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Acetylcysteine

Medical and Pharmacy Editor:

Brand Name: N-acetylcysteine, Mucomyst

Generic Name: Acetylcysteine

Drug Class: N-acetylcysteine, Mucomyst

What Is Acetylcysteine and How Does It Work?

Acetylcysteine is a solution of a naturally occurring amino acid that is used to help clear mucus (acts as a mucolytic agent) and material entrapped in mucus in people that have thick mucus that may interfere with breathing or other functions. For example, acetylcysteine solution may be used to help clear mucus in chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumonia, and in tracheostomy care. Acetylcysteine solution may also be used as an antidote for acetaminophen toxicity.

Acetylcysteine is available under the following different brand names: N-acetylcysteine, and Mucomyst.

Dosages of Acetylcysteine:

Adult and Pediatric Dosage Forms and Strengths

Nebulizer solution

  • 10%
  • 20%

Dosage Considerations – Should be Given as Follows:

Pulmonary Disease

  • Facilitation of expectoration via mucolysis
  • Adult: 5-10 mL of 10% or 20% solution by nebulization every 6-8 hours as needed
  • Pediatric:
  • Children 1-11 months: 1-2 mL of 20% solution or 2-4 mL of 10% solution by nebulization every 6-8 hours as needed
  • Children 1-11 years: 3-5 mL of 20% solution or 6-10 mL of 10% solution by nebulization every 6-8 hours as needed
  • Children over 12 years: 5-10 mL of 10% or 20% solution by nebulization every 6-8 hours as needed

Diagnostic Bronchography

  • 1-2 mL of 20% solution or 2-4 mL of 10% solution administered 2-3 times by nebulization or by intratracheal instillation before procedure

Acetaminophen Overdose

  • See separate drug monograph, acetylcysteine (antidote)

Contrast Agent-Associated Nephrotoxicity (Off-label)

  • Prevention
  • 600 mg orally every 12 hours for 2 days on day before and day of contrast agent administration

Keratoconjunctivitis Sicca (Off-label)

  • Adult and pediatric: 1 drop of 10% solution in eye(s) every 6-8 hours

Dosing Considerations

  • 3-4 g intravenous/intramuscular (IV/IM) every 4-6 hours; not to exceed 24 g/24 hours

Uncomplicated Gonorrhea

  • Direct instillation: 1-2 mL of 10% or 20% solution every hour as needed
  • Routine nursing care of patients with tracheotomy: 1-2 mL of 10% or 20% solution every 1-4 hours by direct instillation into tracheotomy
  • Instillation into segment of bronchopulmonary tree via small plastic catheter into trachea (under local anesthesia and direct vision): 2-5 mL of 20% solution via syringe connected to catheter
  • Instillation via percutaneous intratracheal catheter: 1-2 mL of 20% solution or 2-4 mL of 10% solution every 1-4 hours via syringe connected to catheter

Administration

  • Administer aerosolized bronchodilator 10-15 minutes before administering acetylcysteine via nebulization
  • Nebulizer solution may also be administered orally
Medically Reviewed by a Doctor on 8/10/2017



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