ACC (N-acetylcysteine, NAC; mucolytic agent)

ACC is the brand name of the drug N-acetylcysteine (NAC). NAC works by loosening thick mucus in the upper respiratory tract. It also the antidote of choice for paracetamol overdose and toxicity.

Uses

What is ACC used for?

How should I take ACC?

Read the directions on the packaging for complete information. Check the label and expiration date.

It is available as an effervescent tablet. Completely dissolve the tablet in a glass of water and then drink the entire solution. Do not swallow or chew the tablet whole. Take it with meals.

If you need to take an antibiotic to treat an infection, do not take ACC at least 2 hours before and after.

How do I store ACC?

Store this product at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & Warnings

What should I know before using ACC?

Before using this drug, tell your doctor if you are/have:

• Pregnant or breastfeeding.
• Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
• An allergy to any of the ingredients of this product.
• Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. However, it is likely safe to take. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

This medication is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

• A= No risk
• B= No risk in some studies
• C= There may be some risk
• D= Positive evidence of risk
• X= Contraindicated
• N= Unknown

Side Effects

What side effects can occur from ACC?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

• Autoimmune reaction
• Anaphylactoid reaction
• Trouble breathing (dyspnea)
• Bronchospasm
• Cough
• Dyspepsia
• Flushing
• Increased heart rate (tachycardia)
• Edema
• Skin rash and itchiness
• Nausea
• Vomiting

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with ACC?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

• Antitussives (cough suppressants)
• Antibiotics
• Nitroglycerin
• Activated carbon
• Salicylates
• Ketone bodies

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with ACC?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with ACC?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

• Active peptic ulcer disease (PUD)

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Mucolytic

Dissolve one 200 mg tablet 2 to 3 times per day -OR- half of a 600 mg tablet twice a day or the whole tablet once a day. Do not use it for more than 5 days.

Paracetamol poisoning

Initially, take 140 mg per kg of body weight, followed by 17 maintenance doses of 70 mg per kg of body weight given every 4 hours.

What is the dose for a child?

Mucolytic

For children 6 to 14 years: Give one 200 mg tablet dissolved in water twice a day.

Children 2 to 5 years: Give half of a 200 mg tablet dissolve in water 2 to 3 times a day.

Do not give it for more than 5 days.

Paracetamol poisoning

Same as the adult dose or as directed by a pediatrician.

How is ACC available?

ACC is available in in the following dosage forms and strengths:

• Effervescent tablet: 200 mg, 600 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.