Take ACC 200 effervescent. Medicinal reference book geotar

P N013941/01

Trade name of the drug:

Vicks Active ExpectoMed

International nonproprietary name:

acetylcysteine

Dosage form Vicks Active ExpectoMed:

effervescent tablets

Compound Vicks Active ExpectoMed:

One effervescent tablet contains

active substance: acetylcysteine ​​200 mg or 600 mg

excipients: anhydrous citric acid 843.03/648.99 mg, sodium bicarbonate 695.64/548.72 mg, lemon flavor 100.00/100.00 mg, adipic acid 100.00/41.82 mg, fine adipic acid 20, 00/20.00 mg, povidone 21.33/20.47 mg, aspartame 20.00/20.00 mg.

Description Vicks Active ExpectoMed:

White or white with a yellowish tint, round flat tablets with a lemon odor. There is a risk tablet on one side.

Pharmacotherapeutic group:

expectorant (mucolytic) agent.

ATX code:

R05CB01

Pharmacological action

Pharmacodynamics.

Acetylcysteineexhibits secretolytic and secretomotor effects in the bronchial tract. Liquefies mucus, increasing its volume, making it easier to separate. It remains active even in the presence of purulent sputum.

The mechanism of action is based on the ability of the sulfhydryl groups of acetylcysteine ​​to break the disulfide bonds of acidic mucopolysaccharides of sputum, which leads to depolarization of mucoproteins and a decrease in mucus viscosity.

Helps increase the synthesis of glutathione, which is an important antioxidant factor in intracellular protection and ensures the maintenancefunctional activity and morphological integrity of the cell, which, in particular, explains its effectiveness as an antidote for paracetamol poisoning.

Due to the ability of the sulfhydryl group to neutralize electrophilic oxidative toxins,Acetylcysteinehas an antioxidant effect.

It also has some anti-inflammatory effect (by suppressing the formation of free radicals and reactive oxygen-containing substances responsible for the development of inflammation in the lung tissue).

Pharmacokinetics.

When taken orally Acetylcysteine well absorbed from the gastrointestinal tract. Substantially undergoes a first-pass effect through the liver, metabolized to form cysteine, diacetylcysteine, cystine and various disulfides, which reduces bioavailability to 10%. Maximum concentration Acetylcysteine in blood plasma is achieved after 1-3 hours, in patients with impaired liver function - after 8 hours. The therapeutic effect is observed after 30-90 minutes and lasts for 2-4 hours.

It is excreted mainly by the kidneys in the form of inactive metabolites, a small part is excreted unchanged in the feces.

Penetrates the placental barrier and accumulates in the amniotic fluid.

Indications for use Vicks Active ExpectoMed

Respiratory diseases and conditions accompanied byformation of viscous, difficult to separate mucopurulent sputum:

Acute and chronic bronchitis;

Tracheitis due to bacterial and/or viral infection;

Bronchiolitis;

Pneumonia;

Bronchial asthma;

Bronchiectasis;

Atelectasis due to blockage of the bronchi by mucus plug;

Cystic fibrosis (as part of combination therapy);

removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions;

Catarrhal and purulent otitis media, sinusitis, sinusitis (facilitation of secretion discharge).

The drug is used in the treatment of paracetamol overdose.

Contraindications

Known hypersensitivity to acetylcysteine ​​or other ingredients of the finished dosage form;

Pregnancy, lactation period;

Peptic ulcer of the stomach and duodenum in the acute phase;

Phenylketonuria;

Children under 14 years of age (for tablets 600 mg);

Children under 2 years (for tablets 200 mg).

With caution

Acetylcysteine ​​is used with extreme caution in patients with bronchial asthma, liver disease, kidney disease, adrenal dysfunction, esophageal varicose veins, and in persons prone to pulmonary hemorrhage, hemoptysis, phenylketonuria, and arterial hypotension.

Vicks Active ExpectoMed method of administration and dosage

Orally, after meals, after dissolving the effervescent tablets in a glass of water. Effervescent tablets should be taken immediately after dissolution.

Effervescent tablets 600 mg

adults and adolescents over 14 years of age: 1/2 effervescent tablet 2 times a day or 1 effervescent tablet 1 time a day (600 mg acetylcysteine ​​per day).

Effervescent tablets 200 mg

Adults and adolescents over 14 years of age: 1 effervescent tablet 2-3 timesper day (400-600 mg acetylcysteine ​​per day);

Children aged 6 to 14 years: 1 effervescent tablet 2 times a day(400 mg acetylcysteine ​​per day);

children aged 2 to 6 years: 1/2 effervescent tablet 2-3 times a day (200-300 mg acetylcysteine ​​per day).

