Instructions for taking ACC 200. Is it possible to drink ACC for a long time, and for how many days? Maintaining correct intake

ACC powder is used in the treatment of otitis media, acute and chronic sinusitis, as well as respiratory diseases complicated by the formation of difficult to separate sputum: pneumonia, bronchial asthma, acute, chronic, obstructive bronchitis, bronchiectasis, cystic fibrosis and inflammation of the bronchioles.

Directions for use, dosage and duration of treatment

"ACC" must be taken after meals, after dissolving the powder in a glass of hot water.
For mucolytic therapy aimed at thinning and facilitating the removal of mucus, the dose of “ACC” for children over 14 years of age is 200 mg 2 or 3 times a day. Children from 6 to 14 years old are prescribed 100 mg 3 times a day or 200 mg 2 times a day. The dose recommended by the instructions for "ACC" for children from 2 to 5 years is 100 mg 2 or 3 times a day.

When treating cystic fibrosis, children over 6 years of age are prescribed 200 mg of the drug 3 times a day. It is recommended to give 100 mg of ACC 4 times a day to children aged 2 to 5 years. If necessary, the daily dose of the drug can be increased to 800 mg, but only if the patient’s body weight is more than 30 kg. During treatment, it is recommended to drink as much liquid as possible (juice, tea, compotes and fruit drinks), as this will significantly enhance the therapeutic effect of “ACC”.

The duration of taking the drug for short-term use is 5–7 days. In the treatment of chronic bronchitis and cystic fibrosis, ACC is taken for a longer time to achieve a lasting preventive effect. For long-term illnesses, the duration of therapy is determined by the doctor individually.

Contraindications and side effects of "ACC"

Contraindications to “ACC” are individual intolerance to the components, pregnancy and breastfeeding, pulmonary hemorrhage and hemoptysis, as well as gastric ulcers that occur in the acute stage. The drug should be taken with caution for varicose veins of the esophagus, bronchial asthma, high risk of pulmonary hemorrhage, renal and liver failure.

Side effects of "ACC" can manifest themselves in the form of tinnitus, headache and stomatitis. In very rare cases, nausea, vomiting, heartburn, diarrhea, tachycardia and decreased blood pressure are possible. If you are hypersensitive to the drug, bleeding or an allergic reaction (urticaria, rash, itching, bronchospasm) may develop.

The most famous and frequently prescribed mucolytic drug today is acetylcysteine, which first appeared on pharmacies under the name ACC. This drug can be prescribed to patients of all ages, including children.

Instructions

When prescribing the drug ACC in any dosage form, it should be remembered that for normal coughing the child must drink a sufficient amount of liquid during the day (in the form of drinking water, warm tea, first courses).

ACC Children can be prescribed in the form of granulated powder, one sachet of which is designed for one dose (there are sachets containing 100 and 200 mg of the active substance in one package). In this case, you should pour the contents of one sachet (depending on the doctor’s recommendation) into a cup and add warm, but not boiling water there and stir. After checking the solution temperature ACC under supervision, the child should drink the entire prepared solution at one time.

It is also possible to assign ACC for in the form of syrup, for the preparation of which a special granulated powder is used. This is prepared by adding liquid to a bottle of granules - you should add drinking water up to the mark on the wall of the bottle and mix thoroughly. The finished syrup can be stored in the refrigerator for no more than 12 days. Syrup ACC contains in one measuring spoon (attached to the package for preparing syrup)

Quite often, doctors prescribe the drug “ACC” (“ACC”) for cough to their patients. Instructions for the use of this remedy, as well as its contraindications, indications and side effects will be presented in this article. In addition, we will tell you about the form in which the mentioned medicine is produced, what patients say about it, how much it costs, and so on.

Packaging of the drug, its release form, composition

Do you know in what form the medicine “ACC” (“ACC”) for cough is produced? The instructions for use inform us that this drug is produced in two different forms. Let's look at them in more detail:

Medicine "ACC" is a powder (granulated) intended for the preparation of a solution. This medicine should only be taken orally. One 3-gram packet of powder can contain 200, 100 or 600 mg of acetylcysteine. There are 10, 6 or 20 sachets in a cardboard pack.
The drug "ASS" - effervescent tablets. Aluminum or cardboard tubes can contain 20, 10, 100 or 50 pieces. One tablet contains 600, 200 or 100 mg of acetylcysteine. As for the auxiliary components, these include citric acid anhydride, ascorbic acid, mannitol, lactose anhydride, blackberry flavor and saccharin.

