Acetylcysteine: English spelling of Acetylcystein
Acetylcysteine is the English spelling of the active substance Acetylcystein, which is designated as such in international specialist literature and on English language package inserts. In German specialist language and in German pharmacies, the correct spelling is Acetylcystein, often abbreviated as ACC or NAC (N Acetylcystein). Both spellings refer to the same active substance and are used synonymously in practice. This page is intended for patients who have found the designation Acetylcysteine in English language sources or on imported preparations and are seeking information.
Acetylcystein has been established in Germany since the 1960s as a secretolytic agent for respiratory diseases with thick mucus, and since the 1970s also as an antidote for paracetamol poisoning. In modern therapy, Acetylcystein is used primarily as an over the counter cough expectorant and as a prescription antidote solution. Detailed information on the active substance profile, indications, dosage, side effects and drug interactions can be found on our Acetylcystein Pillar Page.
Definition
The spelling Acetylcysteine derives from international nomenclature (INN, International Nonproprietary Name), while Acetylcystein is the form used in Germany and many European countries. Both designations refer to the same molecule: an acetylated cysteine amino acid derivative with the chemical structural formula C5H9NO3S. In medical specialist literature, in English language package inserts and on imported original preparations, the form Acetylcysteine is used more frequently.
Other common designations are N Acetylcystein, NAC, Mucomyst (older brand name), Fluimucil (internationally used brand name) and ACC (German brand name). Pharmacists and physicians recognize all of these designations as synonyms. With imported preparations or in travel medicine kits, the form Acetylcysteine may occur; the ingredients are then identical to Acetylcystein in German preparations.
Mechanism of Action
Acetylcystein functions as a mucolytic agent in secretolytic therapy. It breaks down disulfide bonds in the glycoproteins of thick mucus, making it more fluid and easier to cough up. In antidote application, Acetylcystein acts as a glutathione precursor and replaces the glutathione consumed by paracetamol in the liver, thereby preventing the formation of the hepatotoxic metabolite NAPQI. More on the mechanism of action can be found on the Acetylcystein Pillar Page.
Indications
- Respiratory diseases with thick mucus, acute and chronic bronchitis, COPD, cystic fibrosis
- Paracetamol poisoning as specific antidote, intravenous or oral
- Contrast induced nephropathy as prophylaxis (controversial, conservatively assessed in guidelines)
- Adjuvant therapy in specific indications such as heavy metal poisoning or hepatic dysfunction
Dosage and Administration
Secretolytic oral adults: 600 mg per day divided into 1 to 3 individual doses. For acute bronchitis 5 to 7 days, for chronic bronchitis longer term according to medical instructions.
Secretolytic oral children: dose adjusted according to age and weight, available in pharmacies in the form of effervescent tablets or granules.
Inhalation: 300 to 600 mg in inhalation solution 1 to 3 times daily, helpful for thick bronchial secretions.
Antidote for paracetamol poisoning intravenous: 150 mg per kg over 60 minutes, then 50 mg per kg over 4 hours, then 100 mg per kg over 16 hours. Ideally begin within 8 hours after poisoning.
Antidote oral: 140 mg per kg initial dose, then 70 mg per kg every 4 hours for 17 doses.
Renal insufficiency/Hepatic insufficiency: usually no adjustment required.
Side Effects
Frequent: gastrointestinal complaints, nausea, vomiting, diarrhea, heartburn, sulfurous taste in mouth.
Occasional: headache, fatigue, skin rash, pruritus, tinnitus, fever.
Rare: anaphylactoid reactions especially with intravenous administration with bronchospasm, hypotension, skin flushing. Bronchospasm possible with inhalation (particularly in asthmatics).
Very rare: severe skin reactions such as Stevens Johnson syndrome, toxic epidermal necrolysis.
For more details on side effects, see the Acetylcystein Pillar Page.
Drug Interactions
- Antitussives (codeine, pentoxyverin, dextromethorphan): secretion stasis possible with concurrent use, avoid combination.
- Antibiotics (penicillins, cephalosporins, tetracyclines, aminoglycosides): possible reduction in effectiveness. Take Acetylcystein and antibiotic with minimum interval of 2 hours.
- Activated charcoal: with oral antidote application, activated charcoal can impair resorption of Acetylcystein.
- Nitroglycerin: theoretical potentiation of vasodilatory effect, clinical relevance unclear.
Special Notes
Pregnancy and lactation: Acetylcystein is considered safe with strict indication. Children: established from 2 years of age in age appropriate dosage.
Asthma bronchiale: caution with inhalation due to bronchospasm risk, possibly co medication with short acting beta 2 agonists.
Peptic ulcer: caution with active gastrointestinal ulcer due to possible gastric mucosa irritation.
Use in paracetamol poisoning: immediately after diagnosis, if possible within 8 hours, in hospital under medical supervision.
Driving ability: not impaired by usual oral administration.
You Might Also Be Interested In
- Acetylcystein, main page on this active substance
- Ambroxol, further secretolytic for respiratory diseases
- Bromhexin, mucolytic with similar indication
- Paracetamol, analgesic with antidote Acetylcystein
- Dextromethorphan, antitussive
Frequently Asked Questions
Is Acetylcysteine the same as Acetylcystein?
Yes, Acetylcysteine is merely the English spelling of Acetylcystein. Pharmacologically it is the identical substance with the same effect, same indications and same side effects. In English language sources and on imported preparations, the form Acetylcysteine is used, in Germany Acetylcystein.
Which spelling is correct in Germany?
In German pharmacies and in German specialist language, Acetylcystein is the correct spelling. On package inserts and in the Red List this form is consistently used. Acetylcysteine is usually encountered by patients in imported preparations or in English language sources.
What is the difference between Acetylcystein and N Acetylcystein?
There is no pharmacological difference. N Acetylcystein (NAC) is the precise chemical designation that specifies the N on the nitrogen for the acetyl group. Acetylcystein is the shorter and more commonly used form. In scientific publications, NAC is often used, in clinical practice usually Acetylcystein or ACC.
Where can I find detailed information on this active substance?
Detailed information on mechanism of action, indications, dosage, side effects, drug interactions and notes can be found on our main page for Acetylcystein. This page contains the comprehensive pillar page with all aspects of the active substance.
Sources
- Gelbe Liste, Acetylcystein Active Substance Profile
- BfArM, Federal Institute for Drugs and Medical Devices
- AWMF Guidelines on Respiratory Diseases and Poisoning
Legal Notice and Disclaimer
The information provided on this page is for general information purposes only and does not constitute medical advice, diagnosis or treatment recommendation. It does not replace the advice of a licensed physician or pharmacist. All statements are based on specialist information published at the time of preparation and recognized scientific sources; the current product information from the manufacturer is always authoritative. Sanoliste assumes no liability for completeness, currency or accuracy of the information presented. In a medical emergency, call the emergency number 112.