Treatment of cystic fibrosis:

Children over 6 years old: 1 effervescent tablet 3 times a day (600 mg acetylcysteine ​​per day);

Children aged 2 to 6 years: 1/2 effervescent tablet 4 times a day (400 mg acetylcysteine ​​per day).

The duration (continuity) of use depends on the characteristics of the disease. When treating chronic bronchitis and cystic fibrosis, treatment can be long-term (up to several months).

Side effect

From the digestive system: rarely - heartburn, nausea, vomiting, diarrhea, feeling of fullness in the stomach; bleeding, partially associated with a hypersensitivity reaction.Allergic reactions:very rarely - skin rash, itching, urticaria, tachycardia, decreased blood pressure, bronchospasm (mainly in patients with bronchial hyperreactivity).

Others:rarely - headache, nosebleeds, rhinorrhea, tinnitus, drowsiness, stomatitis, fever.

If unwanted side effects occur, you should consult a doctor.

Overdose

To date, cases of overdose of acetylcysteine ​​preparations when administered orally have not been described. At a dose of 500 mg/kg, acetylcysteine ​​did not cause symptoms of poisoning. Theoretically possible: diarrhea, heartburn, nausea, vomiting, stomach pain.

Treatment: symptomatic.

Interaction with other drugs

With the simultaneous use of acetylcysteine ​​and antitussives, sputum stagnation may increase due to suppression of the cough reflex, therefore such combined treatment should be carried out only under direct medical supervision.

There is evidence that the thiol group of acetylcysteine ​​can neutralize the activity of some antibiotics (amphotericin B, ampicillin, tetracyclines, excluding doxycycline, semisynthetic penicillins, cephalosporins, aminoglycosides). Therefore, it is advisable to take these antibiotics orally 2 hours after taking acetylcysteine.

It has also been established that antibiotics such as amoxicillin, doxycycline, erythromycin, thiamphenicol, and cefuroxime do not interact with acetylcysteine.

There are reports that the simultaneous use of acetylcysteine ​​and nitroglycerin can lead to an increase in the vasodilatory effect of the latter and a decrease in platelet aggregation. Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

Special instructions.

When using the drug in patients with bronchial asthma, it is necessary to ensure sputum drainage and combine it with bronchodilators.

During the period of use of the drug, patients are recommended to drink plenty of fluids, which supports the secretolytic effect of the drug.

When using the drug, it is necessary to use glass containers and avoid contact of the drug with metal, rubber, oxygen, and easily oxidizing substances.

Each effervescent tablet contains 20 mg of aspartame (equivalent to the content of 11.2 mg of phenylalanine), as a result of which the drug cannot be used by patients with phenylketonuria.

Release form Vicks Active ExpectoMed

Effervescent tablets 200 mg or 600 mg.

10 or 20 tablets in a plastic cylindrical case, sealed with a plastic stopper with a tear-off ring for tampering.

1 or 2 pencil cases along with instructions for use in a cardboard box.

Best before date

2 years.

Do not use after expiration dateindicated on the packaging!

Storage conditions

In a dry place, at a temperature not exceeding 25° C.

Keep out of the reach of children!

Release from pharmacies

Over the counter.

Legal entity in whose name the RU was issued:

Teva Pharmaceutical Enterprises Ltd., Israel.

Manufacturer:

Merkle GmbH, Germany.

In this article you can read the instructions for use of the drug Acetylcysteine. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Acetylcysteine ​​in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Acetylcysteine ​​analogues in the presence of existing structural analogues. Use for the treatment of bronchitis, pneumonia and other diseases accompanied by cough with sputum in adults, children, as well as during pregnancy and lactation. Composition of the drug.

Acetylcysteine- mucolytic agent, is a derivative of the amino acid cysteine. It has a mucolytic effect, facilitates the discharge of sputum due to a direct effect on the rheological properties of sputum. The action is due to the ability to break the disulfide bonds of mucopolysaccharide chains and cause depolymerization of sputum mucoproteins, which leads to a decrease in sputum viscosity. The drug remains active in the presence of purulent sputum.

It has an antioxidant effect due to the ability of its reactive sulfhydryl groups (SH groups) to bind to oxidative radicals and thus neutralize them.

In addition, acetylcysteine ​​promotes the synthesis of glutathione, an important component of the antioxidant system and chemical detoxification of the body. The antioxidant effect of acetylcysteine ​​increases the protection of cells from the damaging effects of free radical oxidation, which is characteristic of an intense inflammatory reaction.

With the prophylactic use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations in patients with chronic bronchitis and cystic fibrosis.

Compound

Acetylcysteine ​​+ excipients.

