Whoa, which form is better? ACC - powder or effervescent tablets. International nonproprietary name

Name:

ACC

Pharmacological
action:

Acetylcysteine ​​(ACC) - mucolytic, expectorant, which is used to thin sputum in diseases of the respiratory system accompanied by the formation of thick mucus. Acetylcysteine ​​is a derivative of the amino acid cysteine.
The mucolytic effect of the drug is of a chemical nature.
Due to the free sulfhydryl group, acetylcysteine ​​breaks the disulfide bonds of acidic mucopolysaccharides, which leads to depolymerization of sputum mucoproteins and a decrease in the viscosity of mucus and promotes expectoration and discharge of bronchial secretions.
The drug remains active in the presence of purulent sputum.
Acetylcysteine also has antioxidant pneumoprotective properties, which is due to its binding by sulfhydryl groups of chemical radicals and, thus, neutralizing them.

In addition, the drug helps to increase the synthesis of glutathione - an important factor in intracellular protection not only from oxidative toxins of exogenous and endogenous origin, but also from some cytotoxic substances.
This feature of acetylcysteine ​​makes it possible to effectively use the latter in case of an overdose of paracetamol.
After oral administration acetylcysteine quickly and completely absorbed and is metabolized in the liver to form cysteine, a pharmacologically active metabolite, as well as diacetylcysteine, cystine, and then mixed disulfides.
Bioavailability is very low - about 10%.
Cmax in blood plasma is achieved 1–3 hours after administration. Binding to blood plasma proteins - 50%.
Acetylcysteine ​​is excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine).
T½ is determined mainly by rapid biotransformation in the liver and is about 1 hour. In case of decreased liver function, T½ increases to 8 hours.

Indications for
application:

Acetylcysteine ​​is prescribed in all cases of diseases with accumulation of thick viscous sputum in the bronchial tree and upper respiratory tract, namely:
- acute and chronic bronchitis, including obstructive;
- bronchiolitis;
- tracheitis;
- bronchial asthma;
- bronchiectasis;
- cystic fibrosis;
- laryngitis;
- sinusitis;
- exudative otitis media.

Mode of application:

Daily dose for the treatment of cystic fibrosis For patients weighing more than 30 kg, up to 800 mg is used.
Children from the 10th day of life to 2 years of age are given 50 mg 2-3 r/s.
At the age of 2-5 years – 400 mg per day, divided into 4 doses. From 6 years – 600 mg/s (divided into 3 doses).
Treatment is continued for a long time, in courses of several months (3-6).
In all other cases, the daily dose for children over 14 years of age and adults is 400-600 mg. From 6 to 14 years – 300-400 mg (divided into 2 doses), 2-5 years – 200-300 mg (divided into 2 doses).
Children from the 10th day of life to 2 years of age are treated with 50 mg 2-3 r/s.

For acute diseases without complications the drug is prescribed for 5-7 days.
In case of complications or in case of chronic course, a course of treatment is possible (up to 6 months).
ACC is taken after meals.
The tablet or contents of the sachet must be dissolved in half a glass of liquid (iced tea, water, juice).

Side effects:

To describe the frequency of side effects, the following classification is used: very often (≥1/10), often (≥1/100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10 000, <1/1000), очень редко (<1/10 000).
From the cardiovascular system: infrequently - tachycardia, arterial hypotension.
From the nervous system: infrequently - headache.
From the skin: uncommon - allergic reactions (itching, urticaria, exanthema, eczema, rash, angioedema).
From the side of the hearing organ: uncommon - ringing in the ears.
From the respiratory system: rarely - shortness of breath, bronchospasm (mainly in patients with hyperreactivity of the bronchial system, which is associated with asthma), rhinorrhea.

From the digestive tract: uncommon - heartburn, dyspepsia, stomatitis, abdominal pain, nausea, vomiting, diarrhea, bad breath.
General disorders: uncommon - fever.
Isolated severe skin reactions (Stevens-Johnson and Lyell syndromes) have been reported.
When using acetylcysteine, bleeding was very rarely reported, which was most often associated with the development of hypersensitivity reactions.
Cases of decreased platelet aggregation have been reported, but there is no clinical confirmation of this.
Very rarely Angioedema, facial swelling, cases of anemia, hemorrhage, anaphylactic reactions or even shock have been reported.