Pharmacological action of the drug

What is “ACC” (“ACC”) cough medicine? The instructions for use state that this is a mucolytic drug. Due to the fact that the structure of the acetylcysteine molecule contains sulfhydryl groups, this causes the rupture of disulfide bonds of mucopolysaccharides (acidic) of sputum. As a result of this effect, the patient's mucus viscosity noticeably decreases.

The drug in question has a mucolytic effect and also facilitates the discharge of sputum due to a direct effect on its rheological properties. This remedy retains its activity even in the presence of purulent mucus.

The ACC medicine, the instructions for which are presented below, is very often used for preventive purposes. In this case, there is a decrease in the severity and frequency of exacerbations in patients with cystic fibrosis and chronic bronchitis.

Pharmacokinetics of the drug

What pharmacokinetic properties does the drug "ACC" have? The instructions do not contain such information. This is due to the fact that pharmacokinetic studies of this medication have not been conducted.

Drug "ACC": indications

The drug in question is prescribed for the following deviations:

acute and chronic sinusitis;
diseases of the respiratory system, which are accompanied by the formation of difficult to separate and viscous sputum (for example, with bronchiectasis, acute and chronic bronchitis, cystic fibrosis, obstructive bronchitis, pneumonia, bronchial asthma and bronchiolitis);
otitis media.

Contraindications

In the presence of what abnormalities should the medicine "ACC" (powder and effervescent tablets) be prescribed under no circumstances? The following conditions are contraindications to the use of this drug:

It should also be noted that this medication is prescribed with extreme caution to patients with varicose veins of the esophagus, diseases of the adrenal glands, renal and/or liver failure.

Directions for use

How should you take ACC for cough? The instructions for use contain the following instructions in this regard. For adolescents and adults, it is prescribed 200 mg three times a day. Children from 6 to 14 years old should take the medicine 100 mg three times a day. For children from 2 to 5 years old, the medication is prescribed 1 tablet (100 mg) twice a day. For a disorder such as cystic fibrosis, a child over 6 years of age is given 2 tablets of the drug (100 mg each) three times a day. As for children from 2 to 6 years old, they should take the medication 100 mg four times a day.

For patients with cystic fibrosis weighing more than 30 kg, the dosage can be increased to 800 mg per day.

If it is short-term, the duration of therapy with the presented medication is 5-7 days. For cystic fibrosis and chronic bronchitis, the drug must be used for a longer time (to prevent infections).

How should I take ACC 200? The instructions state that this drug should be used only after meals (to avoid negative effects on the gastric mucosa). It should be especially noted that additional fluid intake enhances the mucolytic effect of the drug.

Before use, effervescent tablets must be dissolved in half a glass of plain water. The prepared solution should be used immediately. In exceptional cases, it can be left for 2 hours.

Overdose

In case of intentional or mistaken overdose of the drug, the patient experiences symptoms such as vomiting, stomach pain, diarrhea, heartburn and nausea. To date, no severe or life-threatening side effects have been observed.

Drug interactions

What happens if you take any medications and ACC at the same time? Reviews from experts say that combined treatment can cause a number of undesirable reactions. Let's look at them a little further.

With the simultaneous use of acetylcysteine and others, a stagnation of mucus that is dangerous to health may occur (due to suppression of the cough reflex).

During simultaneous use of nitroglycerin and acetylcysteine, there is a possibility of enhancing the vasodilating effect of the former.

There is a synergism of acetylcysteine with the simultaneous use of bronchodilators.

Acetylcysteine can reduce the absorption of penicillins, cephalosporins and tetracycline. In this regard, they must be taken orally 2 hours after taking the first one.

Acetylcysteine is not compatible with antibiotics such as Penicillin, Erythromycin, Cephalosporin, Tetracycline and Amphotericin, as well as proteolytic enzymes.

When acetylcysteine comes into contact with rubber and metal, sulfides are formed, which have a characteristic odor.

Special instructions

For bronchial asthma, the drug in question should be prescribed with extreme caution. This requires systematic monitoring of bronchial patency.

If, after taking the medication, the patient develops side effects, then it is necessary to stop taking the medication and immediately consult a doctor.

When treating patients with diabetes mellitus, it should be taken into account that 1 effervescent tablet corresponds to 0.006 XE.

To date, there is no information about the negative impact of the drug (in recommended dosages) on the ability to drive a car, as well as perform other activities that require special concentration.

Shelf life and storage methods

The drug in question must be stored only in a dry place inaccessible to small children. In this case, the air temperature should not be higher than 25 °C. The shelf life of the drug is three years. After this time, the use of the medication is prohibited.

After taking the effervescent tablet, the plastic or aluminum tube must be tightly closed.

Price and analogues of the drug

The price of the ACC tablet may vary depending on the pharmacy chain, as well as on the markup on the product. However, on average, such a medicine costs about 75-150 Russian rubles. The price of granular powder is similar to effervescent tablets.

