Name: ACC (ACC)
Indications for use:
ACC is prescribed in all cases of diseases with accumulation of thick viscous sputum in the bronchial tree and upper respiratory tract, namely:
• Acute and chronic bronchitis, including obstructive;
• Bronchial asthma;
• Cystic fibrosis;
• Average exudative otitis.
The active substance is acetylcysteine, a derivative of cysteine (amino acid). It has a mucolytic, expectorant effect due to the rupture of bisulfide bonds of sputum mucopolysaccharides. This depolymerizes mucoproteins and increases the viscosity of bronchial secretions. As a result, mucociliary clearance increases and sputum discharge improves. Acetylcysteine has an antioxidant and pneumoprotective effect, which is associated with the binding properties of sulfhydryl groups. It is an antidote for acute poisoning with aldehydes, paracetamol and phenols (the detoxifying effect is possible due to increased production of glutathione).
Acetylcysteine with internal use is almost immediately completely absorbed from the gastrointestinal tract. The active metabolite is cysteine, which is formed in the liver. Further, the metabolism of acetylcysteine passes through the formation of diacetylcysteine, cystine. The end product of metabolism is mixed disulfides.
Bioavailability is 10%. Cmax is determined for internal use after 1-3 hours. Plasma proteins bind 50% of acetylcysteine. The maximum concentration of the pharmacologically active metabolite in the blood is 2 µmol/l.
Inactive metabolites are excreted in the urine (inorganic sulfates, diacetylcysteine), however, a non-cordial amount of acetylcysteine is excreted unchanged in the feces.
The half-life of acetylcysteine depends on biotransformation in the liver. In liver failure, it is 8 hours, while normally it is 1 hour. It passes through the hematoplacental barrier and can accumulate in the fetal waters.
ACC (ACC) method of administration and doses:
• The daily dose for the treatment of cystic fibrosis in patients weighing more than 30 kg is used up to 800 mg.
• Children from the 10th day of life and up to 2 years of age use 50 mg 2-3 r / s.
• At the age of 2-5 years – 400 mg per day, divided into 4 doses.
• From 6 years old – 600 mg / s (divided into 3 doses). Treatment is continued for a long time, courses for several months (3-6).
• In all other cases, the daily dose for children from 14 years of age and adults is 400-600 mg.
• From 6 to 14 years – 300-400 mg (divided into 2 doses).
• 2-5 years – 200-300 mg (divided into 2 doses).
• Children from the 10th day of life and up to 2 years of age use 50 mg 2-3 r / s. In acute diseases without complications, the product is prescribed for 5-7 days. In the case of the presence of complications or in the case of a chronic course, course treatment is possible (up to 6 months).
ACC is taken after a meal. The tablet or the contents of the sachet must be dissolved in half a glass of liquid (cold tea, water, juice).
ACC (ACC) contraindications:
• Hypersensitivity to acetylcysteine and excipients
• Peptic ulcer
• Hereditary fructose intolerance
• Pulmonary hemorrhage or hemoptysis
• In pediatric practice – with hepatitis and renal failure (threat of accumulation of nitrogen-containing products).
ACC (ACC) side effects:
From the gastrointestinal tract – stomatitis, nausea, vomiting, diarrhea, heartburn.
From the side of the central nervous system – headache, tinnitus.
From the side of the CCC – arterial hypotension, increased heart rate.
Allergic reactions – bronchospasm (especially with bronchial hyperreactivity), rash and itching of the skin. Often the cause of hypersensitivity to the product is the presence of propyl and methyl parahydroxybenzoate in the composition.
In pediatric practice, cases of hypersecretion in infants are described. Side effects that threaten life and health are not described. In case of overdose (dyspeptic disorders), symptomatic therapy is prescribed.
Use with other drugs:
Tetracycline and its derivatives (except doxycycline) should not be used together with ACC in pediatrics.
During experimental in vitro studies, there were no cases of inactivation of other types of antibacterial products. However, it is recommended to observe the interval between taking ACC and antibiotic at least 2 hours. In vitro, the incompatibility of acetylcysteine with semi-synthetic penicillins, aminoglycoside and cephalosporin antibiotics has been proven. Such studies have not been conducted with erythromycin, amoxicillin and cefuroxime.
Simultaneous use of antitussive drugs can lead to stagnation of the secretion of the respiratory tract.
The use of nitroglycerin may enhance the vasodilating effect in the aftermath.
ACC 100, 200 – effervescent tablets, 20 pcs.
ACC hot drink – powder for preparing a hot drink for internal use – 200 mg (20 sachets) and 600 mg (6 sachets).
ACC-long – effervescent tablets (600 mg), 10 pcs. in a tube.
ACC powder for solution for oral administration – 100, 200 mg, 2 pcs. in a pack.
In places inaccessible to children. Temperature not more than 30°С. The finished solution should be stored for no more than 12 days in the refrigerator (at a temperature of 2-8°C).
Powder: acetylcysteine and auxiliary components (sucrose).
ACC Long effervescent tablets: acetylcysteine and auxiliary components (ascorbic acid, sodium citrate, saccharin, sodium cyclamate, lactose, citric acid, sodium carbonate, mannitol, sodium bicarbonate, flavoring).
ACC for children: acetylcysteine.
When preparing a solution, a patient with bronchial asthma can inhale air with particles of the product, which causes irritation of the mucous membrane of the upper respiratory tract and can provoke reflex bronchospasm.
For the best mucolytic effect in the treatment with acetylcysteine, it is necessary to take a lot of liquid.
10 ml of the prepared oral solution contains 0.31 carbohydrate units, which should be taken into account for patients with diabetes.
Sorbitol has a slight laxative effect on the stool.
For newborns and children under 1 year of age, acetylcysteine is used exclusively for health reasons under strict medical supervision. The recommended dosage (10 mg/kg body weight) must not be changed.
ACC 200 is not used at the age of up to 2 years.
ACC Long is not recommended for children under 14 years of age.
The speed of reaction when driving and working with machinery does not change when taking acetylcysteine.