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N-ACETYLCYSTEINE
N-acetylcysteine
What is it? N-acetylcysteine is a nonessential amino acid that is used to treat asthma, bronchitis, mercury poisoning, and aging spots on the skin. It may also be used to prevent side effects from chemotherapy and radiation.
Other names for N-acetylcysteine include: NAC, acetylcysteine, and mercapturic acid.
Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.
Before Using: Tell your doctor if you ...
- are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
- are pregnant or plan to become pregnant while using this medicine
- are breast feeding
- have asthma or liver disease
- have any other health problems, such as high blood pressure or heart or blood vessel disease
Dosage: Talk with your doctor, pharmacist, or nurse about how much N-acetylcysteine you should take. The amount depends on the strength of the medicine and the reason you are taking N-acetylcysteine. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more N-acetylcysteine or take it more often than what is written on the directions.
To store this medicine: Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.
Drug and Food Interactions: Do not take N-acetylcysteine without talking to your doctor first if you are taking:
- Carbamazepine (Tegretol(R)) (8)
- Nitroglycerin (Nitrostat(R), Nitro-Dur(R), Nitro-Bid(R)) (11)
Warnings:
Before taking N-acetylcysteine, tell your doctor if you are pregnant or breast feeding
Do not use without a doctor's advice if you have asthma or liver disease (7,8)
Large doses of N-acetylcysteine can be toxic (dangerous) to nerve cells (1)
Side Effects: Call your doctor right away if you have any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash.
Other Possible Side Effects: You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.
- Diarrhea, nausea (upset stomach), vomiting (3)
References:
1. Liniger S (ed): The Natural Pharmacy. Prima Publishing, Rocklin CA; 1998.
2. De Blaisio G, Forgione L, Marrazo R et al: N-acetyl cysteine (NAC) in preventing nausea and vomiting induced by chemotherapy in patients suffering form inoperable non-small-cell lung cancer (NSCLC). Chest:110(4supp):103S.
3. Holdiness MR: Clinical pharmacokinetics of N-acetylcysteine. Clin Pharmacokinet 1991; 20:123-134.
4. Paulsen O, Borgstrom L, Kagedal B et al: No effect of oral NAC on the bioavailability of erythromycin and bacampicillin. Eur Respir J 1988; 1(2):171-175.
5. Wright RO, Anderson AC, Lesko SL et al: Effect of metoclopramide dose on preventing emesis after oral administration of NAC for acetaminophen overdose. J Toxicol Clin Toxicol 1999; 37(1):35-42.
6. Tribble DL, Jones DP, Ardehali A et al: Hypercysteinemia and delayed sulfur excretion in cirrhotics after oral cysteine loads. Am J Clin Nutr 1989; 50(6): 1401-1406.
7. Jones AL, Jarvie DR, Simpson D et al: Pharmacokinetics of NAC are altered in patients with chronic liver disease. Aliment Pharmacol Ther 1997; 11(4): 787-791.
8. Simonart T, Tugendhaft P, Vereecken P et al: Hazards of therapy with high doses of N-acetylcysteine for anticonvulsant-induced hypersensitivity syndrome (letter). Br J Dermatol 1998; 138: 544-564.
9. Horowitz JD, Henry CA, Syrjanen ML et al: Combined use of nitroglycerin and N-acetlycysteine in the management of unstable angina pectoris. Circulation 1988; 77: 787-794.
10. Lawson D & Saggers BA: NAC and antibiotics in cystic fibrosis (letter). Br Med J 1965; 1:317.
11. Hogan JC, Lewis MJ, & Henderson AH: Chronic administration of N-acetylcysteine fails to prevent nitrate tolerance in patients with stable angina pectoris. Br J Clin Pharmacol 1990; 30:573-577.
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