What can replace the product in question? Pharmacy chains have a huge number of analogues of the drug, as well as drugs with a similar effect (expectorant, mucolytic). Among the most popular, I would like to highlight the following medications: “Acestine”, “Acetylcysteine”, “Vicks Active ExpectoMed”, “Mukobene”, “Mukomist”, “Mukonex”, “N-AC-Ratiopharm”, “Fluimucil”, “Exomyuk 200” , "Atsestad", "Lazolvan", "Ambrobene", "Ambroxol", "Mukosol", "Bronkatar", "Solvin", "Bromhexin", "Gedelix", "Mukaltin", "Prospan", "Stoptussin", " Askoril", "Linkas" and others.

Pharmacodynamics. Acetylcysteine (ACC) is a mucolytic, expectorant drug 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 the binding of its sulfhydryl groups to chemical radicals and, thus, their neutralization. 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 a number of cytotoxic substances. This feature of acetylcysteine makes it possible to effectively use the latter in case of an overdose of paracetamol.

Pharmacokinetics. After oral administration, acetylcysteine is quickly and completely absorbed and 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 is 50%. Acetylcysteine is excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine).

T ½ is determined mainly by rapid biotransformation in the liver - ≈1 hour. In case of decreased liver function, T ½ increases to 8 hours.

treatment of acute and chronic diseases of the bronchopulmonary system, which require reducing the viscosity of sputum, improving its discharge and expectoration.

adults and children over 14 years of age Prescribe 400-600 mg of acetylcysteine per day, divided into 1-3 doses.

Children aged 6-14 years Prescribe 400-600 mg/day, divided into 2-3 doses.

Children aged 2-6 years the drug is prescribed in a dosage of 100 mg, 200-400 mg/day, divided into 2-3 doses.

It is recommended to take the drug after meals. Dissolve the contents of the sachet in ½ glass of water, juice or iced tea. After preparing the solution, you should drink it quickly. In some cases, due to the presence of a stabilizer in the composition of the drug - ascorbic acid, the prepared solution can be left for about 2 hours before use. Additional fluid intake enhances the mucolytic effect of the drug.

The treatment period is determined by the doctor depending on the nature and course of the disease (acute or chronic). The drug should not be used for more than 4-5 days without consulting a doctor.

hypersensitivity to acetylcysteine or any of the components of the drug. Gastric and duodenal ulcers in the acute stage, hemoptysis, pulmonary hemorrhage, exacerbation of asthma.

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), единичные (≥1/10 000, <1/1000), очень редко (<1/10 000), частота неизвестна (полученные данные не дают возможности определить частоту).

From the immune system: uncommon - hypersensitivity; rarely - anaphylactic shock, anaphylactic/anaphylactoid reactions.

From the blood and lymphatic system: frequency unknown - anemia.

From the nervous system: infrequently - headache.

From the organ of hearing and labyrinth: infrequently - ringing in the ears.

From the cardiovascular system: infrequently - tachycardia, arterial hypotension; rarely - hemorrhages.

From the respiratory system: single - shortness of breath, bronchospasm (mainly in patients with hyperreactivity of the bronchial system associated with asthma); frequency unknown - rhinorrhea.

From the digestive tract: uncommon - vomiting, diarrhea, stomatitis, abdominal pain, nausea; rarely - dyspepsia; frequency unknown - bad breath.

For the skin and subcutaneous tissues: uncommon - urticaria, rash, Quincke's edema, itching; frequency unknown - rash, eczema, angioedema.

General violations: infrequently - hyperthermia; frequency unknown - facial swelling.

Isolated severe skin reactions (Stevens-Johnson and Lyell syndromes) have been reported very rarely. In most cases, at least one other drug may be more likely to cause mucocutaneous syndrome. Therefore, if any new changes appear on the skin or mucous membranes, you should consult a doctor and immediately stop using acetylcysteine.

Cases of decreased platelet aggregation have been reported, but the clinical significance of this has not been determined.

There are isolated reports of severe skin reactions (Stevens-Johnson and Lyell syndromes) when taking acetylcysteine, so if changes occur in the skin or mucous membranes, you should immediately stop using the drug and consult your doctor regarding further use.

It is recommended to take the drug with caution in patients with a history of gastric and duodenal ulcers, especially in the case of concomitant use of other drugs that irritate the gastric mucosa.

The drug should be used with caution in patients with asthma due to the possible development of bronchospasm. When pouring the contents of the sachet into a bowl during preparation of the solution, the powder may enter the air and irritate the nasal mucosa, as a result of which reflex bronchospasm may occur.

