APPROVED

By order of the Chairman of the Committee

Pharmaceutical control

Ministry of Health
Republic of Kazakhstan

From "_05___"_09___2008

№ __211____________

Instructions for medical use

medicine

ACC® 600 / ACC® 600

Trade name

International generic name

Acetylcysteine

Dosage form

Effervescent tablets 600 mg

Compound

One effervescent tablet contains

active substance- acetylcysteine ​​600 mg

excipients: citric acid anhydrous, sodium bicarbonate, sodium carbonate anhydrous, mannitol, lactose anhydrous, ascorbic acid, sodium cyclamate, sodium saccharin?2H2O, sodium citrate?2H2O, blackberry aroma.

Description

Round smooth tablets white with a notch, blackberry scent

The resulting solution: transparent, colorless, free of foreign particles, with the taste and smell of blackberries

Pharmacotherapeutic group

Expectorants. Mucolytics.

ATC code R05 CB01

Pharmacological properties

Pharmacokinetics

After oral administration, acetylcysteine ​​is rapidly absorbed from gastrointestinal tract(GIT) and is metabolized in the liver into cysteine, a pharmacologically active metabolite, as well as diacetylcysteine, cystine and various mixed disulfides.

Because of high effect“first pass” through the liver, the bioavailability of acetylcysteine ​​is very low (approximately 10%).

In humans, maximum plasma concentrations are reached after 1-3 hours. The maximum plasma concentration of the cysteine ​​metabolite is about 2 µmol/l. The binding of acetylcysteine ​​to plasma protein is approximately 50%.

Acetylcysteine ​​is excreted through the kidneys almost exclusively in the form of inactive metabolites (inorganic sulfates, diacetylcysteine).

The plasma elimination half-life is approximately 1 hour and is mainly determined by hepatic biotransformation. Therefore, impaired liver function leads to prolonged plasma elimination half-lives of up to 8 hours.

Pharmacodynamics

Acetylcysteine ​​is a derivative of the amino acid cysteine. Acetylcysteine ​​has secretolytic and secretomotor effects in respiratory tract. It breaks disulfide bonds between mucopolysaccharide chains and has a depolymerizing effect on DNA chains (in purulent sputum). Thanks to these mechanisms, the viscosity of sputum decreases.

An alternative mechanism of acetylcysteine ​​is based on the ability of its reactive sulfhydryl group to bind chemical radicals and thereby neutralize them.

Acetylcysteine ​​helps increase glutathione synthesis, which is important for detoxification toxic substances. This explains its antidote effect in paracetamol poisoning.

With him prophylactic use it has a protective effect regarding the frequency and severity of exacerbations bacterial infections, which was found in patients with chronic bronchitis and cystic fibrosis.

Indications for use

Secretolytic therapy for acute and chronic diseases bronchi and lungs, accompanied by impaired formation and transportation of sputum.

Directions for use and dosage

Adults and teenagers aged 14 years and older

½ effervescent tablet twice daily or 1 effervescent tablet once daily (equivalent to 600 mg acetylcysteine ​​per day).

Effervescent tablets are pre-dissolved in a glass of water and taken after meals.

The duration of treatment depends on the type and severity of the disease and should be determined by the attending physician.

In case chronic bronchitis and cystic fibrosis should be treated long-term to prevent infection.

Side effects

Rarely (0.1% -< 1%): стоматит, диарея, рвота, изжога и тошнота, headache, tinnitus; bleeding, partly associated with hypersensitivity reactions.

Very rarely (<0,01%): аллергические реакции - зуд, крапивница, кожная сыпь, бронхиолоспазм, тахикардия и артериальная гипотензия.

Reports regarding bronchiolospasm primarily concerned patients with increased bronchial system reactivity associated with bronchial asthma.

Contraindications

Hypersensitivity to acetylcysteine ​​or any component of the drug

Galactose intolerance

Congenital lactase deficiency

Glucose-galactose malabsorption syndrome.

Drug interactions

The simultaneous use of acetylcysteine ​​and antitussives can cause dangerous secretory stagnation due to a decrease in the cough reflex. For this reason, this combination therapy option must be based on a particularly accurate diagnosis.

Tetracycline chloride should be administered separately and at least two hours apart.

