Cough is a reaction of the body aimed at clearing the airways of foreign elements. Thus, a cough, manifested in the appearance of respiratory diseases as a result of the occurrence of infectious and viral diseases, occurs to free the bronchi and lungs from the viscous mucus that forms in them.
ACC is a mucolytic drug, the action of which is aimed at more rapid dilution of mucus and its easier removal. That is why the drug is prescribed for both so-called dry and wet coughs. It should be remembered that any medicine is taken only after consultation with a specialist. Taking ACC on your own can significantly reduce the effectiveness of the drug and cause side effects.
Indications for ACC
Before taking the drug, you must consult your doctor. ACC is prescribed for the following diseases:
- respiratory diseases in the acute and chronic stages accompanied by the formation of sputum;
- otitis media, sinusitis in acute and chronic stages of the disease, rhinosinusitis;
- post-traumatic and postoperative conditions, accompanied by the formation of a viscous secretion.
Methods of using ACC
The daily dose of the drug for adults and adolescents from 14 years of age should not exceed 600 mg, children from 6 to 14 years of age are recommended no more than 400 mg, children under 5 years of age - no more than 300 mg of ACC per day. In some cases, the doctor may increase the daily dose of the medicine.
During the period of colds accompanied by cough with the formation of sputum, ACC is taken for 5 to 7 days. For more severe diseases - cystic fibrosis and bronchitis, the duration of taking the drug may be much longer.
The solution is consumed after meals. It is also recommended to take the medicine with water, as additional fluid intake enhances the effect of the drug.
ACC syrup 20 mg/ml 100 ml No. 1
Name
ACC syrup 20 mgml in vial. 100ml in package No. 1
Storage conditions
The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Once opened, the bottle should be stored for no more than 18 days at a temperature not exceeding 25°C.
Expiration date from date of manufacture
2 years
Product description
The syrup is transparent, colorless, slightly viscous, with a cherry smell.
pharmachologic effect
Mucolytic drug. 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 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.
Pharmacokinetics
Absorption and distribution Absorption is high. Bioavailability when taken orally is 10%, which is due to the pronounced “first pass” effect through the liver. The time to reach Cmax in blood plasma is 1-3 hours. Binding to blood plasma proteins is 50%. Penetrates through the placental barrier. There are no data on the ability of acetylcysteine to penetrate the BBB and be excreted in breast milk. Metabolism and excretion Rapidly metabolized in the liver to form a pharmacologically active metabolite - cysteine, as well as diacetylcysteine, cystine and mixed disulfides. Excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine). T1/2 is about 1 hour. Pharmacokinetics in special clinical cases Impaired liver function leads to an extension of T1/2 to 8 hours.
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, COPD, bronchiolitis, cystic fibrosis); acute and chronic sinusitis; Otitis media
Use during pregnancy and lactation
Due to insufficient data, the use of the drug during pregnancy is contraindicated. For syrup: use of the drug during pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus. If it is necessary to use the drug during lactation, the issue of stopping breastfeeding should be decided.
special instructions
For bronchial asthma and obstructive bronchitis, acetylcysteine should be prescribed with caution under systematic monitoring of bronchial patency. Severe allergic reactions such as Stevens-Johnson syndrome and Lyell's syndrome have been very rarely reported with the use of acetylcysteine. If changes in the skin and mucous membranes occur, the patient should immediately stop taking the drug and consult a doctor. It is not recommended to prescribe the drug to patients with renal and/or liver failure to avoid additional formation of nitrogenous compounds. When dissolving the drug, it is necessary to use glass containers and avoid contact with metals, rubber, oxygen, and easily oxidized substances. You should not take the drug immediately before bedtime (the preferred time of administration is before 18.00). When prescribing the drug to patients on a diet aimed at limiting sodium intake, it is necessary to take into account that 1 ml of ACC® syrup contains 41.02 mg of sodium. There is no need for special precautions when disposing of unused ACC®. Instructions for patients with diabetes mellitus When treating patients with diabetes mellitus, it is necessary to take into account that ACC® in the form of granules for the preparation of oral solution (200 mg, 600 mg, orange 100 mg and 200 mg) contains sucrose. ACC® in the form of granules for the preparation of a solution for oral administration /orange/ 100 mg and 200 mg: 1 sachet of 100 mg corresponds to 0.24 XE, 1 sachet of 200 mg - 0.23 XE. ACC® in the form of granules for the preparation of a solution for oral administration 200 mg: 1 sachet corresponds to 0.21 XE. ACC® in the form of granules for the preparation of a solution for oral administration 600 mg: 1 sachet corresponds to 0.17 XE. Effect on the ability to drive vehicles and operate machinery There is no information on the effect of the drug on the ability to drive vehicles and engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