Pharmacokinetics

When taken orally, it is well absorbed from the gastrointestinal tract. Substantially undergoes first pass effect through the liver, resulting in decreased bioavailability. Binding to plasma proteins up to 50% (4 hours after oral administration). Metabolized in the liver and possibly in the intestinal wall. In plasma it is determined unchanged, as well as in the form of metabolites - N-acetylcysteine, N,N-diacetylcysteine ​​and cysteine ​​ester. Renal clearance accounts for 30% of the total clearance.

Indications

Respiratory diseases and conditions accompanied by the formation of viscous and mucopurulent sputum:

• acute and chronic bronchitis;
• tracheitis due to bacterial and/or viral infection;
• pneumonia;
• bronchiectasis;
• bronchial asthma;
• atelectasis due to blockage of the bronchi by mucus plug;
• sinusitis (to facilitate the passage of secretions);
• cystic fibrosis (as part of combination therapy).

Removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions.

Paracetamol overdose.

Release forms

Effervescent tablets 200 mg and 600 mg.

Powder for solution for oral administration 100 mg and 200 mg.

Solution for inhalation.

Instructions for use and dosage regimen

Inside. Adults - 200 mg 2-3 times a day in the form of granules, tablets or capsules.

Children 2-6 years old - 200 mg 2 times a day or 100 mg 3 times a day in the form of a water-soluble granulate; under 2 years - 100 mg 2 times a day; 6-14 years - 200 mg 2 times a day.

For chronic diseases for several weeks: adults - 400-600 mg per day in 1-2 doses; children 2-14 years old - 100 mg 3 times a day; for cystic fibrosis - children from 10 days to 2 years - 50 mg 3 times a day, 2-6 years - 100 mg 4 times a day, over 6 years - 200 mg 3 times a day in the form of a water-soluble granulate, effervescent tablet or capsules .

Inhalation. For aerosol therapy, 20 ml of a 10% solution or 2-5 ml of a 20% solution are sprayed in ultrasound devices; in devices with a distribution valve - 6 ml of a 10% solution. Duration of inhalation - 15-20 minutes; frequency - 2-4 times a day. When treating acute conditions, the average duration of therapy is 5-10 days; for long-term therapy of chronic conditions, the course of treatment is up to 6 months. In the case of a strong secretolytic effect, the secretion is sucked out, and the frequency of inhalations and the daily dose are reduced.

Intratracheal. To wash the bronchial tree during therapeutic bronchoscopy, use a 5-10% solution.

Locally. 150-300 mg is instilled into the nasal passages (for 1 procedure).

Parenterally. Administer intravenously (preferably by drip or slow stream over 5 minutes) or intramuscularly. Adults - 300 mg 1-2 times a day.

Children from 6 to 14 years old - 150 mg 1-2 times a day. For children under 6 years of age, oral administration is preferable; for children under 1 year of age, intravenous administration of acetylcysteine ​​is possible only for health reasons in a hospital setting. If there are still indications for parenteral therapy, the daily dose for children under 6 years of age should be 10 mg/kg body weight.

For intravenous administration, the solution is further diluted with 0.9% NaCl solution or 5% dextrose solution in a 1:1 ratio.

The duration of therapy is determined individually (no more than 10 days). In patients over 65 years of age, the minimum effective dose is used.

Side effect

• heartburn;
• nausea, vomiting;
• diarrhea;
• feeling of fullness in the stomach;
• skin rash;
• hives;
• bronchospasm;
• with shallow intramuscular injection and in the presence of increased sensitivity, a slight and quickly passing burning sensation may appear, and therefore it is recommended to inject the drug deep into the muscle;
• reflex cough;
• local irritation of the respiratory tract;
• stomatitis;
• rhinitis;
• nosebleeds;
• tinnitus;
• a decrease in prothrombin time due to the administration of large doses of acetylcysteine ​​(monitoring the state of the blood coagulation system is necessary);
• changes in the results of the salicylate quantitation test (colorimetric test) and ketone quantitation test (sodium nitroprusside test).

Contraindications

• peptic ulcer of the stomach and duodenum in the acute phase;
• hemoptysis;
• pulmonary hemorrhage;
• pregnancy;
• lactation period (breastfeeding);
• hypersensitivity to acetylcysteine.

Use during pregnancy and breastfeeding

The use of Acetylcysteine ​​is contraindicated during pregnancy and lactation (breastfeeding).

Use in children

When using acetylcysteine ​​in patients with bronchial asthma, it is necessary to ensure sputum drainage. In newborns, it is used only for health reasons at a dose of 10 mg/kg under the strict supervision of a physician.

Orally for children over 6 years old - 200 mg 2-3 times a day; children aged 2 to 6 years - 200 mg 2 times a day or 100 mg 3 times a day, up to 2 years - 100 mg 2 times a day.