Reports regarding inactivation of antibiotics (semisynthetic penicillins, tetracyclines, cephalosporins and aminoglycosides) resulting from concomitant use of acetylcysteine ​​or other mucolytic drugs are based solely on laboratory experiments in which the relevant substances were directly mixed. However, for safety reasons, oral antibiotics should be administered separately at two-hour intervals.

In cases of simultaneous administration of nitroglycerin (glycerol trinitrate) with acetylcysteine, an increase in its vasodilatory effect and inhibitory effect on platelet aggregation was observed. The clinical significance of these data has not yet been established.

Special instructions

The secretolytic effect of ACC® is supported by sufficient fluid intake.

Due to the high content of active substance ACC® 600, effervescent tablets should not be used in children under 14 years of age. For the age group under 14 years old, the pediatric form is recommended - ACC® junior cough syrup (200 mg/10 ml).

1 effervescent tablet ACC® 600 contains 138.8 mg of sodium. This should be taken into account by those following a salt-free diet.

Manufacturer: Hermes Arzneimittel GmbH

Anatomical-therapeutic-chemical classification: Acetylcysteine

Registration number: No. RK-LS-5No. 021302

Registration date: 15.04.2015 - 15.04.2020

Instructions

• Russian

Trade name

International nonproprietary name

Acetylcysteine

Dosage form

Effervescent tablets 600 mg

Compound

One effervescent tablet contains

active substance - acetylcysteine ​​600.00 mg

excipients: anhydrous citric acid, sodium bicarbonate, anhydrous sodium carbonate, mannitol, anhydrous lactose, ascorbic acid, sodium cyclamate, sodium saccharin, sodium citrate dihydrate, zinc sulfate monohydrate, lemon flavoring "BB"

Description

Tablets are round in shape, with a smooth surface, white, scored, with the smell of lemon, with a diameter of 19.6 to 20.4 mm.

The prepared solution is transparent, colorless, without mechanical inclusions, with the smell of lemon, possibly slightly sulfuric acid.

Pharmacotherapeutic group

Medicines to relieve symptoms of colds and coughs. Expectorants. Mucolytics. Acetylcysteine

ATX code R05 CB01

Pharmacological properties

Pharmacokinetics

After oral administration, acetylcysteine ​​is rapidly absorbed from the gastrointestinal tract (GIT) and metabolized in the liver into cysteine, a pharmacologically active metabolite, as well as into diacetylcysteine, cystine and various mixed disulfides.

Due to the high first pass effect through the liver, the bioavailability of acetylcysteine ​​is very low (approximately 10%).

In humans, maximum plasma concentrations are reached after 1-3 hours. The maximum plasma concentration of the cysteine ​​metabolite is about 2 µmol/l. The binding of acetylcysteine ​​to plasma protein is approximately 50%.

Acetylcysteine ​​is excreted through the kidneys almost exclusively in the form of inactive metabolites (inorganic sulfates, diacetylcysteine).

The plasma elimination half-life is approximately 1 hour and is mainly determined by hepatic biotransformation. Therefore, impaired liver function leads to prolongation of plasma half-life periods up to 8 hours.

Pharmacodynamics

Acetylcysteine ​​is a derivative of the amino acid cysteine. Acetylcysteine ​​has secretolytic and secretomotor effects in the respiratory tract. It breaks disulfide bonds between mucopolysaccharide chains and has a depolymerizing effect on DNA chains (with purulent sputum). Thanks to these mechanisms, the viscosity of sputum decreases.

An alternative mechanism of acetylcysteine ​​is based on the ability of its reactive sulfhydryl group to bind chemical radicals and thereby neutralize them.

Acetylcysteine ​​helps increase glutathione synthesis, which is important for the detoxification of toxic substances. This explains its antidote effect in paracetamol poisoning.

When used prophylactically, it has a protective effect on the frequency and severity of exacerbations of bacterial infections, which was found in patients with chronic bronchitis and cystic fibrosis.

Indications for use

Acute and chronic diseases of the bronchi and lungs, accompanied by the formation of viscous sputum (to facilitate the removal of sputum).

Directions for use and dosage

Adults and teenagers aged 14 years and older

½ effervescent tablet twice a day or 1 effervescent tablet once a day (equivalent to 600 mg acetylcysteine ​​per day).

Effervescent tablets are pre-dissolved in a glass of water and taken after meals.