With caution (Precautions)
The drug should be used with caution in patients with a history of gastric and duodenal ulcers; for bronchial asthma, obstructive bronchitis; liver and/or kidney 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. Contraindications Peptic ulcer of the stomach and duodenum in the acute phase; hemoptysis; pulmonary hemorrhage; pregnancy; lactation period (breastfeeding); children under 2 years of age (syrup, granules for the preparation of solution for oral administration /orange/ 100 mg and 200 mg); children under 6 years of age (granules for the preparation of a solution for oral administration 200 mg); children under 14 years of age (granules for the preparation of a solution for oral administration 600 mg); fructose intolerance, because the drug contains sorbitol (granules for the preparation of an oral solution /orange/ 100 mg and 200 mg, granules for the preparation of an oral solution 200 mg and 600 mg); sucrase/isomaltase deficiency, glucose-galactose deficiency (granules for oral solution /orange/ 100 mg and 200 mg, granules for oral solution 200 mg and 600 mg); hypersensitivity to acetylcysteine and other components of the drug. The drug should be used with caution in patients with a history of gastric and duodenal ulcers; for bronchial asthma, obstructive bronchitis; liver and/or kidney 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.
Directions for use and doses
Syrup Adults and adolescents over 14 years of age are prescribed 10 ml of syrup 2-3 times a day (400-600 mg acetylcysteine). Children aged 6 to 14 years - 5 ml of syrup 3 times a day or 10 ml of syrup 2 times a day (300-400 mg of acetylcysteine). Children aged 2 to 5 years are prescribed 5 ml of syrup 2-3 times a day (200-300 mg of acetylcysteine). For cystic fibrosis, children over 6 years of age are recommended to take the drug 10 ml of syrup 3 times a day (600 mg acetylcysteine); children aged 2 to 5 years - 5 ml of syrup 4 times a day (400 mg acetylcysteine). For short-term colds, the duration of use is 4-5 days. For chronic bronchitis and cystic fibrosis, the drug should be used for a longer period of time to prevent infections. For long-term illnesses, the duration of therapy is determined by the attending physician. The drug is taken orally after meals. Additional fluid intake enhances the mucolytic effect of the drug. ACC® syrup is taken using a measuring syringe or measuring cup contained in the package. 10 ml of ACC® syrup corresponds to 1/2 measuring cup or 2 filled syringes. Using a measuring syringe 1. Open the cap of the bottle by pressing on it and turning it counterclockwise. 2. Remove the cap with the hole from the syringe, insert it into the neck of the bottle and press in until it stops. The stopper is designed to connect the syringe to the bottle and remains in the neck of the bottle. 3. It is necessary to insert the syringe tightly into the stopper. Carefully turn the bottle upside down, pull the syringe plunger down and draw the required amount of syrup (ml). If air bubbles are visible in the syrup, press the plunger all the way and then refill the syringe. Then return the bottle to its original position and remove the syringe. 4. The syrup from the syringe should be poured onto a spoon or directly into the child’s mouth (into the cheek area, slowly, so that the child can swallow the syrup). While taking the syrup, the child should be in an upright position. 5. After use, rinse the syringe with clean water.
Overdose
Acetylcysteine when taken at a dose of 500 mg/kg/day does not cause signs and symptoms of overdose. Symptoms: in case of an erroneous or intentional overdose, phenomena such as diarrhea, vomiting, stomach pain, heartburn, and nausea are observed. Treatment: symptomatic therapy.
Side effect
According to WHO, undesirable effects are classified according to their frequency of development as follows: very often (?1/10), often (?1/100,
Compound
Active substance: acetylcysteine 20 mg; Excipients: methyl parahydroxybenzoate - 1.3 mg, sodium benzoate - 1.95 mg, disodium edetate - 1 mg, sodium saccharinate - 1 mg, sodium carmellose - 2 mg, sodium hydroxide (10% aqueous solution) - 30-70 mg, Cherry flavoring - 1.5 mg, purified water - 910.25-950.25 mg.