Contraindications:

Hypersensitivity to acetylcysteine ​​and excipients;
- peptic ulcer;
- hereditary fructose intolerance;
- pulmonary hemorrhage or hemoptysis;
- in pediatric practice - for hepatitis and renal failure (threat of accumulation of nitrogen-containing products).

Use ACC with caution with peptic ulcer of the stomach or duodenum.
When preparing the solution, a patient with bronchial asthma may inhale air containing particles of the drug, which causes irritation of the mucous membranes of the upper respiratory tract and can provoke reflex bronchospasm.
For a better mucolytic effect, you should take plenty of fluids when treating with acetylcysteine.
10 ml of ready-made oral solution contains 0.31 carbohydrate units, which should be taken into account by patients with diabetes mellitus.
Sorbitol has a slight laxative effect on stool.

Newborns and children under 1 year of age acetylcysteine ​​is used exclusively for health reasons under strict medical supervision. The recommended dosage (10 mg/kg body weight) cannot be changed.
ACC 200 is not used for children under 2 years of age.
ACC Long is not recommended for children under 14 years of age.
Reaction speed when driving and operating equipment does not change when taking acetylcysteine.

Interaction
other medicinal
by other means:

Tetracycline and its derivatives (except doxycycline) should not be used together with ACC in pediatrics.
During experimental in vitro studies, no cases of inactivation of other types of antibacterial drugs were identified.
Nevertheless, It is recommended to maintain a gap between taking ACC and antibiotics at 2 o'clock (at least).
In vitro, the incompatibility of acetylcysteine ​​with semisynthetic penicillins, aminoglycoside and cephalosporin antibiotics has been proven. Such studies have not been conducted with erythromycin, amoxicillin and cefuroxime.
The simultaneous use of antitussives can lead to stagnation of respiratory tract secretions.
Use with nitroglycerin may enhance the vasodilator effect of the latter.

Pregnancy:

Acetylcysteine ​​has no embryotoxic effect, however, during pregnancy, as well as during breastfeeding, it is prescribed only if indicated under the supervision of a physician.

Overdose:

There are no data on cases of overdose of acetylcysteine ​​dosage forms intended for oral administration.
Acetylcysteine ​​when taken at a dose of 500 mg/kg/day does not cause signs and symptoms of overdose.
Symptoms: Overdose may result in gastrointestinal symptoms such as nausea, vomiting and diarrhea.
Treatment: there is no specific antidote for acetylcysteine ​​poisoning, therapy is symptomatic.

Release form:

ACC 100, 200 - effervescent tablets 20 pcs.
ACC hot drink – hot drink powder for internal use- 200 mg (20 sachets) and 600 mg (6 sachets).
ACC-long – effervescent tablets (600 mg), 10 pcs. in the tube.

ACC powder for the preparation of solution for oral administration – 100, 200 mg, 2 pcs. packaged.
ACC for children - powder for preparing a solution for internal use, 30 g in a 75 ml bottle (20 mg/ml) and 60 g in a 150 ml bottle (20 mg/ml).

Storage conditions:

In places inaccessible to children.
Temperature no more than 30°C.
The prepared solution can be stored for no more than 12 days in the refrigerator (at a temperature of 2-8°C).

1 sachet (100 mg) ACC granules for oral solution (orange) contains:

- excipients: ascorbic acid, sucrose, saccharin, orange flavor.

1 effervescent tablet (100 mg) ACC contains:
- active ingredient: acetylcysteine ​​- 100 mg;
- excipients: citric acid anhydride - 679.85 mg, sodium bicarbonate - 291 mg, mannitol - 65 mg, ascorbic acid - 12.5 mg, lactose anhydride - 75 mg, sodium citrate - 0.65 mg, saccharin - 6 mg, blackberry flavoring "B" - 20 mg.

In the article we will look at the instructions for use for “ACC 100 mg”.