The duration of treatment depends on the type and severity of the disease and should be determined by the attending physician.

Side effects

Not often

- allergic reactions (itching, urticaria, skin rash, bronchospasm, Quincke's edema)

Tachycardia

Arterial hypotension

Headache

Fever

Stomatitis, abdominal pain, diarrhea, vomiting, heartburn and nausea

Tinnitus

Rarely

Dyspnea, bronchospasm (mainly in patients with increased reactivity of the bronchial system associated with bronchial asthma)

Very rarely

Bleeding and hemorrhage partially associated with hypersensitivity reactions

Anaphylactic reactions, up to anaphylactic shock

Stevens-Johnson syndrome or Lyell's syndrome

Contraindications

Hypersensitivity to acetylcysteine ​​or components of the drug

Galactose intolerance

Congenital lactase deficiency

Glucose-galactose malabsorption syndrome

Children and teenagers up to 14 years old

Pregnancy and lactation

Peptic ulcer of the stomach and duodenum in the acute stage

Hemoptysis

With caution: varicose veins of the esophagus, bronchial asthma, diseases of the adrenal glands, liver and/or kidney failure, arterial hypertension.

Drug interactions

The simultaneous use of acetylcysteine ​​and antitussives may cause accumulation of sputum due to a decrease in the cough reflex. For this reason, this combination therapy option must be based on a particularly accurate diagnosis.

The use of activated carbon may weaken the effect of acetylcysteine.

Reports regarding inactivation of antibiotics (semisynthetic penicillins, tetracyclines, cephalosporins and aminoglycosides) resulting from concomitant use of acetylcysteine ​​or other mucolytic drugs are based solely on laboratory experiments , in which significant substances were directly mixed. Despite this, for safety reasons, oral antibiotics should be administered separately, at two-hour intervals.

In cases of simultaneous administration of nitroglycerin (glycerol trinitrate) with acetylcysteine, an increase in its vasodilatory effect and inhibitory effect on platelet aggregation was observed. The clinical significance of these data has not been established.

If simultaneous treatment with nitroglycerin and acetylcysteine ​​is necessary, treatment should be carried out under the close supervision of a physician, due to the possibility of severe hypotension, which in some cases is heralded by headache.

Acetylcysteine ​​eliminates the toxic effects of paracetamol.

Special instructions

During the use of acetylcysteine, in very rare cases, the development of severe skin reactions, such as Stevens-Johnson syndrome and Lyell's syndrome, has been observed. If changes occur in the skin and mucous membranes, the patient should immediately stop taking acetylcysteine ​​and consult a doctor.

Caution should be exercised when treating acetylcysteine ​​in patients suffering from bronchial asthma and in patients with a history of gastric or duodenal ulcers, as well as at risk of gastrointestinal bleeding (for example, latent peptic ulcer or esophageal varices).

Caution should also be exercised in patients with histamine intolerance. Long-term use of the drug should be avoided in such patients, since acetylcysteine ​​affects histamine metabolism and may cause intolerance symptoms (for example, headache, runny nose, itching).

The use of acetylcystine, especially at the beginning of treatment, can lead to excessive dilution of sputum in the bronchi, thereby causing an increase in its volume; if the patient cannot expectorate sputum, the necessary measures should be taken (for example, postural drainage and suction).

One effervescent tablet contains 6.03 mmol (138.8 mg) sodium. This should be taken into account when prescribing the drug to patients on a low sodium diet (low salt diet).

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

The drug does not affect the ability to drive a vehicle or operate potentially dangerous machinery.

Overdose

To get rid of isolated and chronic cases of diseases of the bronchopulmonary system, accompanied by the release of difficult to separate sputum, medications are used.

One of the most effective and widely used is, available in the following forms for oral use:

The drug contains sucrose, which is important for people with diabetes to know.

Mechanism of action

ACC powder is prescribed for wet cough. The main causes of this type of cough are accumulated in the lungs and bronchi.

Due to the coughing mechanism, the body tries to get rid of mucus, which is often very thick. Liquefaction of sputum promotes its rapid removal and relief from coughing.

The medicinal effect occurs due to the main component acetylcysteine. Acetylcysteine ​​molecules break down the bonds between mucopolysaccharide chains, making mucus less viscous and easier to expectorate. The instructions for using ACC powder emphasize the fact that the drug has a positive effect in cases where purulent inclusions are present in the mucus discharge.

