Acetylcysteine ‚Äč‚Äčis an expectorant and expectorant that is also used in paracetamol intoxications. Read more!


The active substance acetylcysteine is an expectorant and expectorant derived from the natural amino acid (protein building block) cysteine. It can also be used for poisoning with the painkiller acetaminophen as an antidote (antidote). Here you read all important information on the effects and use of acetylcysteine ‚Äč‚Äčas well as possible changes and side effects.

This is how acetylcysteine ‚Äč‚Äčworks

The mucolytic effect of acetylcysteine ‚Äč‚Äčis best studied and confirmed in cystic fibrosis. However, the active substance is also recommended for other diseases that are associated with increased formation of viscous mucus in the bronchi.

The long polysaccharide chains of the mucus are cross-linked via so-called disulfide bridges. Acetylcysteine ‚Äč‚Äčand the amino acid cysteine ‚Äč‚Äčreleased from it can dissolve these crosslinks and thereby liquefy the mucus, which makes it easier to cough it off and carry it off.

The active ingredient acetylcysteine ‚Äč‚Äčis also used in the therapy of paracetamol overdoses. Paracetamol, a commonly used analgesic, is broken down in the liver over two stages, with the short-lived transitional form (abbreviated NAPQI) being very reactive and must be immediately detoxified by the small protein glutathione. When glutathione is depleted before the reactive transition form is completely detoxified, it accumulates and reacts with the genetic material and proteins of liver cells, resulting in cell death. In order to avoid liver failure, it is therefore necessary to administer acetylcysteine ‚Äč‚Äčas quickly as possible, from which the body can again form glutathione.

Absorption, breakdown and excretion of acetylcysteine

After ingestion, the active ingredient is rapidly absorbed into the blood via the intestine and converted to cysteine ‚Äč‚Äčin the liver. After about an hour, half of the drug is excreted by the kidneys; With limited kidney performance, this time can go up to eight hours.

When is acetylcysteine ‚Äč‚Äčused?

The mucolytic agent acetylcysteine ‚Äč‚Äčis approved for the treatment of diseases in which mucus forms in the bronchial tubes or is difficult to remove. These include, for example, severe lung infections, pneumonia and cystic fibrosis.

Likewise, acetylcysteine ‚Äč‚Äčis approved as an antidote for the treatment of paracetamol or acrylonitrile intoxication.

Acetylcysteine ‚Äč‚Äčis often used as a cysteine ‚Äč‚Äčreplacement for parenteral nutrition (for example, by infusion) and dietary nutrition. Cysteine ‚Äč‚Äčis a protein building block.

Off-label, ie outside the regulatory area, the drug is used preventively for the treatment of renal dysfunction and also in psychiatric disorders such as schizophrenia, obsessive-compulsive disorder and depression.

The duration of use is a few days to permanent depending on the clinical picture.

This is how acetylcysteine ‚Äč‚Äčis applied

In self-medication, acetylcysteine ‚Äč‚Äčis usually consumed as a juice or effervescent tablet for mucus solution. Adults and children 14 years of age take either 600 milligrams once a day or 200 milligrams of acetylcysteine ‚Äč‚Äčup to three times a day. Smaller children (aged two and over) receive less depending on their body weight. It is important that enough water or tea is drunk, otherwise the mucus remover can not work. The active ingredient can be combined with other expectorant medicines.

The use as antidote is reserved for the doctor

What are the side effects of acetylcysteine?

Acetylcysteine ‚Äč‚Äčcan hardly be overdosed and is almost free of side effects at therapeutic doses. In one in a hundred to a thousand treated can lead to allergic reactions to the drug (itching, rash, palpitations, drop in blood pressure - the intake must be stopped immediately!). In addition, tinnitus, headache, fever, abdominal pain, heartburn, nausea, vomiting and diarrhea are possible.

What should be considered when taking acetylcysteine?

Acetylcysteine ‚Äč‚Äčshould not be taken with cough torments (pentoxyverine, dextromethorphan, codeine). The suppressed cough reflex otherwise causes a secretion jam. This can be dangerous especially at night.

Studies have shown that acetylcysteine ‚Äč‚Äčcan react with some antibiotics (tetracycline, gentamycin, penicillin and others) and limits its effectiveness. However, as this happens only in the case of direct contact of the substances, it is recommended to take the active ingredients at least two hours apart.

The use of acetylcysteine ‚Äč‚Äčduring pregnancy and lactation does not show any direct harmful effects, but should still be discussed with a doctor first.

The active substance should be taken by children 2 years of age and older, if they do not have a severe hepatic or renal impairment.

How to Get Acetylcysteine ‚Äč‚ÄčMedication

Preparations containing the active substance acetylcysteine ‚Äč‚Äčcan be obtained without prescription as a mucus remover in the pharmacy.

In some cases, acetylcysteine ‚Äč‚Äčeffervescent tablets are also offered in the drugstore, but here the delivery may be made only as a dietary agent and not for the treatment of diseases.

Since when is acetylcysteine ‚Äč‚Äčknown?

Although the structure of the amino acids has been known for much longer, the approval of acetylcysteine ‚Äč‚Äčas a mucus remover in Germany was not until 1960. Since the mid-1970s, it has been approved as an antidote for paracetamol poisoning. Since it is not subject to ongoing patent protection, there are numerous generics with the active ingredient in the German pharmaceutical market acetylcysteine.

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