Special instructions

Acetylcysteine ​​is used with caution in patients with bronchial asthma, diseases of the liver, kidneys, and adrenal glands.

A 1-2 hour interval should be observed between taking acetylcysteine ​​and antibiotics.

Acetylcysteine ​​reacts with some materials such as iron, copper and rubber used in the spray device. In places of possible contact with acetylcysteine ​​solution, parts made of the following materials should be used: glass, plastic, aluminum, chromed metal, tantalum, sterling silver or stainless steel. After contact, the silver may tarnish, but this does not affect the effectiveness of acetylcysteine ​​and does not cause harm to the patient.

Drug interactions

The simultaneous use of acetylcysteine ​​with antitussives may increase sputum stagnation due to suppression of the cough reflex.

When used simultaneously with antibiotics (including tetracycline, ampicillin, amphotericin B), their interaction with the thiol group of acetylcysteine ​​is possible.

When taking acetylcysteine ​​and nitroglycerin simultaneously, the vasodilator and antiplatelet effects of the latter may be enhanced.

Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

Pharmaceutically incompatible with solutions of other drugs. On contact with metals and rubber, it forms sulfides with a characteristic odor.

Analogues of the drug Acetylcysteine

Structural analogues of the active substance:

• N-AC-ratiopharm;
• N-acetylcysteine;
• Acestine;
• Acetylcysteine ​​Canon;
• Acetylcysteine ​​Teva;
• Acetylcysteine ​​solution for inhalation 20%;
• Acetylcysteine ​​solution for injection 10%;
• Acetylcysteine ​​PS;
• ACC injection;
• ACC Long;
• AC-FS;
• Vicks Active ExpectoMed;
• Mukobene;
• Mucomist;
• Mukonex;
• Fluimucil;
• Exomyuk 200;
• Espa-Nat.

Analogs by pharmacological group (secretolytics):

• Marshmallow syrup;
• Ambrobene;
• Ambroxol;
• Ambrosan;
• Ambrosol;
• Ascoril;
• Bromhexine;
• Bronchicum;
• Bronchicum inhalate;
• Bronchicum cough lozenges;
• Bronchicum cough syrup;
• Bronchipret;
• Bronchostop;
• Bronchotil;
• Gedelix;
• Hexapneumin;
• GeloMyrtol;
• Herbion primrose syrup;
• Herbion plantain syrup;
• Glycyram;
• Chest collection;
• Breast Elixir;
• Joset;
• Dr. MOM;
• Dr. Theiss syrup with plantain;
• Zedex;
• Insti;
• Carbocysteine;
• Cashnol;
• Codelac Broncho;
• Coldact Broncho;
• Coldrex broncho;
• Lazolvan;
• Libexin Muco;
• Linkas;
• Mukaltin;
• Mucosol;
• Expectorant collection;
• Pectosol;
• Pectusin;
• Pertussin;
• overslept;
• Rinicold Broncho;
• Sinupret;
• Mixture for inhalation;
• Licorice syrup;
• Solutan;
• Stoptussin;
• Cough tablets;
• Terpinhydrate;
• Travisil;
• Tussamag;
• Tussin;
• Tussin Plus;
• Fervex for cough;
• Flavamed;
• Flavamed forte;
• Fluifort;
• Fluditek;
• Halixol;
• Erdostein.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Trade name of the drug:

International nonproprietary name:

acetylcysteine.

Dosage form:

effervescent tablets.

Compound:

1 effervescent tablet contains:
active ingredient: acetylcysteine ​​– 200.00 mg; excipients: anhydrous citric acid – 558.50 mg; sodium bicarbonate – 200.00 mg; sodium carbonate anhydrous – 100.00 mg; mannitol – 60.00 mg; anhydrous lactose – 70.00 mg; ascorbic acid – 25.00 mg; sodium saccharinate – 6.00 mg; sodium citrate – 0.50 mg; blackberry flavor “B” – 20.00 mg.
Description: round flat-cylindrical tablets of white color with a score on one side, with the smell of blackberry. There may be a faint sulfuric odor.

Reconstituted solution: colorless, transparent solution with a blackberry odor.
There may be a faint sulfuric odor.

Pharmacodynamics

Acetylcysteine ​​is a derivative of the amino acid cysteine. It has a mucolytic effect, facilitates the discharge of sputum due to a direct effect on the rheological properties of sputum. The action is due to the ability to break the disulfide bonds of mucopolysaccharide chains and cause depolymerization of sputum mucoproteins, which leads to a decrease in sputum viscosity. The drug remains active in the presence of purulent sputum.
It has an antioxidant effect based on the ability of its reactive sulfhydryl groups (SH groups) to bind to oxidative radicals and thus neutralize them.
In addition, acetylcysteine ​​promotes the synthesis of glutathione, an important component of the antioxidant system and chemical detoxification of the body. The antioxidant effect of acetylcysteine ​​increases the protection of cells from the damaging effects of free radical oxidation, which is characteristic of an intense inflammatory reaction.
With the prophylactic use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations of bacterial etiology in patients with chronic bronchitis and cystic fibrosis.