ACC powder is beneficial for patients suffering from chronic diseases of the lungs and bronchi. Acetylcysteine ​​activates the synthesis of substances that are components of the body's antioxidant system, which protect cells from damage during inflammatory processes. Due to this property, ACC is recommended to be taken for preventive purposes.

Absorption of the active substance occurs instantly. Over a period of one to three hours, the maximum levels of the presence of ACC components in the blood vessels occur. The instructions for using the powder state that inactive metabolites are excreted by the kidneys.

It is worth noting: the substances of the drug penetrate the placenta, which is especially important for pregnant women to know.

Method of use for cough

The drug is recommended for use in all cases of diseases associated with the appearance of viscous sputum in the lungs and bronchi. These diseases include the following:

• any degree of severity;
• congenital diseases associated with impaired respiratory function (cystic fibrosis);
• inflammatory processes in the sinuses.

In any form of these diseases, a positive effect is observed from the drug ACC (powder). How to take the medicine in each specific case is prescribed by the doctor, indicating the dose and frequency of administration.

In any case, the instructions for using ACC granules state that you need to dissolve the contents in a glass of hot water and drink. Depending on the disease and age of the patient, the number of doses per day and the duration of use of the medicine are determined. Usually one sachet of medicine is consumed per dose.

It is important that drinking plenty of fluids during treatment improves the effect of the drug and speeds up recovery.

Instructions for use

For any course of disease of the bronchopulmonary system, ACC powder is used. How to take the drug is explained in the instructions supplied with the drug. The choice of dose is based on the patient’s body weight and age, the severity of the disease, and the presence of other physiological disorders in the body.

The doctor will always prescribe the exact dose of the ACC drug to the patient. Instructions for use in sachets have special instructions and may differ from other forms of release.

How to breed?

The primary question for a person taking medicine is how to dilute ACC? The powder must be used strictly as prescribed; improper use of the substance can lead to unexpected consequences.

In this case, you should not be afraid of any unforeseen situations, but you must adhere to some recommendations.

The contents of the sachet must be dissolved in liquid before use and drunk immediately. In this way, the best effect from the ACC drug will be achieved. The powder, which contains ascorbic acid, has a pleasant taste.

In some cases, the medicine can be taken 2 hours after diluting the powder in water.

You should not take the liquid in which the drug was diluted after two hours.

It is important to take the right amount of water to dissolve the powder. The recommended dose is a whole glass, that is, approximately 200 ml. This volume is suitable for both children and adults. As is traditionally noted in the instructions for use for mucolytics, additional fluid will only have a positive effect on the body, it will quickly thin out sputum and speed up the release of mucus.

What water to dissolve in?

Competently following the instructions helps with ACC powder. What water to dissolve in - hot or cold - is one of the important points in the treatment process.

Adults and children are prescribed ACC in powder. The instructions for use state that it is best to dilute it in hot water. Children cannot always drink a drink, so in such cases it is permissible to use warm water.

In what water to dissolve the ACC powder also depends on the conditions of administration. If you are on the road and there is no hot water at hand, then you should not skip taking the drug - you can dissolve it in a liquid at room temperature.

How to take?

A convenient form of release is ACC in bags. How to take the medicine is indicated by its instructions. You should drink the diluted drink immediately after eating.

The duration of treatment in standard cases of colds is from five to seven days. If the patient suffers from chronic forms of bronchopulmonary diseases, then ACC sachets are prescribed for a longer period.

Although the instructions for use are not indicated, with prolonged treatment the effectiveness of acetylcysteine ​​decreases. For this reason, long-term monotherapy with ACC powder is not used.

How many times a day should you drink?

The result of treatment and recovery time depend on how often the patient takes ACC. The powder, the method of application of which is determined by the age and body weight of the patient, helps to quickly get rid of sputum.

Typically, the following age groups of patients are distinguished:

• children from two to six years old;
• children aged six to fourteen;
• children over 14 years old and adults.

The answer to the question: how many times a day should you drink ACC? The answer to the question also depends on the type and complexity of the disease. The powder in bags can have different dosages - 100, 200 and 600 mg. The frequency of administration also depends on this.