When the cold season approaches, the number of colds increases, and a person suffers from all the unpleasant symptoms - runny nose, sore throat and fever. A particularly unpleasant manifestation is a cough. There are many drugs for the treatment of cough, each of which contains different active components, has certain medicinal properties and side effects and is designed for a particular type of cough - wet or dry.

When treating wet cough, ACC becomes one of the most effective medicines.

Mechanism of influence of the drug

In "ACC 100 mg" the active ingredient is acetylcysteine. The drug was developed in the mid-20th century by Italian pharmacists and since then has repeatedly proven its effectiveness in treating cough.

It must be taken into account that coughing is a normal protective reaction of the human body in case of damage to the respiratory system and colds. There are two main types of cough: dry and wet. Acetylcysteine ​​is only suitable for relieving the symptoms of a wet cough, that is, one that is characterized by the production of sputum, a special secretion of the bronchi. This secretion binds pathogenic organisms, and coughing later removes it from the bronchi. But if too much mucus is produced, it may become difficult to remove it from the bronchi. This process is especially difficult in children, since their respiratory passages are narrow. As a result, the child suffers, tries unsuccessfully and for a long time to cough up sputum, which complicates the patient’s condition and slows down recovery, causing insomnia.

Acetylcysteine

Acetylcysteine ​​makes this task easier. In structure, it is similar to the amino acid cysteine, capable of breaking down mucopolysaccharides, which constitute the essence of bronchial sputum. Thanks to this, it becomes less viscous and can freely exit the human body. Acetylcysteine ​​is also often prescribed for sinusitis and purulent otitis media.

Despite the fact that “ACC 100 mg” is used in the treatment of predominantly young patients, at the same time it is not only a drug for children and is used with equal success to eliminate cough in patients of all age categories. When acetylcysteine ​​enters the body, it enters the liver, where it is metabolized to cysteine, and then passes into the systemic circulation in this form.

The drug "ACC" is produced by companies such as Hexal AG (Germany) and Sandoz (Slovenia).

Composition of "ACC" and dosage forms

According to the instructions for “ACC” (100 milligrams or any other dosage), the drug has the following forms: tablets, granulated powder for preparing a suspension (solution) in bags, syrup, 20% solution for inhalation, as well as an injection solution.

The syrup contains the following substances: cherry flavor, methyl parahydroxybenzoate, sodium benzoate, caramelose, saccharinate and disodium edetate.

The granules for making the solution have the following composition: ascorbic acid, saccharin, sucrose, orange or lemon-honey flavoring.

“ACC 100 mg” tablets have a dosage of one hundred and two hundred milligrams, the “ACC Long” version of the drug contains 600 milligrams. The sachets may also contain one hundred or two hundred milligrams of acetylcysteine. One milliliter of syrup contains about twenty milligrams of the active substance, the volume of the bottle is 100 ml. Each bottle has a cup and a measuring syringe, so the required dose can be easily measured.

The tablets include, in addition to acetylcysteine, citric and ascorbic acids, lactose, mannitol, sodium carbonate, citrate, bicarbonate and saccharin.

Indications

"ACC 100 mg" is most often prescribed for inflammatory pathologies of the lower tract of the respiratory system. But the scope of its use may be wider than this.

The medication is indicated in the following cases:

• with bronchitis;
• in the treatment of poisoning with paracetamol;
• with bronchiolitis;
• in the prevention of various complications after surgical intervention on the respiratory organs;
• with pulmonary inflammation;
• with tracheitis;
• with sinusitis;
• with expansion of the bronchial area, that is, bronchiectasis;
• with otitis;
• with cystic fibrosis;
• with laryngitis.

Instructions for "ACC 100 mg"

In accordance with the instructions, the medicine must be taken after meals, the last use should be no later than six o'clock in the evening. The effect of the medication is enhanced by additional fluid intake.

To prepare the solution, pour the bag of granules into one glass of water. The tablets can also be thrown into warm water, after which they will dissolve. Instead of water, the use of other liquids is allowed, for example, tea, compote or juice. The syrup is made ready-made. A full glass of syrup contains acetylcysteine ​​in an amount of 400 mg, a full syringe contains 100 mg. With its help, it is convenient to draw the drug from the bottle and easily give the medicine to a small child.