Interaction with other drugs
With the simultaneous use of acetylcysteine and antitussives, sputum stagnation may occur due to suppression of the cough reflex. With the simultaneous use of acetylcysteine and oral antibiotics (penicillins, tetracyclines, cephalosporins, etc.), the latter may interact with the thiol group of acetylcysteine, which can lead to a decrease in antibacterial activity. Therefore, the interval between taking antibiotics and acetylcysteine should be at least 2 hours (except for cefixime and loracarbef). Concomitant use with vasodilators and nitroglycerin may lead to an enhanced vasodilator effect.
Release form
The syrup is transparent, colorless, slightly viscous, with a cherry smell. 1 ml Active substance: acetylcysteine 20 mg; Excipients: methyl parahydroxybenzoate - 1.3 mg, sodium benzoate - 1.95 mg, disodium edetate - 1 mg, sodium saccharinate - 1 mg, sodium carmellose - 2 mg, sodium hydroxide (10% aqueous solution) - 30-70 mg, Cherry flavoring - 1.5 mg, purified water - 910.25-950.25 mg. 100 ml - dark glass bottles (1) complete with a measuring cup and syringe - cardboard packs.
Contraindications for ACC
ACC is contraindicated in the following cases:
- high sensitivity to the components included in the drug;
- exacerbation of peptic ulcers;
- pulmonary hemorrhage and hemoptysis;
- children under 2 years of age;
- pregnancy and lactation period.
Special Recommendations
For what type of cough should ACC be used?
Cough is one of the main symptoms accompanying infectious respiratory diseases. In the process of inflammation of the respiratory tract, changes occur that provoke the formation of viscous mucus - sputum.
The drug cannot be called a universal antitussive and is rarely prescribed for dry cough, as a first-line remedy. But nevertheless, ACC for dry cough is acceptable if the dry cough does not cause discomfort and does not impair the quality of life, does not disturb sleep and appetite, does not lead to vomiting, is not paroxysmal, that is, does not require the use of antitussive drugs.
ACC for dry cough can be used at the very beginning of the disease, to accelerate the transition of a cough from unproductive to productive, or with an unproductive cough to dilute viscous sputum and speed up its discharge.
During a productive cough, thanks to ACC, sputum discharge occurs faster and easier, due to which the bronchi and lungs are cleansed. At the same time, the sputum becomes more liquid.
ACC and kidney diseases
For kidney diseases at any stage, ACC is taken only after a doctor’s prescription and under his strict supervision. Components of the drug may conflict with other medications taken for renal failure and other kidney diseases.
ACC and alcohol
No interaction of the main active component of the mucolytic drug ACC with ethanol was detected. However, this does not mean that the drug can be used together with alcohol.
The main purpose of any drug is to eliminate the infection that has entered the body and alleviate the painful state of the body, promoting its further recovery. Alcohol, on the contrary, actively reduces the body’s protective and regenerative functions, exacerbating the body’s immunodeficiency. Accordingly, the effectiveness of the drug will also be reduced by alcohol. In addition, drinking alcohol can cause side effects of acetylcysteine.
ACC for pregnant and lactating
At the research stage, no direct or indirect harm to the mother and fetus was identified.
At the same time, there is a possibility of negative effects of acetylcysteine on the mother’s body and the development of the fetus remains. Therefore, taking the drug during pregnancy is contraindicated. If during the period of breastfeeding a child there is an urgent need to take ACC, stop feeding for the period of treatment.
ACC for children
In children with respiratory diseases as a result of viral or infectious diseases, sputum formation occurs differently than in adults. The secretion secreted by the bronchi has a more viscous structure. At the same time, the chest muscles of a child are much weaker than those of an adult. This is why coughing up sputum in children is much more difficult. In addition, sputum that stagnates in a child’s body can cause a faster spread of infection since it is a favorable environment for the proliferation of harmful bacteria and viruses.
Children's ACC is also prescribed only by a doctor based on preliminary research. You can take the drug at the first signs of cough. This allows you to avoid stagnation of sputum, since the drug provokes its liquefaction, thereby facilitating its coughing.
ACC®
A mucolytic agent that thins sputum, increases its volume, and facilitates the separation of sputum. The action is associated with the ability of free sulfhydryl groups of acetylcysteine to break intra- and intermolecular disulfide bonds of acidic mucopolysaccharides of sputum, which leads to depolymerization of mucoproteins and a decrease in sputum viscosity.
In addition, it reduces induced hyperplasia of mucoid cells, enhances the production of surfactants by stimulating type II pneumocytes, and stimulates mucociliary activity, which leads to improved mucociliary clearance.