1. The first age group of children (from 2 to 6 years old) is prescribed 1 sachet of ACC granules at a dosage of 100 mg 2 or 3 times a day. This corresponds to a daily dose of acetylcysteine ​​of 200–300 mg.
2. Children from six to fourteen years old, in accordance with the instructions for use, need to take 300–400 mg of the active substance per day. To do this, drink 1 sachet of medication with a dosage of 100 mg three times a day or 200 mg sachet twice a day.
3. For treatment, adults and children over 14 years of age are recommended to consume 400 to 600 mg of acetylcysteine ​​per day. The number of doses of the drug depends on the chosen dosage - 100 mg, 200 mg or 600 mg.

If you have a sachet of ACC with a dosage of 600 mg, then it is enough to take the medicine once a day. A dosage of 200 mg is taken 2 or 3 times. Packets labeled 100 mg are taken two at a time - twice or three times a day.

Important information for patients

Here is some important information that people taking ACC need to know. What water to dissolve in (hot or cold) is described above. But it is also worth considering the type of drinking glass. You cannot use metal or rubber, only glass or ceramic mugs and glasses.

1. If the patient suffers from irritation of the gastric mucosa, then it is better to take granulated ACC rather than effervescent tablets. The powder, how to drink and dilute it, is described above.
2. Be sure to read the accompanying papers for the ACC drug. The instructions for use of the powder have prescribed contraindications. For example, the drug should not be used by people with allergic reactions to acetylcysteine.
3. People with stomach and duodenal ulcers should not use ACC for treatment.
4. The instructions for use of granules do not recommend taking the substance to women during pregnancy and breastfeeding.
5. You cannot combine taking the drug and antitussives.

Acetylcysteine ​​is incompatible with tetracycline and penicillin antibiotics and reduces their absorption. Therefore, if patients are prescribed antibacterial drugs, then it is worth distinguishing between taking ACC powder and antibiotics with a break of at least two hours.

People suffering from chronic diseases of the bronchopulmonary system, pulmonary or heart failure may be prescribed ACC. The powder, the use of which in prescribed doses, guarantees easier breathing, as well as a reduction in the risk of infectious inflammation in the bronchi and lungs.

What kind of reviews does the drug receive?

Doctors are increasingly prescribing ACC for patients with various diseases of the bronchopulmonary system. In most cases, the powder receives only positive reviews.

Timely start of taking the powder guarantees speedy relief from the disease.

A large number of patients note the fact that a positive effect is observed almost from the first day of use. The drug is well tolerated. Consumers also write that the substance has the following advantages:

• liquefaction of sputum in 3–4 days even in severe cases of the disease;
• Possibility to accept children and adults;
• pleasant taste sensations, which is important for children.

Patients testify that the drug allows you to get rid of an annoying cough caused by viscous sputum in a matter of days. The granular form is especially in demand, allowing you to prepare a medicinal drink in a matter of moments.

Granules are convenient to use on the road, at work, or on a business trip. Only one sachet of ACC is needed per dose. The sachets and instructions for use are in a cardboard box, which is convenient to take with you.

There are various forms of ACC release. Instructions for use of the powder describe dosages of 100 mg, 200 mg and 600 mg. But the greatest demand for adults is for sachets labeled 200 mg ACC. It is convenient to take cough powder at this dose three times a day at a time, since adult patients are usually prescribed 600 mg of acetylcysteine ​​per day.

ACC powder in granules 100 mg for children is ideal for children and corresponds to a single dose. The main thing is to strictly follow the doctor’s recommendations - how many times a day to drink ACC. The powder dissolves quickly and tastes very pleasant, which is important for kids.

Useful video

For useful information about the treatment of bronchitis, watch this video:

Conclusion

1. ACC powder helps to quickly get rid of cough and other diseases of the bronchi and lungs.
2. Proper use will allow you to get rid of mucus in the lungs in a short time, liquefy it and remove it from the body.
3. To take the drug correctly, you need to understand how to dissolve ACC. This is indicated in the instructions for use: just pour the contents of the package into hot water, stir and drink immediately.
4. Usually one packet is enough for a single dose; the main thing is to choose the right dosage - 100, 200 or 600 mg.
5. In most cases of use, a positive effect is observed within a few days of use.

ACC Long is a mucolytic expectorant.

Used to thin sputum in diseases of the respiratory system accompanied by the formation of thick mucus. The active substance Acetylcysteine ​​is a derivative of the amino acid cysteine. The mucolytic effect of the drug is of a chemical nature.