The finished solution must be taken no later than three hours after preparation, but it is recommended to do this immediately. Under no circumstances should the drug be diluted in a metal container, as this releases substances that are hazardous to health. For this purpose, only glass or ceramic dishes are used. The use of "ACC 100 mg" should be correct.

Dosage

The dosage for this form as syrup is as follows:

• 2-3 times a day, five milliliters - for patients from two to six years old;
• 3-4 times a day, five milliliters - from six to fourteen years.

What do the instructions for use for the ACC 100 mg powder tell us?

For a suspension, the approximate quantities are as follows:

• 2-3 times a day, one packet of 100 mg - from two to six years;
• twice a day, two packets of 100 mg - from six to fourteen years;
• three times a day, two packets of 100 mg - after fourteen years.

For tablets, the dosage is as follows:

• 2-3 times a day, one tablet of 100 mg - from two to six years;
• twice a day, two tablets of 100 mg - from six to fourteen years;
• three times a day, two tablets of 100 mg - after fourteen years.

It is necessary to adhere to the daily dosage so that the amount of the active substance does not exceed the following marks:

• 200-300 milligrams - from two to six years;
• 300-400 milligrams - from six to fourteen years;
• 400-600 milligrams - after fourteen years.

This is confirmed by the instructions for “ACC 100” for children.

It is advisable to use the inhalation solution three times a day. One inhalation includes two to five milliliters of solution, its duration is from 15 to 20 minutes.

Duration of treatment

The average treatment course with tablets, syrup and granules ranges from five to seven days, the inhalation course is five to ten days. If necessary, the duration of therapy can be extended by the pediatrician. All forms of the ACC medicine for patients under two years of age can only be prescribed by the attending physician; dosages are determined individually.

The solution is administered intravenously exclusively in a hospital setting, the approximate amount being ten milligrams per kilogram of body weight.

Contraindications

The drug has several contraindications. Its use during exacerbation of ulcerative pathology of the duodenum and stomach is strictly prohibited. Outside this period, the medication is used carefully. With care, the drug is prescribed to patients under two years of age and infants. In this case, therapy should be carried out under medical supervision.

This type of drug, ACC Long, is used only to treat adult patients; it should not be given to children under fourteen years of age. Parenteral administration of the drug is permitted only after six years of age.

Careful reception

You should also take the medicine with caution in the following conditions:

• for bronchial asthma;
• with hemoptysis;
• during lactation and pregnancy;
• with kidney failure;
• with pathologies of the adrenal glands;
• with liver failure.

Side effects

During the use of ACC 100 mg, the patient may experience some negative manifestations. But if you follow the instructions and observe the dosage, they are rare. These include:

• stomatitis;
• noise in ears;
• hives;
• headache;
• Patients with diabetes need to remember that the drug contains sucrose.

Signs of drug overdose

An overdose of ACC 100 mg tablets, as well as other forms, may occur in some cases:

• if the child has taken an adult dosage;
• when taking too large a dose without special indications;
• the drug accumulates in the body (with prolonged use without monitoring the state of the blood and the activity of the kidneys and liver).

In case of an overdose, a sharp deterioration in the condition occurs: blood pressure decreases, dry mouth, vomiting, nausea are noted, and there may be a skin rash in the form of itching and allergic dermatitis, bronchospasm. In severe cases - anaphylactic shock and Quincke's edema.

Features of interaction with other medications

The instructions for use for ACC 100 mg are very detailed.

If acetylcysteine ​​is used simultaneously with antitussive drugs due to inhibition of the cough reflex, then dangerous mucus stasis can occur (this combination must be used carefully).

Taking it along with nitroglycerin can enhance the vasodilatory effect of the latter.

There is a synergism between bronchodilators and acetylcysteine.

Acetylcysteine ​​reduces the absorption of tetracycline, penicillins, erythromycin, amphotericin B, cephalosporins, proteolytic enzymes, so they should be taken no earlier than two hours after consuming ACC.

