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Acetylcysteine: Uses, Side Effects, Dosage Use | Good Doctor

Acetylcysteine ​​is a mucolytic drug whose function is to thin phlegm or mucus in the mouth, throat and lungs.

In addition, acetylcysteine ​​in other forms can also be used to prevent liver damage from acetaminophen overdose.

To find out more about this drug, let’s look at the following explanation.

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What is acetylcysteine

acetylcysteine ​​medication.
Acetylcysteine ​​liquid. Photo Source :

Acetylcysteine ​​comes in 3 forms, a liquid that is inhaled, a liquid for injection, and a tablet drug that is taken by mouth or orally. Drugs in liquid form are usually only available in generic form.

When inhaled by mouth, acetylcysteine ​​liquid helps thin and loosen phlegm in the airways due to certain lung diseases. Such as emphysema, bronchitis, pneumonia, and cystic fibrosis.

To use it you need a tool called a nebulizer. A medical device whose use is to change medicine in liquid form into vapor particles and put the drug directly into the lungs.

When taken orally, acetylcysteine ​​tablets are used as a medication to prevent liver damage from acetaminophen overdose. In this article, we will discuss more about acetylcysteine ​​in liquid form that is inhaled.

Ways of working

This drug is a mucolytics class whose job is as a phlegm or mucus thinning agent. It will react to the chemicals in the phlegm.

From there the phlegm will become thinner, easier to expel, and clear the airways of patients who have problems due to certain lung diseases.

Therefore, this drug is not suitable for people who have a dry cough.

Before taking this drug

If you plan to use this drug, be sure to consult a doctor or medical officer and tell your doctor about these things:

  • Tell your doctor or pharmacist if you are allergic to this drug or if you have any other allergies. Because this drug may contain ingredients that can cause allergies in your body.
  • Those of you who have allergies should be vigilant because this drug can cause severe allergic reactions such as difficulty breathing and swelling of the tongue and throat.
  • If you have a history of diseases such as asthma and peptic ulcers, don’t forget to convey this to your doctor.
  • Tell your doctor or pharmacist all medicines you are taking or have recently taken. Including vitamins, supplements, and also treatment with herbal medicines.
  • For Moms who are pregnant it is better to consult a doctor before taking this drug. Because this drug belongs to group B, which means:
    • This drug has been tested in pregnant animals and has not shown any risk to the fetus.
    • However, not enough studies have been conducted in pregnant women to demonstrate a risk to the fetus.
  • For Moms who are breastfeeding, it is also a good idea to consult a doctor first. Because this drug can be carried by breast milk and can have side effects on the baby.

Drug interactions

This drug can be less effective or can cause dangerous side effects if used with certain types of other drugs. Therefore it is important to tell your doctor the history of any drugs you are currently using.

In general, acetylcysteine ​​does not cause fatal or dangerous reactions. Here are some drugs that can cause reactions when used together:

  • Activated charcoal
  • Azithromycin
  • Bazedoxifene/conjugated estrogens
  • Chloramphenicol
  • Clarithromycin
  • Demeclocycline
  • Dichlorphenamide
  • Doxycycline
  • Erythromycin base
  • Erythromycin ethylsuccinate
  • Minocycline
  • Erythromycin lactobionate
  • Erythromycin stearate
  • probenecid
  • Sodium picosulfate/magnesium oxide/anhydrous citric acid
  • Tetracycline
  • Vancomycin

When you use a nebulizer, make sure not to mix it with other types of drugs without the knowledge of a doctor or medical officer.

Acetylcysteine ​​side effects

Both inhaled and oral medications have side effects. But usually the effects that arise are not fatal, only a few cases show dangerous reactions.

Here are some side effects of inhaled acetylcysteine:

  • Increased frequency of coughing (the effect of this drug is to thin phlegm in the respiratory tract)
  • Nauseous
  • Vomit
  • Cold or runny nose
  • The appearance of sores in the mouth such as canker sores which are sometimes painful
  • Fever
  • Asphyxiate
  • Wheezing
  • If the symptoms get worse, contact the doctor immediately. Especially if symptoms of difficulty breathing and chest feel very tight.

Here are some side effects of drugs taken orally (to prevent liver damage):

  • Terrible stomach ache
  • Black stools
  • Nausea and vomiting that looks like coffee grounds
  • Call your doctor if you have severe vomiting, coughing up blood, dark urine, and yellowing of the skin and whites of the eyes.

Usage recommendations

To prevent errors in consumption and side effects, you should always pay attention to the recommendations for using the drug.

Both what is stated on the package and as explained by the doctor when giving the prescription. Do not use more or less than the given dose.