Remains active against purulent sputum, mucopurulent and mucous sputum.
Increases the secretion of less viscous sialomucins by goblet cells, reduces the adhesion of bacteria to the epithelial cells of the bronchial mucosa. Stimulates mucous cells of the bronchi, the secretion of which is lysed by fibrin. It has a similar effect on the secretion formed during inflammatory diseases of the ENT organs. It has an antioxidant effect due to the presence of an SH group that can neutralize electrophilic oxidative toxins.
Acetylcysteine easily penetrates into the cell and is deacetylated to L-cysteine, from which intracellular glutathione is synthesized. Glutathione is a highly reactive tripeptide, a powerful antioxidant, cytoprotector that traps endogenous and exogenous free radicals and toxins.
Acetylcysteine prevents exhaustion and helps increase the synthesis of intracellular glutathione, which is involved in the redox processes of cells, thus promoting the detoxification of harmful substances. This explains the effect of acetylcysteine as an antidote for paracetamol poisoning.
Paracetamol exerts its cytotoxic effect through the progressive depletion of glutathione.
The main role of acetylcysteine is to maintain proper levels of glutathione concentration, thereby providing protection to cells. Protects alpha1-antitrypsin (elastase inhibitor) from the inactivating effects of HOCl, an oxidizing agent produced by myeloperoxidase of active phagocytes.
It also has an 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).
Terms of use
The rules for diluting the medicine are specified in the annotation. To create a liquid solution, the simplest algorithm is performed:
- The package is carefully opened along the cut line;
- pour into a cup;
- pour 3200 ml of hot water;
- stir.
The manufacturer points out that you cannot pour boiling water over the medicine - just use hot water.
To get the maximum effect from the medicine, you must consider:
- that the prepared solution is consumed immediately after eating and cannot be stored;
- a hot drink is absorbed faster into the gastrointestinal tract and accelerates the expected mucolytic effect;
- if the patient has a low-grade fever or fever, then cool the mixture before taking it;
- You should not use a drug prepared more than 3 hours ago - it is no longer suitable and will not be able to perform its intended functions.
You can also drink other warm liquids along with the medication. They will replenish losses, accelerate the liquefaction of sputum and speed up recovery.
The list of special dosage regimens includes:
- The need for long-term therapy is daily intake of 400 to 600 mg, divided into several procedures. The duration of the manipulations should not exceed 3-6 months, the final dates are set by the local therapist.
- Treatment of cystic fibrosis - 200 mg three times a day.
If excessive secretion and cough continue after two weeks of therapy, then a repeat diagnostic examination and revision of the initial diagnosis is necessary.
Buy ACC 100 powder for preparing a solution for oral administration Orange for children 3g No. 20 in pharmacies
ACC Buy ACC in pharmacies DOSAGE FORMS granules for the preparation of solution for oral administration orange 100 mg
MANUFACTURERS Salutas Pharma GmbH (Germany)
GROUP Mucolytic agents
COMPOSITION The active substance is acetylcysteine.
INTERNATIONAL NON-PROPENTED NAME Acetylcysteine
SYNONYMS Acetylcysteine, Acetylcysteine Sediko effervescent instant, Acetylcysteine Stada International, Acetylcysteine-Hemofarm, ACC 100, ACC 200, ACC injection, ACC Long, Vicks Active ExpectoMed, Muco Sanigen, Mukobene, Mukonex, Tussicom, Fluimucil
PHARMACOLOGICAL ACTION Mucolytic agent. Pharmacodynamics. The presence of sulfhydryl groups in the structure of acetylcysteine promotes the rupture of disulfide bonds of acidic mucopolysaccharides of sputum, which leads to a decrease in the viscosity of mucus. The drug remains active in the presence of purulent sputum. 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.
INDICATIONS FOR USE Diseases of the respiratory system, accompanied by the formation of viscous, difficult to separate sputum: acute and chronic bronchitis, obstructive bronchitis, laryngotracheitis, pneumonia, bronchiectasis, bronchial asthma, bronchiolitis, cystic fibrosis. Acute and chronic sinusitis, inflammation of the middle ear (otitis media).
CONTRAINDICATIONS Hypersensitivity to acetylcysteine or other components of the drug, pregnancy, breastfeeding, children under 2 years of age.