If acetylcysteine ​​comes into contact with metals and rubber, sulfides with a specific aroma are formed.

Analogs

When looking for a cheaper analogue compared to ACC, you should pay attention to some medicines:

• "Fluimucil", produced in Italy. It is intended to eliminate the first symptoms of coughs and colds, but can be used to facilitate the passage of viscous secretions from the nose. It contains 600 milligrams of acetylcysteine, flavorings, sorbitol and citric acid. The drug costs about 300 rubles.
• "Ambrobene" is produced in Germany in the form of syrup, based on another active component - ambroxol hydrochloride. The medicine allows you to cope with a lingering cough that is difficult to expectorate, helps remove phlegm, and softens the airways. Price - 200-300 rub.
• "Ambroxol", produced in Russia. It contains the same active component and is included in the category of expectorant mucolytic drugs. The price ranges from 40 to 50 rubles.

special instructions

As the instructions for “ACC” (100 mg or any other dosage) indicate, acetylcysteine ​​for obstructive bronchitis and bronchial asthma must be prescribed carefully, under constant monitoring of bronchial patency.

If side effects develop, the patient should stop taking the medicine and consult a specialist.

When dissolving the product, use glass containers and avoid contact with oxygen, metals, oxidizing substances and rubber.

When treating patients with diabetes mellitus, it should be taken into account that one “ACC 200” tablet is equal to 0.006 XE and two “ACC 100” pills. The instructions for the tablets confirm this.

There is no negative data regarding the impact on the ability to drive vehicles, as well as operate machinery, if the drug is used in the recommended dosage. It does not affect concentration and speed of psychomotor reactions.

Instructions for medical use of the drug

Description of pharmacological action

Indications for use

Respiratory diseases accompanied by the formation of viscous, difficult to separate sputum:

Acute and chronic bronchitis;
obstructive bronchitis;
laryngotracheitis;
pneumonia;
bronchiectasis;
bronchial asthma;
bronchiolitis;
cystic fibrosis;
acute and chronic sinusitis;
inflammation of the middle ear (otitis media).

Release form

tablets for the preparation of an effervescent drink 200 mg; aluminum tube 20, cardboard pack 1;
tablets for the preparation of an effervescent drink 200 mg; aluminum tube 25, cardboard pack 2;
tablets for the preparation of an effervescent drink 200 mg; aluminum tube 25, cardboard pack 4;
tablets for the preparation of an effervescent drink 200 mg; contour packaging without cells 4, cardboard pack 15;

Pharmacodynamics

The presence of sulfhydryl groups in the structure of acetylcysteine ​​promotes the rupture of disulfide bonds of acidic mucopolysaccharides of sputum, which leads to a decrease in the viscosity of mucus. The drug remains active in the presence of purulent sputum.

With the prophylactic use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations in patients with chronic bronchitis and cystic fibrosis.

Use during pregnancy

To ensure safety, due to insufficient data, the use of the drug during pregnancy and lactation is possible only if the expected benefit to the mother outweighs the potential risk to the fetus or infant.

Contraindications for use

Hypersensitivity to acetylcysteine ​​or other components of the drug;
peptic ulcer of the stomach and duodenum in the acute stage;
hemoptysis;
pulmonary hemorrhage;
pregnancy;
lactation.

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

Side effects

In rare cases, headache, inflammation of the oral mucosa (stomatitis) and tinnitus may occur. Extremely rarely - diarrhea, vomiting, heartburn and nausea, decreased blood pressure, increased heart rate (tachycardia). In isolated cases, allergic reactions such as bronchospasm (mainly in patients with bronchial hyperreactivity), skin rash, itching and urticaria are observed. In addition, there are isolated reports of bleeding due to hypersensitivity reactions.

If side effects develop, you should stop taking the drug and consult a doctor.

Directions for use and doses

Adults and adolescents over 14 years of age: 2–3 times a day, 2 effervescent tablets of 100 mg or 2–3 times a day, 1 effervescent tablet of 200 mg (400–600 mg of acetylcysteine ​​per day).