On this page you will find all the information about ACC Long: complete instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews from people who have already used ACC Long. Would you like to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Mucolytic drug.

Conditions for dispensing from pharmacies

Available without a prescription.

Prices

How much does an ACC long cost? The average price in pharmacies is 450 rubles.

Release form and composition

White, round, scored tablets with a smooth surface and blackberry flavor:

• One effervescent tablet contains the active ingredient: acetylcysteine ​​600 mg
• Excipients: anhydrous citric acid (1385.0 mg), sodium bicarbonate (613.4 mg), anhydrous sodium carbonate (320.0 mg), mannitol (150.0 mg), anhydrous lactose (150.0 mg), ascorbic acid acid (75.0 mg), sodium cyclamate (30.0 mg), sodium saccharinate 2HgO (5.0 mg), sodium citrate 2HgO (1.6 mg), blackberry flavor “B” (40.0 mg).

Pharmacological effect

Acetylcysteine ​​is the active substance of ACC Long tablets, which has an expectorant effect and facilitates the discharge of sputum due to its effect on its rheological properties. It is a derivative of cysteine, an aliphatic sulfur-containing amino acid. Acetylcysteine ​​breaks the disulfide bonds of mucopolysaccharide chains, which causes depolymerization of sputum mucoproteins and a decrease in mucus viscosity, and also promotes better expectoration and discharge of bronchial secretions. The substance retains its effect in the presence of purulent sputum.

Acetylcysteine ​​has antioxidant and pneumoprotective effects due to the binding of oxidative radicals by its reactive sulfhydryl groups and, consequently, their neutralization. In addition, it promotes the formation of glutathione, an important component of the body's chemical detoxification process and antioxidant system. The antioxidant activity of the substance helps to increase intracellular protection from the negative effects of free radical oxidation, which occurs during an intense inflammatory process.

In the case of prophylactic use of the drug, there is a decrease in severity and

Indications for use

The drug ACC Long is indicated for all pathologies associated with the accumulation of thick viscous sputum in the upper respiratory tract and bronchial tree, for example:

• bronchiectasis;
• cystic fibrosis;
• chronic and acute;
• bronchiolitis;

Contraindications

Hypersensitivity to acetylcysteine ​​or other components of the drug, pregnancy, breastfeeding, children under 14 years of age.

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.

Use during pregnancy and lactation

According to the instructions, ACC Long is contraindicated for use during pregnancy and lactation, which is due to the lack of data confirming the safety/efficacy of therapy in this group of patients.

Instructions for use

The instructions for use indicate that ACC long is taken orally after meals. Effervescent tablets should be dissolved in 1 glass of water.

• For adults and adolescents over 14 years of age, it is recommended to prescribe the drug 200 mg (ACC 200) 2-3 times a day, which corresponds to 400-600 mg of acetylcysteine ​​per day, or 600 mg (ACC Long) 1 time/day.

The tablets should be taken immediately after dissolution; in exceptional cases, you can leave the prepared solution for 2 hours. Additional fluid intake enhances the mucolytic effect of the drug.

Side effects

Uncontrolled use is fraught with side effects. The respiratory and digestive systems are usually affected. Against the background of bronchial asthma, bronchospasms appear. Painful shortness of breath is less common.

A common side effect is abdominal pain. Sometimes nausea occurs, transforming into vomiting. Some patients experience diarrhea and dyspepsia. Less commonly, noise occurs in the hearing organs. Another common side effect is allergies. Skin rashes are usually present. They are accompanied by painful itching. Less common is a decrease in blood pressure. Anaphylactic reactions are uncommon.

Other side effects include:

• headaches;
• fever;
• decreased platelet aggregation.

Against the background of increased sensitivity, isolated bleeding is observed. No serious side effects that are life-threatening to the patient have been observed to date.

Overdose

In case of overdose, the following symptoms may occur: abdominal pain, vomiting, diarrhea, nausea. No severe symptoms were observed in case of overdose.

In such cases, symptomatic treatment is carried out.