SIDE EFFECTS In rare cases, headaches, inflammation of the oral mucosa (stomatitis) and tinnitus are observed. Extremely rare - diarrhea, vomiting, heartburn and nausea, drop in blood pressure, increase in heart rate (tachycardia). In isolated cases, allergic reactions such as bronchospasm (mainly in patients with bronchial hyperreactivity), skin rash, itching and urticaria are observed. In addition, there are isolated reports of bleeding due to hypersensitivity reactions. If side effects develop, you should stop taking the drug and consult a doctor.
INTERACTION With the simultaneous use of acetylcysteine and antitussives, mucus stagnation may occur due to suppression of the cough reflex. Therefore, such combinations should be selected with caution. The simultaneous use of acetylcysteine and nitroglycerin can lead to an increase in the vasodilatory effect of the latter. Pharmaceutically incompatible with antibiotics (penicillins, cephalosporins, erythromycin, tetracycline and amphotericin B) and proteolytic enzymes. Upon contact with metals and rubber, sulfides with a characteristic odor are formed. Reduces the absorption of penicillins, cephalosporins, tetracycline (they should be taken no earlier than 2 hours after ingestion of acetylcysteine).
METHOD OF APPLICATION AND DOSAGE In the absence of other prescriptions, it is recommended to adhere to the following dosages: Mucolytic therapy. Adults and adolescents over 14 years of age are recommended to take 1 sachet 2 - 3 times a day (400 - 600 mg per day). Children aged 6 to 14 years are recommended to take ACC® 200 mg 3 times a day, 1 sachet or 2 times a day, 1 sachet (300 - 400 mg per day). Children aged 2 to 5 years are recommended to take 2-3 times a day, 1/2 sachet (200-300 mg per day). Cystic fibrosis. Children over 6 years of age are recommended to take 1 sachet (600 mg per day) 3 times a day. Children aged 2 to 5 years are recommended to take 1/2 sachet (400 mg per day) 4 times a day. For patients with cystic fibrosis and a body weight of more than 30 kg, if necessary, the dose can be increased to 800 mg of acetylcysteine per day. The granules should be dissolved in water, juice or iced tea and taken after meals.
OVERDOSE In case of erroneous or intentional overdose, phenomena such as diarrhea, vomiting, stomach pain, heartburn and nausea are observed. To date, no severe or life-threatening side effects have been observed.
SPECIAL INSTRUCTIONS With caution - peptic ulcer of the stomach and duodenum in the acute stage; hemoptysis, pulmonary hemorrhage, esophageal varices, bronchial asthma, adrenal diseases, liver and/or kidney failure. Pregnancy and breastfeeding For safety reasons, due to insufficient data, the use of the drug during pregnancy and breastfeeding is only possible if the expected benefit to the mother outweighs the potential risk to the fetus or infant. For patients with bronchial asthma and obstructive bronchitis, acetylcysteine should be prescribed with caution under systematic monitoring of bronchial patency. When treating patients with diabetes, it is necessary to take into account that the drug contains sucrose. When working with the drug, you must use glass containers and avoid contact with metals, rubber, oxygen, and easily oxidized substances.
STORAGE CONDITIONS Store in a dry place, protected from light, at a temperature not exceeding 25 C.
Recommendations for admission
The manufacturer's instructions indicate the diseases for which the drug can be used. Among the pathological processes that cause acute nonproductive cough are:
- bronchial asthma;
- lung abscesses;
- bronchiectasis;
- cystic fibrosis;
- inflammation of the bronchioles - bronchiolitis;
- chronic obstructive pulmonary disease;
- pneumonia;
- acute, chronic form of bronchitis;
- tracheitis and laryngotracheitis.
The annotation for the drug indicates the main adverse reactions and contraindications for use. The product should not be used:
- in acute form or exacerbation of a chronic ulcer;
- bleeding in the respiratory tract, accompanied by the release of blood particles along with secretions;
- glucose-galactose malabsorption syndrome;
- during pregnancy and breastfeeding;
- in childhood - up to 6 years.
The drug is contraindicated in patients with a tendency to spontaneous allergic reactions or congenital intolerance to one of the components that make up the powder. Particular caution should be exercised before use by patients with a history of certain diseases:
- with arterial hypertension - constantly elevated blood pressure;
- ulcers – gastrointestinal, esophagus;
- pathologies of the adrenal glands;
- liver, kidney failure;
- histamine intolerance.
Long-term use of medications can become a source of allergies, respiratory problems, and dyspeptic disorders. These deviations occur as a result of an overdose. The manufacturer advises using the medication strictly according to the instructions, without independently increasing the dose or duration of administration.
