ACC: instructions for use, contraindicationsindications, side effects, dosage for children syrup, granules,effervescent tablets

Update: October 2018

АЦЦ (Acetylcysteine) – лекарственное средство, обладающее
expectorant and mucolytic effect, which is assigned to
liquefaction of the viscous bronchus secretion in diseases of the organs
respiratory system, proceeding with the formation of thick, difficult
отходящей sputum

The history of the invention of the drug came in the middle of the past
century. It was then that Professor Ferrari, who worked in Italian
pharmaceutical company “Zambon”, found similarities
acetylcysteine ​​with cysteine ​​protein, which has the ability
break the mucopolysaccharide molecules of which
bronchopulmonary secret. The first drug based on acetylcysteine
wore the name Fluimucil.

Фармгруппа: Муколитический препарат.

Composition, physico-chemical properties, price

ACC is available in the form of tablets (effervescent, soluble), granules
and powder for oral administration with different dosages
active ingredient. Another dosage form is a solution.
for injection (intravenous and intramuscular).

Tablets ATC effervescent

Granules

Solution

Syrup

Main substance Acetylcysteine 100, 200 или 600 мг Acetylcysteine 300 мг  1 ml – 20 mg acetylcysteine
Excipients Citric and ascorbic acid, lactose, mannitol, citrate and
sodium hydrogen carbonate, aromatic substances
Ascorbic acid, aromatic substances, sucrose,
saccharin.
Sodium hydroxide, edetate disodium, ascorbic acid, water
for injection
 Methyl parahydroxybenzoate, sodium benzoate, edetate
disodium, carmellose and saccharinate sodium, sodium hydroxide, water
refined, cherry flavor
Physicochemical properties Effervescent tablets of a round form and white color, flat. Have
berry fruit flavor
Homogeneous granules without agglomerated inclusions, white
and with the smell of fruit
Clear solution, liquid, colorless  Syrup бесцветный, прозрачный, слегка вязкий, с запахом
cherries
Packaging In plastic tubes of 10 or 20 pieces In waterproof bags, 6, 10, 20, 50 pieces per pack. By
100 mg vial (for suspension)
By 3 мл в ампулах, по 5 ампул в картонной пачке  By 100 мл во флаконах из темного стекла, с мерным
cup and syringe
Price

№ 20 200 mg: 150-180 rubles.

№ 20 100 mg: 120-130 rubles.

№5: 100-130 rubles.

Price 230 руб.

pharmachologic effect

The mucolytic effect of the drug is provided by the current
substance acetylcysteine, which is a derivative of cysteine
(amino acids). Acetylcysteine ​​molecule has in its structure
sulfhydryl groups, which contributes to the disruption of disulfide
links mucopolysaccharides in the composition of sputum, which provide
viscosity of the secret. As a result, the phlegm softens and is lighter.
separated from the walls of the bronchi.

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

Another effect of acetylcysteine ​​is antioxidant.
pneumoprotective effect, which is implemented by binding and
decontamination of 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
internal and external origin, which allows the use of ACC
with an overdose of paracetamol.

Pharmacokinetics

Quickly and fully absorbed, being metabolized in
the liver. In the course of metabolic reactions formed pharmacologically
active cysteine ​​and a number of other mixed disulfides. Bioavailability
is only about 10%. The maximum concentration is reached in
blood 1-3 hours after administration. Fiery Protein Coupling
reaches 50%. Acetylcysteine выводится почками как неактивные
metabolites. Very fast half-life of about 1 h.
объясняется биотрансформацией вещества в the liver. With дисфункции
liver this period increases to 8 h.

Byказания к применению

Diseases of the respiratory system in which it is formed
hard-to-separate, viscous sputum:

  • laryngotracheitis;
  • bronchitis (acute and chronic);
  • bronchiectasis;
  • pneumonia;
  • obstructive bronchitis;
  • lung abscesses;
  • bronchiolitis;
  • bronchial asthma;
  • cystic fibrosis.

Sinusitis (chronic and acute). Otitis media is average.

Contraindications to receive ACC

  • Aggravation of GU and duodenal ulcer;
  • Pulmonary hemorrhage, hemoptysis;
  • Pregnancy and lactation, ACC is prohibited during pregnancy
    on any term;
  • Individual intolerance;

The instructions for use of the ACC for children indicated that the treatment
perhaps strictly for medical purposes, is contraindicated:

  • Children age up to 2 years (except granules for cooking
    drug in the vial and injection).
  • Children’s age up to 6 years (granules 200 mg);
  • Children’s age up to 14 years (granules 600 mg).

Be wary appoint people with pathological varicose veins
on the esophagus, with the risk of bleeding from the lungs, bronchial asthma,
pathology of the adrenal glands, liver failure and
the kidneys.