Special instructions

When prescribing and using the drug ACC Long, it is important to consider:

1. Information for patients with diabetes: 1 tablet of ACC Long corresponds to 0.01 XE (bread units);
2. Drinking plenty of fluids during treatment enhances the mucolytic effect of acetylcysteine;
3. Acetylcysteine ​​affects the metabolism of histamine, so patients with histamine intolerance should not take tablets for a long time - this can lead to symptoms of hypersensitivity (itching, rhinitis, headache);
4. The tablets contain sodium compounds, which should be taken into account by patients on a salt-free diet;
5. The tablets contain lactose and are therefore not prescribed to patients with rare hereditary forms of galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome;
6. When prescribing ACC Long to patients with obstructive bronchitis and bronchial asthma, strict systematic monitoring of bronchial patency is required.

Drug interactions

1. The simultaneous use of antitussive drugs and acetylcysteine ​​can lead to stagnation of sputum (since such drugs suppress the cough reflex).
2. Acetylcysteine ​​may enhance the vasodilatory effect of nitroglycerin and vasodilating drugs.
3. Oral antibiotics (tetracyclines, penicillins, cephalosporins) can interact with the thiol group of acetylcysteine, which may result in a weakening of their antibacterial effect. The interval between taking ACC Long and antibiotics (except loracarbef and cefixime) should be 2 hours or more.

ACC Long is a drug with mucolytic action.

Release form and composition

ACC Long is produced in the form of effervescent tablets: flat-cylindrical, round, chamfered, with a line on one side; with a blackberry odor, there may also be a faint odor of sulfur; The solution prepared from tablets is transparent, colorless, with a blackberry and sometimes a faint sulfuric odor (10 pcs. or 20 pcs. in polypropylene tubes, one tube in a cardboard pack).

Composition per 1 tablet:

• active ingredient: acetylcysteine ​​– 600 mg;
• auxiliary components: sodium carbonate, sodium bicarbonate, lactose, sodium cyclamate, citric acid, sodium citrate dihydrate, sodium saccharinate dihydrate, mannitol, ascorbic acid, blackberry flavoring "B".

Pharmacological properties

Pharmacodynamics

Acetylcysteine ​​is a derivative of cysteine ​​(an amino acid). It has a mucolytic effect, facilitating the discharge of sputum due to a direct effect on its rheological properties. Acetylcysteine ​​breaks disulfide bonds in mucopolysaccharide chains and causes depolymerization of sputum mucoproteins, resulting in a decrease in sputum viscosity. The activity of the drug remains even in the presence of purulent discharge.

In addition, acetylcysteine ​​has an antioxidant effect based on the ability of its reactive SH groups (sulfhydryl groups) to interact with oxidative radicals and neutralize them. Acetylcysteine ​​is also involved in the synthesis of glutathione, which is an important component of chemical detoxification and antioxidant defense of the body. The antioxidant effect of the drug helps protect cells from the action of free radicals formed during any intense inflammatory reaction.

Prophylactic use of the drug ACC Long leads to a decrease in the frequency and severity of bacterial exacerbations in patients with cystic fibrosis and chronic bronchitis.

Pharmacokinetics

Absorption of acetylcysteine ​​is high. The bioavailability of the drug when taken orally is about 10%, since it undergoes a first-pass effect through the liver. The maximum plasma concentration is achieved 1–3 hours after taking ACC Long. The drug is 50% bound to plasma proteins.

Metabolism occurs in the liver. A pharmacologically active metabolite is formed - cysteine, as well as inactive metabolites - cystine, diacetylcysteine ​​and mixed disulfides. The drug is excreted by the kidneys in the form of inactive metabolites (diacetylcysteine, inorganic sulfates). The half-life is about 1 hour. In case of liver dysfunction, the half-life increases to 8 hours.

Acetylcysteine ​​penetrates the placental barrier. There is no data on its excretion in breast milk and penetration through the blood-brain barrier.

Indications for use

According to the instructions, ACC Long is used for respiratory diseases accompanied by the formation of difficult to separate viscous sputum, namely:

• cystic fibrosis;
• obstructive bronchitis;
• laryngotracheitis;
• chronic and acute bronchitis;
• tracheitis;
• COPD (chronic obstructive pulmonary disease);
• pneumonia;
• bronchial asthma, bronchiectasis;
• bronchiolitis;
• lung abscess.

The drug is also used for otitis media (inflammation of the middle ear), acute and chronic sinusitis.