For patients with liver and kidney diseases, acetylcysteine should be prescribed with caution to avoid the accumulation of nitrogen-containing substances in the body.

The use of acetylcysteine, mainly at the beginning of treatment, can cause dilution of bronchial secretions and an increase in its volume. If the patient is unable to cough up sputum effectively, postural drainage and bronchoaspiration are necessary.

Acetylcysteine affects histamine metabolism, so long-term therapy should not be prescribed to patients with histamine intolerance, as this may lead to symptoms of intolerance (headache, vasomotor rhinitis, itching).

A slight sulfuric odor is not a sign of a change in the drug, but is specific to the active substance.

The drug contains sucrose, so it should not be prescribed to patients with rare hereditary forms of fructose intolerance, sucrase-isomaltase deficiency or glucose-galactose malabsorption syndrome.

One sachet of ACC ® 100 contains 2.8 g of sucrose (about 0.24 bread units), one sachet of ACC ® 200 contains 2.7 g of sucrose (approximately 0.23 bread units). This should be taken into account when using the drug in patients with diabetes.

Use during pregnancy and breastfeeding. Pregnancy. Clinical data on the use of acetylcysteine in pregnant women is limited. Animal studies have shown no direct or indirect adverse effects on pregnancy, embryofetal development, childbirth or postnatal development.

Breastfeeding. There is no information on penetration into breast milk.

The drug should be taken during pregnancy and breastfeeding only after a careful assessment of the benefit/risk ratio.

Children. 100 mg powder is used in children over 2 years of age, 200 mg powder is used in children over 6 years of age.

The ability to influence reaction speed when driving vehicles or working with other mechanisms. No effect.

interaction studies were conducted only with adults.

The use of antitussives together with acetylcysteine can increase sputum stagnation due to a decrease in the severity of the cough reflex.

Activated carbon reduces the effectiveness of acetylcysteine.

When used simultaneously with antibiotics such as tetracyclines (except doxycycline), ampicillin, amphotericin B, cephalosporins, aminoglycosides, they may interact with the thiol group of acetylcysteine, which leads to a decrease in the activity of both drugs. Therefore, the interval between taking these drugs should be at least 2 hours. This does not apply to cefixime and loracarbef.

With simultaneous administration of nitroglycerin and acetylcysteine, significant hypotension and dilatation of the temporal artery were detected. If it is necessary to use nitroglycerin and acetylcysteine simultaneously in patients, it is necessary to monitor hypotension, which can be severe, and they should be warned about the possibility of headache.

Acetylcysteine can be a cysteine donor and increase glutathione levels, which helps detoxify oxygen free radicals and certain toxic substances in the body.

Acetylcysteine reduces the hepatotoxic effect of paracetamol.

Upon contact with metals or rubber, sulfides with a characteristic odor are formed, so glassware should be used to dissolve the drug.

Effect on laboratory tests. Acetylcysteine may interfere with the colorimetric assay of salicylates and the determination of ketone bodies in urine.

there are no data on cases of overdose with oral administration of acetylcysteine.

Symptoms: An overdose may be manifested by gastrointestinal symptoms such as nausea, vomiting, diarrhea.

Treatment: There is no specific antidote for acetylcysteine poisoning; therapy is symptomatic.

at a temperature not exceeding 25 °C. Keep out of the reach of children.

ACC is a drug that has a mucolytic and expectorant effect, helping to remove viscous mucus from the respiratory tract. In addition, the medicine helps reduce the toxic effect of toxic substances on the body and has a mild anti-inflammatory effect. The main active ingredient of the drug is acetylcysteine.

In order for the medicine to provide maximum benefit during treatment and not have harmful effects, it should be taken correctly, guided by the instructions for the drug and the recommendations of the attending physician. Let's look at how to properly take the ACC drug in the form of powder and tablets (ACC 600 Long, ACC 200, ACC 100).

The drug, regardless of the form of release, is recommended to be taken after meals (preferably 1.5 - 2 hours after meals). As a rule, ACC for adult patients is prescribed in a dosage of 200 mg twice - three times a day or in an amount of 600 mg once a day.

The powder (granules) for preparing the solution must be dissolved in clean water, juice or cool tea immediately before use, mixing thoroughly.

The powder for preparing a hot medicinal drink should be dissolved in a glass of hot water and drunk until it cools down. If necessary, the prepared solution can be stored for no more than 3 hours before administration.

ACC effervescent tablets must be dissolved in half a glass of non-hot water and preferably taken immediately after dissolution. ACC and other medications should not be dissolved in the same container.