Dosage

Effervescent tablets ACC 100 and 200 mg

The tablet should be dissolved in water (100 ml) and taken immediately.
after cooking. In exceptional cases, it is permissible to store
solution maximum 2 hours. Is taken after meals, additionally
drinking water.

  • Children 2-5 years: One tablet of 100 mg or half
    200 mg tablets three times-twice a day (200-300 mg per day).
  • Children 6-14 liters: One tablet 100 mg or half a tablet
    200 mg three times a day. 2nd scheme: two tablets of 100 mg or one each
    200 mg tablet twice a day (300-400 mg per day).
  • Adolescents from 14 l and adults: 200 mg one tablet each
    two to three times a day (400-600 mg per day).

In cases of cystic fibrosis, the dose and regimen is different.

  • Children 2-6 liters: one tablet 100 mg or half a tablet 200
    mg four times a day (200 mg per day).
  • Children older than 6 liters: two tablets of 100 mg or one tablet
    200 mg three times a day (600 mg per day).

Patients weighing more than 30 kg set a daily dose of 800
mg, evenly distributed in doses.

Granules

The instructions for use of the powder ACC specify the method
preparation of the dosage form. Half sachet or teabag
dissolved in juice, chilled tea or water and drink the composition after
food. To obtain syrup, drinking water is added to the vial until
marks and shake.

  • Children up to 2 liters: 50 mg (half a measuring spoon) two or three times
    day (100-150 mg per day). Strictly prescribed by a doctor!
  • Children 2-5 liters: One scoop (100 mg) 2-3 r per day (200-300 mg
    per day).
  • Children 6-14 liters: One scoop (100 mg) three times a day (300-400
    мг per day).
  • Adolescents over 14 years old and adults: Two measuring spoons (200 mg)
    two to three times a day (400-600 mg per day).

The regimen for cystic fibrosis is similar to tablets.

Syrup

  • Syrup принимают после еды, отмеряв должное количество шприцем
    or a cup. 10 ml syrup = half a cup or 2 full
    syringes. It should be washed down with water to increase mucolytic
    effect.
  • Children 2-5 liters: 5 ml syrup 2-3 r per day (200-300 mg per
    day);
  • Children 6-14 liters: 5 ml of syrup 3 r per day or 10 ml twice in
    день (300-400 мг в day);
  • Children over 14 liters, adults: 10 ml of syrup 2-3 r per day
    (400-600 мг per day).

For cystic fibrosis:

  • Дети 2-6 л: 5 мл сиропа 4 р в день (400 мг в day);
  • Дети старше 6 л: по 10 мл сиропа 3 р в д (600 мг per day).

Injection

Designed for in / in or in / m introduction only in conditions
hospital

  • V / m: injected deep into the muscle. In / in: diluted with 0.9% NaCl in
    1: 1 ratio, slow administration.
  • Children 1-6 liters: 10 mg solution per 1 kg of body weight.
  • Children 6-14 liters: 150 mg (one and a half ml) 1 or 2 p per day.
  • Children older than 14 liters and adults: 300 mg (3 ml) 1-2 r in
    day.

Duration of admission. Short cold: 5-7 days. More
serious illness – long, as prescribed by a doctor.

Side effects when taking ACC

  • CNS: rarely – noise in the head, headache.
  • Digestive tract: diarrhea, stomatitis, vomiting, nausea,
    heartburn.
  • SSS: the fall of blood pressure, tachycardia.
  • Alregii: bronchospasm, which is possible with hyperresponsiveness
    bronchial system, urticaria and skin rash.
  • Occasionally, pulmonary hemorrhage may develop in people with
    hypersensitivity to the drug.

special instructions

  • The drug should be diluted only in glassware. With
    contact with metals forms sulfides.
  • Patients with asthma and obstructive bronchitis should be performed.
    control of patency of the bronchi.
  • With развитии любых побочных эффектов прием препарата
    stop.
  • Patients with diabetes should consider the content
    glucose: 100 mg ACC – 0.006 XE.
  • Does not affect the ability to drive a car and work with
    complex mechanisms.
  • With caution prescribed for pathology of the kidneys, liver.

Drug interactions

  • Do not recommend combining acetylcysteine ​​and cough drops,
    as it is dangerous to suppress the cough reflex and stagnation
    sputum
  • With одновременном применении с нитроглицерином усиливается
    vasodilator effect of the latter.
  • ACC reduces the adsorption of penicillins, cephalosporins and
    tetracycline, so antibiotics are prescribed 2 hours after taking
    mucolytic.

Analogs

 ринофлуимуцил
Vicks Active (140-280 rubles) Fluimucil (150-250 rubles) Acetylcysteine Rinofluimucil (nasal) 250 rub.

Автор: врач-гигиенист, эпидемиолог

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