Contraindications

Absolute:

• pulmonary hemorrhage;
• coughing up blood or bloody sputum from the respiratory tract;
• exacerbation of peptic ulcer of the stomach and duodenum;
• lactose intolerance, lactase enzyme deficiency, glucose-galactose malabsorption syndrome (since the tablets contain lactose);
• children under 14 years of age;
• period of pregnancy and breastfeeding;
• hypersensitivity to acetylcysteine ​​or auxiliary components of the drug.

Relative (ACC Long is used with caution):

• obstructive bronchitis;
• bronchial asthma;
• indications in the anamnesis of peptic ulcer of the duodenum and stomach;
• arterial hypertension;
• varicose veins of the esophagus;
• renal failure;
• liver failure;
• adrenal gland diseases;
• histamine intolerance (long-term treatment with the drug should be avoided, since acetylcysteine ​​affects histamine metabolism and can lead to signs of intolerance such as vasomotor rhinitis, headache and itching).

ACC Long, instructions for use (method and dosage)

ACC Long 600 mg is intended for oral use. The tablets are pre-dissolved in one glass of water. The prepared solution should be taken immediately. In exceptional cases, the prepared solution can be drunk later, but it should not be left for more than 2 hours. The drug is taken after meals. The mucolytic effect of acetylcysteine ​​increases with additional fluid intake.

The duration of treatment for short-term colds is from 5 to 7 days. In case of cystic fibrosis and chronic bronchitis, ACC Long must be taken for a longer time to achieve a preventive effect.

Unless otherwise prescribed, the drug is used 1 tablet once a day.

Side effects

• digestive system: uncommon – dyspeptic disorders, vomiting, nausea, stomatitis, diarrhea, abdominal pain;
• respiratory system: rarely - bronchospasm (more often with bronchial asthma in patients with bronchial hyperreactivity), shortness of breath;
• sense organs: infrequently – tinnitus;
• allergic reactions: uncommon - skin rash, urticaria, itching, exanthema, low blood pressure, Quincke's edema, tachycardia; very rarely - Lyell's syndrome, Stevens-Johnson syndrome, anaphylactic reactions;
• other reactions: very rarely - fever, headache; in isolated cases - decreased platelet aggregation and bleeding.

Overdose

In case of an overdose of ACC Long (intentional or mistaken), symptoms such as vomiting, nausea, heartburn, stomach pain and diarrhea are observed.

In case of overdose, symptomatic therapy is prescribed.

Special instructions

To prepare a solution for oral administration, use glass containers and avoid contact with rubber, metals, easily oxidized substances and oxygen.

For patients with obstructive bronchitis and bronchial asthma, ACC Long is prescribed with caution, regularly monitoring bronchial patency.

If severe allergic reactions develop, as well as any changes in the mucous membranes and skin, you should stop taking the drug and immediately consult a doctor.

Information for patients with diabetes: one effervescent tablet contains 0.001 XE (bread units).

Impact on the ability to drive vehicles and complex mechanisms

Use during pregnancy and lactation

ACC Long should not be used by pregnant women, as data on the use of the drug during this period are limited.

If it is necessary to prescribe acetylcysteine ​​during lactation, it is necessary to decide on stopping breastfeeding.

Use in childhood

ACC Long is contraindicated in children under 14 years of age.

For impaired renal function

In patients with renal failure, ACC Long is used with caution.

For liver dysfunction

In patients with liver failure, ACC Long is used with caution.

Drug interactions

The simultaneous use of antitussive drugs and acetylcysteine ​​can lead to stagnation of sputum (since such drugs suppress the cough reflex).

Oral antibiotics (tetracyclines, penicillins, cephalosporins) can interact with the thiol group of acetylcysteine, which may result in a weakening of their antibacterial effect. The interval between taking ACC Long and antibiotics (except loracarbef and cefixime) should be 2 hours or more.

Acetylcysteine ​​may enhance the vasodilatory effect of nitroglycerin and vasodilating drugs.

Analogs

Analogues of ACC Long are: ACC 100, ACC 200, N-AC-ratiopharm, N-acetylcysteine, Acestine, Acetylcysteine, Vicks Active ExpectoMed, Mukobene, Mucomist, Mukonex, Fluimucil.

Terms and conditions of storage

Store in a place protected from light and moisture at a temperature of no more than 30 °C. Keep away from children. After taking another tablet, you must close the tube tightly.

The shelf life is 3 years.