It is worth considering that additional fluid intake enhances the effect of the drug. But the simultaneous use of the following drugs can reduce effectiveness and lead to the development of adverse reactions:

activated carbon;
antitussives (possible stagnation of mucus due to relief of the cough reflex);
nitroglycerin (possibly enhancing the vasoconstrictor effect of nitroglycerin);
antibiotics (reduces the absorption of penicillins, tetracycline, cephalosporins, etc.).

How many days can you take ACC?

On average, the duration of therapy with ACC is from 5 to 7 days. In severe cases, with chronic pathologies of the respiratory system (bronchitis, tracheitis), the course of treatment can be extended, which is determined individually by the attending physician. Taking the drug for too long can lead to disruption of the natural processes of self-cleaning of the bronchi.

ACC 200 description and instructions

Posted September 22, 2014 6:22am MSK by admin Category . When coughing with sputum (wet, moist cough)

ACC 200 is one of the most popular drugs for the treatment of diseases accompanied by accumulation of sputum in the respiratory tract and an unproductive wet cough. For the convenience of patients, ACC can be taken in several forms:

powder (granules) for preparing a hot drink – 200 mg, 20 sachets;
effervescent tablets for oral administration – 200 mg, 20 pieces.

Mechanism of action and indications for use

ACC 200 is used to treat children and adults suffering from any inflammatory diseases of the respiratory tract, with sputum separation. The active component of the drug is an amino acid derivative: acetylcysteine in a dose of 200 mg, it has pronounced mucolytic and expectorant properties, that is, it makes sputum less viscous, increases its production and facilitates the removal of secretions from the respiratory system. By reducing the viscosity of sputum and increasing its secretion, the respiratory tract is cleared of accumulation of mucus, pus and microbes. Acetylcysteine is also able to activate the synthesis of glutathione, a natural antioxidant that protects cells from the damaging effects of free radicals and toxic substances; in particular, taking acetylcysteine helps neutralize the toxic effects of paracetamol in case of drug overdose.

It is recommended to take ACC in tablets or powders only as prescribed by a doctor and following the prescribed doses and method of administration - powder for oral administration or effervescent tablets. Acetylcysteine can interact with other medications, such as antibiotics, so before taking it you should carefully study the instructions for use in children and adults.

Main forms of release of ACC 200

ACC 200 for the treatment of colds in adults and children over 6 years of age is used in the form of powder (granules) to prepare an oral solution and effervescent tablets, which also need to be dissolved in a small amount of water.

Many patients do not understand the difference between these 2 forms of the drug and easily replace one form with another, without even thinking about the peculiarities of their pharmacokinetics and pharmacodynamics in the body.

ACC 200 – effervescent tablets

Effervescent tablets - a characteristic “hissing” sound that occurs when a tablet gets into water, occurs due to the interaction of organic carboxylic acids and sodium chloride, which are part of the shell, with water, which releases carbon dioxide, which forms “bubbles”. Thanks to this, all active substances in the tablet are released as quickly as possible. This ensures rapid entry of the active substance, acetylcysteine, into the blood, which means the therapeutic effect occurs quickly, but also lasts for quite a long time.

Effervescent tablets are effective for colds - sore throat, pharyngitis, bronchitis and other diseases in which the patient's condition does not suffer greatly, but long-term exposure is required. This form of ACC release has one big drawback - it produces acid in the digestive system and can cause exacerbation of gastritis, peptic ulcers and other diseases of the gastrointestinal tract.

Powder for preparing solution

Powder for preparing a solution is the fastest-acting and most effective form of the drug. Unlike tablets, syrups and other forms of release, the powder contains fewer inactive substances, it enters the stomach in dissolved form and is absorbed by the entire mucous membrane of the organ, which ensures almost instantaneous entry of the drug into the blood and a therapeutic effect that occurs within a few minutes . ACC 200 in powder form is indicated for severe diseases - obstructive bronchitis, pneumonia, bronchiolitis and for the treatment of children with non-productive severe cough. The powder is effective as an emergency remedy to alleviate the patient’s condition, but since the effect of the drug is much shorter, it is recommended to take it more often - as prescribed by a doctor - 3-4 times a day or, after stabilizing the condition, switch to other forms of the drug. Another feature of powder preparations is the occurrence of drowsiness after taking them.

Instructions for use

According to the instructions for use, ACC 200 is prescribed to children over 6 years of age at a dose of up to 400 mg per day, children over 14 years of age and adults 1 tablet or 1 powder 3 times a day. The course of treatment depends on the severity of the disease and can range from 5–7 days for common colds, to several months for the treatment of chronic infections.

Method of preparing a solution for oral administration:

Method for preparing a solution for drinking: 1 sachet of ACC 200 is poured into 1 glass of warm water, stirred until the powder ingredients are completely dissolved and offered to the patient.