Children aged 6 to 14 years: 3 times a day, 1 effervescent tablet 100 mg or 2 times a day 2 effervescent tablets or 3 times a day 1/2 effervescent tablet 200 mg, or 2 times a day 1 effervescent tablet 200 mg tablet (300–400 mg acetylcysteine ​​per day).

Children aged 2 to 5 years: 2-3 times a day, 1 effervescent tablet 100 mg or 2-3 times a day 1/2 effervescent tablet 200 mg (200-300 mg acetylcysteine ​​per day).

Cystic fibrosis.

For patients with cystic fibrosis and a body weight of more than 30 kg, if necessary, the dose can be increased to 800 mg of acetylcysteine ​​per day.

Children aged 2 to 6 years - 1 effervescent tablet 100 mg 4 times a day or 1/2 effervescent tablet 200 mg 4 times a day (400 mg acetylcysteine ​​per day).

Effervescent tablets should be dissolved in one glass of water and taken after meals. The tablets should be taken immediately after dissolution; in exceptional cases, the ready-to-use solution can be left for 2 hours.

Additional fluid intake enhances the mucolytic effect of the drug. For short-term colds, the duration of use is 5–7 days. For chronic bronchitis and cystic fibrosis, the drug should be taken for a longer period of time to achieve a preventive effect against infections.

Instructions for patients with diabetes:

1 effervescent tablet 100 mg corresponds to 0.006 XE, 1 effervescent tablet 200 mg corresponds to 0.006 XE.

Overdose

In case of an erroneous or intentional overdose, phenomena such as diarrhea, vomiting, stomach pain, heartburn and nausea are observed. To date, no severe or life-threatening side effects have been observed.

Interactions with other drugs

With the simultaneous use of acetylcysteine ​​and antitussives, mucus stagnation may occur due to suppression of the cough reflex. Therefore, such combinations should be selected with caution.

The simultaneous use of acetylcysteine ​​and nitroglycerin can lead to an increase in the vasodilatory effect of the latter.

Pharmaceutically incompatible with antibiotics (penicillins, cephalosporins, erythromycin, tetracycline and amphotericin B) and proteolytic enzymes.

Upon contact with metals and rubber, sulfides with a characteristic odor are formed.

Reduces the absorption of penicillins, cephalosporins, tetracycline (they should be taken no earlier than 2 hours after ingestion of acetylcysteine).

Special instructions for use

For patients with bronchial asthma and obstructive bronchitis, acetylcysteine ​​should be prescribed with caution under systematic monitoring of bronchial patency.

When treating patients with diabetes, it is necessary to take into account that granules for preparing syrup contain sorbitol, and granules for preparing oral solution and effervescent tablets contain sucrose.

When working with the drug, you must use glass containers and avoid contact with metals, rubber, oxygen, and easily oxidized substances.

Storage conditions

In a dry place, at a temperature not exceeding 25 °C. Close the tube tightly after taking the tablet.

Best before date

ATX classification:

** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug ACC 200, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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ACC is a drug with a mucolytic effect, used for various respiratory diseases.

Release form and composition

ACC is available in the form of effervescent tablets, granules for oral solution and orange granules for syrup.

The tablets of the drug are round and flat, white. They have a blackberry scent. Tablets are sold in strips of 4 pieces and in aluminum or plastic tubes of 20 and 25 pieces. One paper or cardboard box contains 15 strips, 1, 2 or 4 tubes of tablets.

Granules for the preparation of a solution for oral use are homogeneous, white in color with an orange odor. Available in 3 g bags of combined material. One cardboard pack contains 20 or 50 bags of granules. Granules for making syrup may have a slightly yellow tint.

The active ingredient in all dosage forms of ACC is acetylcysteine. 1 tablet, a bag of granules and 5 ml of finished syrup contain 100 mg of the active ingredient. ACC 200 tablets containing 200 mg of acetylcysteine ​​are also available.

The excipients in the composition of the drug tablets are the following components:

• Citric acid anhydride;
• Ascorbic acid;
• Sodium bicarbonate;
• Lactose anhydride;
• Mannitol;
• Sodium citrate;
• Blackberry flavor B;
• Saccharin.

