In respiratory diseases such as chronic bronchitis , chronic obstructive pulmonary disease (COPD) and emphysema, the progression is rapid and severe, requiring a combination of various medications .

Fortunately, the pharmaceutical industry has developed drugs with mucolytic/antioxidant properties such as acetylcysteine, which turns out to be quite effective in combating the aforementioned conditions. 

In the following article, we will talk in detail about acetylcysteine, providing information on its therapeutic indications, possible adverse effects and contraindications.

What is acetylcysteine?

During the natural course of diseases, periods of inflammation develop due to oxidative stress (imbalance between free radicals and antioxidants in the body). 

In this sense, acetylcysteine, being an antioxidant medication, counteracts the harmful effect, by decreasing the levels of free radicals and increasing those of glutathione . In addition, acetylcysteine ​​breaks mucin chains, making it a fluidizer for respiratory secretions .

Important: Acetylcysteine ​​comes as 200 mg and 600 mg oral solution powder sachets and 40 mg/1 ml and 100 mg/5 ml oral suspension , both for oral use. For the parenteral route, it comes in 300 mg/3 ml vials .

What is acetylcysteine ​​used for?

Broadly speaking, acetylcysteine ​​acts in respiratory diseases and as an antidote for paracetamol poisoning . Next, we will focus on its clinical utility at the pulmonary level in diseases such as: 

1. Bronchitis

In chronic bronchitis , hypersecretion and viscosity phenomena, inflammation of the bronchial walls and bronchospasm occur, producing an obstruction of the airways . In this case, acetylcysteine ​​decreases the viscosity of the mucus.

Note: Despite its usefulness, current studies published in the Cochrane magazine question the efficacy of the drug in promoting lung function , although it could be useful in reducing exacerbations. (1)

2. Cystic fibrosis

In patients with cystic fibrosis, the therapeutic objective is to fluidize the thick sputum lodged in the airways . In this sense, acetylcysteine ​​gained therapeutic interest because it is anti-inflammatory, antioxidant, and mucolytic .

To highlight: A report from the American Society of Respiratory and Critical Medicine has questioned its use, since there is no certainty about its usefulness and/or possible risks associated with the drug. (two)

3. Chronic obstructive pulmonary disease

In patients who are not being treated with inhaled corticosteroids, or patients who are but still have exacerbations and chronic bronchitis, they may benefit from mucolytic/antioxidant therapies such as acetylcysteine , with doses up to 600 mg every 12 hours , depending on the Spanish COPD Guide . (3)

4. Emphysema

Pulmonary fibrosis and obliteration of lung tissue characterize emphysema, the final phase of many respiratory diseases. In this sense, immunomodulatory therapies, which include the administration of acetylcysteine , could be useful to stop its progress. (4)

side effects of acetylcysteine

All medications can carry certain risks, causing adverse reactions in their administration. Therefore, among the most marked adverse effects of the use of acetylcysteine , we have:

  • Bronchoconstriction (narrowing of the airways) and bronchorrhea (abundant secretion of mucus from the bronchi).
  • Gastrointestinal discomfort (vomiting, for example).
  • Urticaria, tinnitus (perception of noise in the ears) and headache.

Important: In case of presenting any of the aforementioned side effects, it is necessary to stop the use of acetylcysteine ​​and seek medical attention immediately.

Contraindications of acetylcysteine

There are certain limitations in the consumption of medicines, since they could cause unwanted effects in patients. In this sense, acetylcysteine ​​should not be administered in the following clinical conditions: 

  • Known hypersensitivity to the active substance.
  • Pregnant and lactating women.
  • Children under 2 years of age (infants are unable to cough up fluidized mucus).
  • Gastrointestinal ulcers.

You should know: Before starting treatment with acetylcysteine, it is advisable to inform the doctor about the health conditions that are suffered , thus avoiding unwanted reactions and to receive more information about therapeutic alternatives.

Key Findings

  • Acetylcysteine ​​is a medication used as a treatment for respiratory disorders associated with oxidative stress and hyperviscosity . 
  • Acetylcysteine ​​comes as granulated powder, syrup (both taken orally) , and parenterally administered ampoules.
  • Adverse effects of acetylcysteine ​​are related to fluidization of mucus and hypersensitivity reactions .
  • Acetylcysteine ​​should not be administered to children under 2 years of age , or to pregnant or lactating women .

Leave a Reply

Your email address will not be published. Required fields are marked *