Pharmacokinetics

Absorption is high. They are quickly metabolized in the liver to form a pharmacologically active metabolite - cysteine, as well as diacetylcysteine, cystine and mixed disulfides. Bioavailability when taken orally is 10% (due to the presence of a pronounced “first pass” effect through the liver). The time to reach the maximum concentration (Cmax) in the blood plasma is 1-3 hours. The connection with blood plasma proteins is 50%. Excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine).
The half-life (T1/2) is about 1 hour, impaired liver function leads to an extension of T1/2 to 8 hours. Penetrates the placental barrier.
There are no data on the ability of acetylcysteine ​​to penetrate the blood-brain barrier and be excreted in breast milk.

Indications for use

Respiratory diseases accompanied by the formation of viscous, difficult to separate sputum:
acute and chronic bronchitis, obstructive bronchitis;
tracheitis, laryngotracheitis;
pneumonia;
lung abscess;
bronchiectasis, bronchial asthma, chronic obstructive pulmonary disease (COPD), bronchiolitis;
cystic fibrosis;
Acute and chronic sinusitis, inflammation of the middle ear (otitis media).

Contraindications

hypersensitivity to acetylcysteine ​​or other components of the drug;
peptic ulcer of the stomach and duodenum in the acute stage;
pregnancy;
breastfeeding period;
hemoptysis, pulmonary hemorrhage;
lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
children under 2 years of age (for this dosage form).

With caution: a history of gastric and duodenal ulcers, bronchial asthma, obstructive bronchitis, liver and/or renal failure, histamine intolerance (long-term use of the drug should be avoided, since acetylcysteine ​​affects the metabolism of histamine and can lead to signs of intolerance , such as headache, vasomotor rhinitis, itching), varicose veins of the esophagus, diseases of the adrenal glands, arterial hypertension.

Use during pregnancy and breastfeeding

Data on the use of acetylcysteine ​​during pregnancy and breastfeeding are limited, therefore the use of the drug during pregnancy is contraindicated. If it is necessary to use the drug during breastfeeding, the issue of stopping it should be decided.

Directions for use and doses

Inside, after eating.
Effervescent tablets should be dissolved in one glass of water. The tablets should be taken immediately after dissolution; in exceptional cases, the ready-to-use solution can be left for 2 hours. Additional fluid intake enhances the mucolytic effect of the drug. For short-term colds, the duration of use is 5-7 days. For chronic bronchitis and cystic fibrosis, the drug should be taken for a longer period of time to achieve a preventive effect against infections.
In the absence of other prescriptions, it is recommended to adhere to the following dosages:
Mucolytic therapy:
adults and children over 14 years of age: 1 effervescent tablet 2-3 times a day (400-600 mg);
children from 6 to 14 years old: 1 effervescent tablet 2 times a day (400 mg);
children from 2 to 6 years old: 1/2 effervescent tablet 2-3 times a day (200-300 mg).
Cystic fibrosis:
children from 2 to 6 years: 1/2 effervescent tablet 4 times a day (400 mg);
children over 6 years old: 1 effervescent tablet 3 times a day (600 mg).

Side effect

According to the World Health Organization (WHO), adverse effects are classified according to their frequency as follows: very often (≥1/10), often (≥1/100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10000, <1/1000) и очень редко (<1/10000); частота неизвестна (частоту возникновения явлений нельзя определить на основании имеющихся данных).
Allergic reactions
uncommon: skin itching, rash, exanthema, urticaria, angioedema, decreased blood pressure, tachycardia;
very rare: anaphylactic reactions up to anaphylactic shock, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).
From the respiratory system
rarely: shortness of breath, bronchospasm (mainly in patients with bronchial hyperreactivity in bronchial asthma).
From the gastrointestinal tract
uncommon: stomatitis, abdominal pain, nausea, vomiting, diarrhea, heartburn, dyspepsia.
Sensory disorders
uncommon: tinnitus.
Others
uncommon: headache, fever, isolated reports of bleeding due to a hypersensitivity reaction, decreased platelet aggregation.

Overdose

Symptoms: In case of an erroneous or intentional overdose, phenomena such as diarrhea, vomiting, stomach pain, heartburn and nausea are observed.
Treatment: symptomatic.