In ACC granules for preparing the solution, the auxiliary substances are:

• Saccharin;
• Sucrose;
• Ascorbic acid;

Granules for making syrup, in addition to the active substance, contain:

• Propyl parahydroxybenzoate;
• Methyl parahydroxybenzoate;
• Sodium citrate;
• Sorbitol;
• Dry orange flavoring.

Indications for use

According to the instructions, ACC in all dosage forms can be used in the treatment of respiratory diseases that are accompanied by the formation of difficult to separate sputum:

• Pneumonia;
• Obstructive bronchitis;
• Acute and chronic bronchitis;
• Bronchial asthma;
• Bronchiectasis;
• Bronchiolitis;
• Cystic fibrosis.

Indications for the use of ACC are also chronic and acute sinusitis and otitis media.

According to the instructions, ACC in the form of granules for preparing a solution is also used for laryngotracheitis, and in the form of granules for preparing syrup – for chronic obstructive pulmonary disease.

Contraindications

According to the instructions, ACC in all dosage forms is contraindicated in case of hypersensitivity to the components included in its composition, as well as during pregnancy and lactation.

Additional contraindications to the tablets are pulmonary bleeding, hemoptysis and peptic ulcer of the stomach and duodenum in the acute phase, and for granules for preparing the solution - age up to 2 years.

Directions for use and dosage

ACC tablets should be taken after meals, first dissolving them in half a glass of water. It is advisable to take it immediately after dissolution.

Granules for preparing the solution can be dissolved in juice, iced tea or water. The solution should be taken after meals.

To prepare the syrup, add room temperature water to the bottle with granules up to the mark.

The dosage of the drug depends on the patient’s age:

• Children under 2 years old - 2.5 ml of syrup 2-3 times a day under the supervision of a doctor;
• Children 2-6 years old - 1 tablet (ACC 100) or 1 sachet of granules for preparing a solution or 5 ml of syrup 4 times a day;
• Children over 6 years old and adults – 2 tablets (ACC 100) or 2 bags of granules for preparing a solution or 10 ml of syrup 2-3 times a day.

The maximum daily dose for adult patients is 600 mg of the active ingredient acetylcysteine. In cases of cystic fibrosis, it can be increased to 800 mg.

The duration of treatment for short-term colds usually does not exceed a week. For cystic fibrosis and chronic bronchitis, long-term therapy with the drug is required.

Side effects

The use of ACC in some cases can cause the following side effects:

• Headache;
• Noise in ears;
• Nausea and vomiting;
• Diarrhea;
• Heartburn;
• Stomatitis;
• Reduced blood pressure;
• Tachycardia.

In very rare cases, the use of ACC can cause allergic reactions in the form of bronchospasm, itching, urticaria and skin rash. The presence of hypersensitivity reactions when using the drug can lead to bleeding.

In case of an overdose of the drug, body reactions such as nausea and vomiting, heartburn, abdominal pain, and diarrhea are observed. In such cases, symptomatic therapy is necessary.

special instructions

Patients with obstructive bronchitis and bronchial asthma require regular monitoring of bronchial patency during treatment with ACC.

The drug should be used with caution in case of impaired liver and kidney function, diseases of the adrenal glands, varicose veins of the esophagus, as well as peptic ulcers of the stomach and duodenum in the acute phase.

The mucolytic effect of ACC increases with additional fluid intake.

The drug is incompatible with proteolytic enzymes and antibiotics (cephalosporins, tetracycline, penicillins, erythromycin and amphotericin B).

The remedy should not be combined with antitussive drugs, since the suppression of the cough reflex caused by the latter can lead to dangerous stagnation of mucus.

When preparing a solution and syrup using granules of the drug, you must use glass containers and avoid contact with easily oxidized substances, rubber and metals. Otherwise, sulfides with a specific odor are formed.

Analogs

Analogues of the drug in the form of tablets are ACC Long, Fluimucil and Acestine, and in the form of granules - Mukonex and Acetylcysteine-Sedico.

Terms and conditions of storage

ACC must be stored out of the reach of children, at a temperature not exceeding 25 °C.

The shelf life of tablets is 3, and granules – 4 years.