabolism and nutrition disorders: Acidosis.
Musculoskeletal and connective tissue disorders: Arthralgia.
Nervous system disorders: Convulsion.
Respiratory, thoracic and mediastinal disorders: Respiratory arrest.
Vascular disorders: Hypo/hypertension, syncope.
Potentially Fatal: Serious hypersensitivity reactions (e.g. bronchospasm, angioedema), fluid overload resulting in hyponatraemia and seizures (IV). |
Drug Interactions
Build-up of bronchial secretions due to reduced cough reflex with antitussive drugs. Reduced effect with activated charcoal. May enhance the vasodilatory effects of nitroglycerin. May reduce the pharmacological effects of antibiotics.
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ATC Classification
V03AB23 - acetylcysteine ; Belongs to the class of antidotes. Used to neutralize paracetamol overdose.
S01XA08 - acetylcysteine ; Belongs to the class of other ophthalmologicals. R05CB01 - acetylcysteine ; Belongs to the class of mucolytics. Used in the treatment of wet cough. |