Interaction with other drugs

With the simultaneous use of acetylcysteine ​​and antitussives, sputum stagnation may occur due to suppression of the cough reflex.
When used simultaneously with antibiotics for oral administration (penicillins, tetracyclines, cephalosporins, etc.), they may interact with the thiol group of acetylcysteine, which can lead to a decrease in their antibacterial activity. Therefore, the interval between taking antibiotics and acetylcysteine ​​should be at least 2 hours (except for cefixime and loracarbene).
Concomitant use with vasodilating agents and nitroglycerin may lead to increased vasodilatory effects.

Special instructions

Instructions for patients with diabetes mellitus
1 effervescent tablet corresponds to 0.006 XE.
When working with the drug, you must use glass containers and avoid contact with metals, rubber, oxygen, and easily oxidized substances.
Cases of severe allergic reactions such as Stevens-Johnson syndrome and Lyell's syndrome have been very rarely reported with the use of acetylcysteine. If changes occur in the skin and mucous membranes, you should immediately consult a doctor and stop taking the drug.
In patients with bronchial asthma and obstructive bronchitis, acetylcysteine ​​should be prescribed with caution under systemic monitoring of bronchial patency.
You should not take the drug immediately before bedtime (it is recommended to take the drug before 18.00).

Impact on the ability to drive vehicles and machinery

There is no data on the negative effect of the drug ACC 200 in recommended doses on the ability to drive vehicles or use machinery.
Special precautions when disposing of unused medicinal product
There is no need for special precautions when disposing of unused ACC 200.
Close the tube tightly after taking the tablet!

Storage conditions

In a dry place at a temperature not exceeding 25°C.
Keep out of the reach of children.

Best before date

3 years.

Do not use after expiration date.

Is a medicine. A doctor's consultation is required.

The drug has as its main substance acetylcysteine . Additional components in tablets –, saccharin , sucrose , flavoring .

In addition to the main substance, each package of powder contains flavoring additive "Aromatic" Lemon , lactose monohydrate , .

Release form

The medicine is available in the form of a solution for internal use or capsules. In addition, such a release form is known as effervescent tablets.

Pharmacological action

Mucolytic action.

Pharmacodynamics and pharmacokinetics

About acetylcysteine It is important to know what it is and what its mechanism of action is before using the drug. It is a derivative amino acid cysteine . The effect of the drug Acetylcysteine ​​is due to the fact that it sulfhydryl group splits disulfide acidic connections sputum mucopolysaccharides . This is what causes mucolytic action. Mucoregulatory activity depends on increased secretion of less viscous substances sialomucins by goblet cells . On epithelial cells bronchial mucosa, bacterial adhesion is reduced. This is due to a decrease in viscosity sputum and promotions mucociliary clearance .

The disinfecting effect of the drug is due to the action of free sulfhydryl group that influences electrophilic oxidative toxins , neutralizing them.

This drug protects cells from free radicals both through direct interaction with them and through transport cysteine for synthesis .

The drug breaks down quickly when used internally. But his bioavailability – approximately 10%. The degree of binding to plasma proteins is 50%. The maximum concentration is observed after 60-180 minutes. The active substance can be supplied through placental barrier and accumulate in the amniotic fluid. The half-life is 60 minutes. At – up to 8 hours.

Excreted mainly by the kidneys as inactive. Some part is excreted unchanged by the intestines. In plasma it is determined unchanged, as well as metabolite N-acetylcysteine , cysteine ​​ester And N,N-diacetylcysteine .

Indications for use

The medicine is used for difficult separation sputum , lung , catarrhal And purulent otitis , removal of viscous secretions from the respiratory tract after operations, as well as in the case of post-traumatic conditions. In addition, among his testimony are interstitial lung diseases , cystic fibrosis , lungs , poisoning

Contraindications

This remedy should not be used during an exacerbation, pulmonary , hypersensitivity to the drug hemoptysis , .

Side effects

The drug may cause adverse reactions such as:

• rash, bronchospasm ;
• nausea, stomatitis , vomiting, feeling of a full stomach;

In rare cases, tinnitus, burning at the injection site (if a solution is used), as well as a reflex cough are possible. rhinorrhea and local irritation of the respiratory tract with inhalation application.

Instructions for use of Acetylcysteine ​​(Method and dosage)

Dosages are selected depending on the age and nature of the patient’s disease.

Instructions for use of Acetylcysteine ​​indicate that for children 2–6 years old, a daily dosage of 100 mg 3 times or 200 mg 2 times is usually indicated. The medicine is used in the form of a water-soluble granule. And for children under 2 years of age, a daily dose of 2 times 100 mg is prescribed. In turn, children 6-14 years old are given 200 mg daily 2 times, in case of cystic fibrosis – 200 mg 3 times. The medicine can be taken in the form of effervescent tablets, capsules or granules.