The liquid for dissolving the powder or granules should be warm, but not hot; in addition to water, you can use tea, compote or juice. For children under 14 years of age, the powder can be dissolved in half a glass of water.

Directions for use of effervescent tablets

Method of using effervescent tablets - a 200 mg tablet is dissolved in 200 ml of non-hot water, then, depending on the age of the patient, give him 1/2 cup - when prescribed 100 mg at a time or 1 glass at a time. Unlike other forms of ACC, effervescent tablets are taken strictly after meals, as they can damage the gastrointestinal mucosa.

ACC 200 is recommended for the treatment of colds and inflammatory diseases of the respiratory system, as part of complex therapy; it is not used for dry cough or complete absence of sputum and is not recommended as monotherapy. Only a doctor can prescribe the optimal combination of medications, so it is recommended to take ACC only after consulting your doctor. Before use, carefully study the instructions; there are contraindications and restrictions for use.

ACC powder instructions for use

The drug ACC is a drug that has a mucolytic effect and is intended for the treatment of a variety of diseases of the respiratory system. Available in granular form. The granules are intended for further dissolution in water and drinking.

Release form and composition

The active ingredient is acetylcysteine. The granules have a homogeneous consistency without lumps with an orange aroma. Each packet of granules contains 200 or 100 mg of acetylcysteine. In addition to the active substance, auxiliary components have been added to the composition: saccharin, ascorbic acid, sucrose and orange flavoring. A cardboard package may contain 50 or 20 disposable sachets, each of which is made of three-layer material. The package contains detailed instructions.

Indications for use

ACC should be used for the following painful conditions:

formation of difficult to separate sputum of viscous consistency;
obstructive bronchitis;
bronchiectasis;
laryngotracheitis;
bronchial asthma;
cystic fibrosis;
pneumonia;
in the treatment of chronic and acute sinusitis;
bronchiolitis;
otitis media;
other diseases of the respiratory system.

Contraindications

The ban on taking the ACC drug applies to nursing and pregnant women, children under two years of age, and patients with hypersensitivity to any component of this drug. Increased caution is required when prescribing ACC to people with varicose veins in the esophagus, hemoptysis, bronchial asthma (due to a possible complication in the form of bronchospasm), failure of the kidneys or adrenal glands, liver, or peptic ulcer. In pregnant women, taking ACC is possible only in extreme cases, when the benefit outweighs the likelihood of developing undesirable consequences.

Directions for use and dosage

ACC in adolescents, starting from the age of 14 years and in adults, is used according to the scheme. In the treatment of diseases of the respiratory system, you should take 1 packet containing acetylcysteine 200 mg or 2 packets with 100 mg of the drug 3 times over 24 hours. The total dose of acetylcysteine ranges from 400 to 600 mg per day. It is divided into several doses after consultation with a doctor.

Children from 6 to 14 years of age should consume 300–400 mg of the drug per day. The dose is divided into 3 or 2 times at approximately equal intervals.

Children from 2 to 5 years old are prescribed ACC at a dose of 100 mg twice a day.

A different treatment regimen is performed in the treatment of cystic fibrosis. From the age of six, three doses of 200 mg are required. Children 2–5 years old should take 100 mg of the drug four times in 24 hours. Sometimes it is necessary to increase the daily dose to 800 mg in patients who weigh more than 30 kg.

Diseases that last a short time require treatment with ACC for about 6 to 7 days. In the case of treatment of cystic fibrosis or chronic problems with the respiratory system, a long course is required, selected by the doctor strictly individually.

How to dilute ACC powder?

The drug ACC is prescribed strictly after meals. The granules in the bag must be dissolved in a cool liquid (tea, water, juice). Parallel intake of liquids significantly increases the activity of acetylcysteine.

Side effects

During therapy, the following unpleasant complications may occur:

headache;
tinnitus;
the appearance of inflammatory elements in the oral cavity;
nausea or heartburn;
stool disorder;
tachycardia;
decreased blood pressure;
Isolated complaints of allergic complications were recorded. The most common occurrence is bronchospasm, which is usually recorded in patients with increased bronchial reactivity. Possible itching or rash;
development of bleeding (extremely rare).

Special instructions

Patients with diabetes mellitus should take into account the fact that a packet of ACC with a dosage of 200 mg corresponds to 0.23 VE, and with a dosage of 100 mg - 0.24 VE. The granules contain sucrose. When feeding and lactation, ACC is prescribed under strict medical supervision in extreme cases.