The following are recommendations for use for those of you who will use acetylcysteine ​​with a nebulizer:

  • You can only inhale acetylcysteine ​​from the nebulizer using a face mask, mouth piece, of courseor IPPB machine (Intermittent Positive Pressure Breathing).
  • Make sure you use the nebulizer with medical staff to ensure the dosage and method used are correct.
  • Do not mix acetylcysteine ​​liquid before you are ready to use the nebulizer.
  • After the liquid medicine is mixed into the nebulizer container, make sure to use it no more than 1 hour. Do not use a mixture that has been more than 1 hour.
  • This medicinal liquid may change color after the bottle is opened. But don’t worry, because this is just a chemical reaction and doesn’t affect the drug content.
  • When you use this drug, you may feel an unpleasant odor. But the smell will disappear with time.
  • Clean the nebulizer after every use. Nebulizers that are not cleaned properly can become clogged due to residue from the medication left behind.
  • Once the medicine bottle is open, store it in a place at room temperature away from heat and moisture.

The following are recommendations for use for those of you who are taking oral medications to prevent liver damage:

  • Do not take this drug without a doctor’s prescription. Make sure you consume it under the supervision of a doctor.
  • The doctor will usually do a blood check to find out the level of acetaminophen in your body.
  • From there the doctor will give recommendations for how long you should take acetylcysteine, don’t stop until your doctor tells you to stop.
  • If you vomit 1 hour after taking this drug, you are required to immediately take 1 more dose.

Things to note

Reported from Healthlineto suppress side effects and also maximize treatment with this drug, it’s a good idea to follow some recommendations.

One of the most important is to consume according to the recommendations or doses given by the doctor. Because if not, this drug can pose several risks including:

If you stop

If you stop using the drug or don’t finish it, there is a risk of symptoms such as: wheezing and the breathing difficulties got worse.

If you don’t take your medication on schedule

This medicine must be taken according to the schedule made so that symptoms such as difficulty breathing and wheezing not getting any worse. Do not change the drug use schedule without consulting a doctor.

So what if you forget to use it? If it’s only been a few minutes or hours, hurry up to use it.

However, if the time is approaching the schedule for using the next drug, you do not need to replace the forgotten dose. You can immediately continue using the drug according to the next schedule.

If you use it excessively

Using drugs in large quantities at once does not mean healing will be achieved more quickly. Therefore you are still advised to use it according to the dosage.

Yes, even though inhaled drugs rarely cause an overdose in the lungs, your body could actually be immune to this drug and no longer work.

If you feel that the effectiveness of the drug is not optimal and you use it frequently, you should immediately contact your doctor.

How do you know if this drug is working effectively

For inhalation type drugs, you can know that this drug is starting to work if you start to cough frequently and are accompanied by phlegm.

In addition, symptoms such as difficulty breathing and wheezing also decreasing.

Dosage of drug use

The prescription for the dose and frequency of use of the drug will usually depend on several factors, including:

  • Patient age
  • What conditions are encountered
  • The severity of the patient’s condition
  • The patient’s condition or medical history
  • How did the patient react when given the first dose of the drug

Here are some prescription drug doses that are usually given to adult patients and children. This time we will only discuss the dosage of using inhaled drugs:

  • Generic: Acetylcysteine
  • Form : Inhaled solution
  • Strength : 10% (100 mg/mL) or 20% (200 mg/mL) solution
  • Tools used: Nebulizer

Dosage to thin phlegm in the respiratory tract

  • For patients 18 years and older: The recommended dose is 3-5 mL of the 20% solution, or 6-10 mL of the 10% solution, administered 3-4 times per day.
  • Can also be given 1-10 mL of 20% solution or 2-20 mL of 10% solution with a frequency of every 2 to 6 hours.
  • For patients aged 0-17 years : This drug has not been confirmed as safe for patients younger than 18 years. It’s a good idea to consult a doctor.

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Storage of acetylcysteine ​​drugs

To keep the ingredients in the drug from being damaged and to keep it in good quality, there are a number of steps you can take:

  • Store unopened vials of medicine at room temperature, away from moisture and away from objects with high temperatures. Try to keep the temperature between 20 to 25 degrees Celsius.
  • If the bottle has been opened before and still leaves some contents inside, you can store it in the fridge. But there is a time limit for this medicine, you can only use it for a maximum of 4 days after the first bottle is opened.
  • If you need a thinner dose of medicine, you can use the medicine after it has been diluted with a solution for about 1 hour.
  • What if you use refill medicine? The prescription for this drug can usually be refilled and you don’t need to get a new prescription. Doctors will usually include refill doses when they first give a prescription.

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