Adults take 200 mg of the drug 2-3 times every day in any possible form of release.

For aerosol therapy 20 ml of a 10% solution is sprayed in ultrasonic devices, and 6 ml of a 10% solution is sprayed in devices with a distribution valve. Inhalation do every day for 15-20 minutes 2-4 times. For acute conditions, therapy lasts 5-10 days, for chronic conditions – up to six months.

With strong secretolytic action needs to be sucked secret , as well as reduce the frequency of use and dosage of the drug.

Overdose

In case of overdose, the medicine can cause nausea, abdominal pain, and vomiting.

Therapy is symptomatic. In case of severe symptoms of overdose, you should urgently consult a specialist.

Interaction

Combination of the drug with oral taking semi-synthetic penicillins , cephalosporins , tetracyclines (except) aminoglycosides requires compliance with a two-hour interval. Acetylcysteine ​​with others antitussives medications can cause dangerous mucus stagnation. When combined with this medicine, it may also increase vasodilating action .

Terms of sale

The drug is approved for over-the-counter release.

Storage conditions

Optimal storage conditions for Acetylcysteine: dry, dark place, out of reach of children, temperature not higher than 25 °C, sealed packaging.

Best before date

Five years.

Acetylcysteine ​​analogues

Level 4 ATX code matches:

The following common analogues of Acetylcysteine ​​are sold:

• Vicks Active ExpectoMed ;
• N-AC-ratiopharm ;
• N-acetylcysteine ;
• Acestine ;
• Acetylcysteine ​​SEDICO ;
• Mukobene ;
• Mukonex ;
• N-AC-ratiopharm ;
• Exomyuk 200 ;
• Mucomist .

They are all similar in their action, but may have some application features.

ACC is a drug with an expectorant and mucolytic effect, promoting the liquefaction and discharge of viscous sputum.

This is one of the most famous medications used in the treatment of respiratory diseases accompanied by the formation of difficult-to-discharge secretions.

On this page you will find all the information about ACC: complete instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews from people who have already used ACC tablets. Would you like to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Mucolytic drug.

Conditions for dispensing from pharmacies

Available without a prescription.

Prices

How much do ACC effervescent tablets cost? The average price in pharmacies is 200-300 rubles.

Release form and composition

The drug is produced in different dosage forms:

• ACC 100 mg (effervescent tablets);
• ACC 200 mg (effervescent tablets);
• ACC 600 mg (effervescent tablets);
• ACC granules for making syrup;
• Powder for preparing a solution;
• ACC syrup.

They are available with different concentrations of the active substance - they contain 100, 200 and 600 mg of the active substance acetylcysteine ​​+ auxiliary components. ACC 100 mg tablets are intended for children, and the drug with the highest concentration of acetylcysteine ​​(600 mg) is called ACC Long and is prescribed to adult patients and adolescents over 14 years of age.

Pharmacological effect

The mucolytic effect of the drug is provided by the active substance acetylcysteine, which is a derivative of cysteine ​​(amino acid). The acetylcysteine ​​molecule has sulfhydryl groups in its structure, which contributes to the disruption of disulfide bonds of mucopolysaccharides in the composition of sputum, which ensure the viscosity of the secretion. As a result, the sputum softens and is more easily separated from the walls of the bronchi.

The drug has a direct effect on the thickness and rheological properties of sputum, maintaining proper activity even with purulent impurities in the bronchial secretion. With the prophylactic use of acetylcysteine, patients with cystic fibrosis and chronic bronchitis note a decrease in the number and severity of exacerbations.

Another effect of acetylcysteine ​​is an antioxidant pneumoprotective effect, which is realized by binding and neutralizing chemical radicals with sulfhydryl groups. The drug accelerates the synthesis of glutathione, a factor of intracellular protection from a number of cytotoxic substances and oxidative toxins of internal and external origin, which allows the use of ACC in case of paracetamol overdose.

Indications for use

• (inflammation of the mucous membrane of the larynx);
• (inflammation of the tracheal mucosa);
• (spicy, );
• bronchiectasis (chronic suppurative process in irreversibly deformed bronchi);
• bronchiolitis (inflammation of the bronchioles);
• medium exudative (damage to the mucous membranes of the middle ear cavities);
• (inflammation of one or more paranasal sinuses);
• cystic fibrosis (severe dysfunction of the respiratory system and gastrointestinal tract).