It is prohibited to use ACC with substances that have an antitussive effect. Possible stagnation of mucus in the bronchi. You need to know that nitroglycerin taken simultaneously with acetylcysteine will enhance its vasodilating effect. ACC is incompatible with drugs related to antibiotics. This is especially true for cephalosporins, penicillins, erythromycin, amphotericin B and tetracycline. It is also impossible to take ACC with proteolytic enzymes. ACC granules dissolve only in glass containers. Do not use metal utensils. In the presence of bronchial asthma or obstructive bronchitis, acetylcysteine is prescribed with periodic monitoring of bronchial patency.

Analogues of ACC

Preparations containing acetylcysteine: Acestad tablets and granules, Acestal S, ACC hot drink, ACC tablets, Fluimucil and many others.

Drugs with a similar therapeutic effect include Ambroxol, Sudafred, Fluifort, Lazolvan, Bromhexine.

Terms and conditions of storage

ACC can be stored in rooms with a room temperature of about 25 degrees. The shelf life in original packaging is 4 years. The drug should be hidden from children. Dispensing from pharmacies is permitted without a prescription.

ACC powder price

ACC granules for the preparation of oral solution 100 mg, 20 pcs. -from 113 rub.

ACC granules for the preparation of oral solution 200 mg, 20 pcs. -from 121 rub.

Release form: Solid dosage forms. Pills.

General characteristics. Compound:

Granules for making syrup (orange) 5 ml of finished syrup
active substance:
acetylcysteine 100 mg
excipients: methyl parahydroxybenzoate; propyl parahydroxybenzoate; sorbitol; sodium citrate; orange flavor
ACC® 100

Effervescent tablets 1 table.
active substance:
acetylcysteine 100 mg
ACC® 200

Effervescent tablets 1 table.
active substance:
acetylcysteine 200 mg
excipients: ascorbic acid; citric acid anhydride; lactose anhydride; mannitol; sodium citrate; sodium bicarbonate; saccharin; blackberry flavoring
ACC®

Granules for preparing a solution for oral administration (orange) 1 pack. (3 g)
active substance:
acetylcysteine 100 mg
200 mg
excipients: sucrose; ascorbic acid; saccharin; orange flavor
Granules for preparing a solution for oral administration 1 pack. (3 g)
active substance:
acetylcysteine 200 mg
600 mg
excipients: ascorbic acid; sucrose; saccharin; honey and lemon flavors
ACC® Long

Effervescent tablets 1 table.
active substance:
acetylcysteine 600 mg
excipients: citric acid - 625 mg; sodium bicarbonate - 327 mg; sodium carbonate - 104 mg; mannitol - 72.8 mg; lactose - 70 mg; ascorbic acid - 75 mg; sodium cyclamate - 30.75 mg; sodium saccharinate dihydrate - 5 mg; sodium citrate dihydrate - 0.45 mg; blackberry flavor “B” – 40 mg
Description of the dosage form
Granules for making syrup (orange): homogeneous granules, white to yellowish in color, without agglomerated particles, with an orange aroma.

Granules for the preparation of a solution for oral administration (orange): homogeneous granules, white, without agglomerated particles, with the smell of orange.

Granules for the preparation of a solution for oral administration: white homogeneous granules, no more than 1.5 mm in size, without agglomerates and mechanical impurities, with the smell of lemon and honey.

Effervescent tablets, 100 mg, 200 mg: white, round, flat tablets, scored (200 mg), with blackberry flavor.

Effervescent tablets, 600 mg: white, round tablets, beveled, scored on one side, with a smooth surface, with a blackberry flavor. Appearance of the solution: when dissolving 1 table. in 100 ml of water you get a colorless transparent solution with the smell of blackberries.

Pharmacological properties:

Acetylcysteine (ACC) is a mucolytic expectorant that is used to thin out sputum in diseases of the respiratory system accompanied by the formation of thick mucus. Acetylcysteine is a derivative of the amino acid cysteine. ACC acts secretolytically and increases motility of the respiratory tract. The mucolytic effect of the drug is of a chemical nature. Due to the presence of a free sulfhydryl group, acetylcysteine breaks the disulfide bonds of acidic mucopolysaccharides, which leads to depolymerization of sputum mucoproteins. As a result, the viscosity of sputum decreases. The drug ACC is also active against purulent sputum.
The ACC drug also has antioxidant pneumoprotective properties, which are due to the binding of chemical radicals by its sulfhydryl groups and, thus, their neutralization. In addition, ACC helps increase the synthesis of glutathione, an important factor in intracellular protection not only from toxins of exogenous and endogenous origin, but also from a number of cytotoxic substances. This feature of ACC makes it possible to effectively use it in acute poisoning with paracetamol and other toxic substances (aldehydes, phenols).
After oral administration, acetylcysteine is quickly and completely absorbed and metabolized in the liver to form cysteine, a pharmacologically active metabolite, as well as diacetylcysteine, cystine, and subsequently mixed disulfides. Bioavailability is very low - about 10%. Cmax in blood plasma is achieved 1-3 hours after administration. Binding to blood plasma proteins is about 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 use:

Acute and chronic diseases of the bronchopulmonary system, accompanied by increased production of sputum with worsening expectoration.