Contraindications

Contraindications to the use of ACC are as follows:

• pulmonary hemorrhage;
• pregnancy;
• peptic ulcer of the stomach and duodenum in the acute phase;
• hemoptysis;
• lactation period (breastfeeding);
• children under 14 years of age (dosage forms containing acetylcysteine ​​600 mg);
• children under 6 years of age (the drug is in the form of granules for the preparation of a solution for oral administration 200 mg);
• hypersensitivity to acetylcysteine ​​and other components of the drug.

WITH caution the drug should be used in patients with varicose veins of the esophagus, with an increased risk of developing pulmonary hemorrhage and hemoptysis, with bronchial asthma, diseases of the adrenal glands, liver and/or kidney failure.

ACC LONG should not be prescribed to children under 14 years of age. In this category of patients, it is recommended to use oral dosage forms with a lower acetylcysteine ​​content.

Use during pregnancy and lactation

Acetylcysteine ​​has no embryotoxic effect, however, during pregnancy, as well as during breastfeeding, it is prescribed only if indicated under the supervision of a physician.

Instructions for use

The instructions for use indicate that ACC effervescent tablets are taken orally after meals. They should be dissolved in 1 glass of water and drunk immediately; in exceptional cases, you can leave the prepared solution for 2 hours. Additional fluid intake enhances the mucolytic effect of the drug.

For short-term colds, the duration of use is 5-7 days. For chronic bronchitis and cystic fibrosis, the drug should be used for a longer period of time to prevent infections.

Instructions for ACC 200:

1. Children aged 6 to 14 years are recommended to take 1 tablet. (ACC 200) 2 times/day, which corresponds to 400 mg of acetylcysteine ​​per day.
2. Children aged 2 to 6 years are recommended to take the drug 1/2 tablet. (ACC 200) 2-3 times/day, which corresponds to 200-300 mg of acetylcysteine ​​per day.
3. For adults and adolescents over 14 years of age, it is recommended to prescribe the drug 200 mg (ACC 200) 2-3 times a day, which corresponds to 400-600 mg of acetylcysteine ​​per day, or 600 mg (ACC Long) 1 time a day.
4. For cystic fibrosis, children over 6 years of age are recommended to take 1 tablet. (ACC 200) 3 times/day, which corresponds to 600 mg of acetylcysteine ​​per day. Children aged 2 to 6 years – 1/2 tablet. (ACC 200) 4 times/day, which corresponds to 400 mg of acetylcysteine ​​per day.

Side effects

ACC effervescent tablets are generally well tolerated; when taken orally as a solution, a number of side effects may develop, which include:

• From the digestive system - nausea, sometimes vomiting, heartburn, stool disorder in the form of diarrhea (diarrhea).
• Allergic reactions are rare and may vary in severity. They manifest themselves in the form of a rash on the skin, itching, and urticaria (a rash and swelling of the skin that looks like a nettle burn). In extremely rare cases, there may be a reaction from the bronchi in the form of their spasm, reminiscent of an attack of bronchial asthma. In very severe allergic reactions, anaphylactic shock develops with the development of multiple organ failure against the background of a progressive decrease in systemic blood pressure.
• From the cardiovascular system - tachycardia (increased heart rate), arterial hypotension (decreased systemic blood pressure).
• From the central nervous system - headache, tinnitus,

If symptoms of adverse reactions appear, use of the drug should be stopped and medical help should be sought.

Overdose

Various disorders of the digestive system (stool disorders, nausea, vomiting, heartburn, pain in the stomach).

If the described phenomena occur, the symptoms are treated with medication.

Special instructions

1. The mucolytic effect of ACC increases with additional fluid intake.
2. Patients with obstructive bronchitis and bronchial asthma require regular monitoring of bronchial patency during treatment with ACC.
3. The drug is incompatible with proteolytic enzymes and antibiotics (cephalosporins, tetracycline, penicillins, erythromycin and amphotericin B).
4. The remedy should not be combined with antitussive drugs, since the suppression of the cough reflex caused by the latter can lead to dangerous stagnation of mucus.
5. The drug should be used with caution in case of impaired liver and kidney function, diseases of the adrenal glands, varicose veins of the esophagus, as well as gastric and duodenal ulcers in the acute phase.

Drug interactions

Tetracycline and its derivatives (except doxycycline) should not be used together with ACC in pediatrics.

During experimental in vitro studies, no cases of inactivation of other types of antibacterial drugs were identified. However, it is recommended to maintain a gap of at least 2 hours between taking the ACC and the antibiotic. In vitro, the incompatibility of acetylcysteine ​​with semisynthetic penicillins, aminoglycoside and cephalosporin antibiotics has been proven. Such studies have not been conducted with erythromycin, amoxicillin and cefuroxime.

The simultaneous use of antitussives can lead to stagnation of respiratory tract secretions.

Use with nitroglycerin may enhance the vasodilator effect of the latter.