Important! Get to know the treatment

Directions for use and dosage:

Adults and children over 14 years of age: 400-600 mg of acetylcysteine per day (divided into 1-3 doses).
Children aged 6-14 years: 400-600 mg of acetylcysteine per day (divided into 2-3 doses).
Children aged 2-6 years: 200-400 mg of acetylcysteine per day (divided into 2 doses).
It is recommended to take the drug after meals. The effervescent tablet/sachet contents are dissolved in ½ glass of water, juice or iced tea. To enhance the mucolytic effect of ACC, additional fluid intake is recommended.
The duration of treatment for chronic diseases is determined by the doctor depending on the nature or course of the disease. For acute uncomplicated diseases, acetylcysteine is used for 5-7 days.

Features of application:

Acetylcysteine should be used with caution in patients with a history of gastric and duodenal ulcers, especially in the case of concomitant use of other medications that irritate the gastric mucosa. Isolated severe skin reactions (Stevens-Johnson syndrome and Lyell's syndrome) have been reported. Therefore, if changes occur in the skin or mucous membranes, you should immediately stop using the drug and consult your doctor regarding subsequent use of the drug. Acetylcysteine should be used with caution in patients with asthma due to the possible development of bronchospasm. When pouring the contents of the sachet into a bowl during preparation of the solution, the powder may enter the air and irritate the nasal mucosa, as a result of which reflex bronchospasm may occur. For patients with liver and kidney diseases, acetylcysteine should be prescribed with caution to avoid the accumulation of nitrogen-containing substances in the body. The use of acetylcysteine causes dilution of bronchial secretions. If the patient is unable to cough up sputum effectively, postural drainage and bronchoaspiration are necessary. Acetylcysteine affects histamine metabolism, so long-term therapy should not be prescribed to patients with histamine intolerance, as this may lead to symptoms of intolerance (headache, vasomotor rhinitis, itching).
Effervescent tablets contain sodium compounds. This should be taken into account by patients on a low-sodium, salt-free diet. Powder for oral solution contains sucrose and should not be administered to patients with rare hereditary forms of fructose intolerance, α-isomaltase deficiency or glucose-galactose malabsorption syndrome.
One sachet of ACC 100 contains 2.8 g of sucrose (about 0.24 bread units - XE); one sachet of ACC 200 contains 2.7 g of sucrose (about 0.23 XE). This should be taken into account when using the drug in patients with diabetes.
Use during pregnancy and breastfeeding. Today there are not enough observations regarding the use of the drug during pregnancy and lactation, so the drug during this period can be prescribed only when the expected benefit to the mother outweighs the potential risk to the fetus or child.
Children. Used in children over 2 years of age.
The ability to influence reaction speed when driving vehicles and working with other mechanisms. No effect.

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.
On the part of the hearing organ: infrequently - ringing in the ears.
General disorders: infrequently - fever.
From the respiratory system: rarely - dyspnea, bronchospasm (mainly in patients with hyperreactivity of the bronchial system, which is associated with asthma), rhinorrhea.
From the gastrointestinal tract: infrequently - heartburn, dyspepsia, stomatitis, abdominal pain, nausea, vomiting, diarrhea.
Isolated severe skin reactions (Stevens-Johnson syndrome and Lyell's syndrome) have been reported. When using acetylcysteine, bleeding was very rarely reported, which was most often associated with the development of hypersensitivity reactions. Many studies have noted inhibition of platelet aggregation, but there is no clinical confirmation of this. Very rarely, cases of angioedema, facial edema, anemia, hemorrhage, anaphylactic reactions or even shock have been reported.

Interaction with other drugs:

The simultaneous use of acetylcysteine with antitussives may increase sputum stagnation due to inhibition of the cough reflex.
When used simultaneously with antibiotics such as tetracycline (except for doxycycline), ampicillin, amphotericin B, cephalosporins, aminoglycosides, they may interact with the thiol group of acetylcysteine, which leads to a decrease in the activity of both drugs. Therefore, the interval between the use of these drugs should be at least 2 hours. This does not apply to cefixime and loracarbef. Activated carbon reduces the effectiveness of acetylcysteine. It is not recommended to dissolve acetylcysteine with other drugs in the same glass. Acetylcysteine reduces the severity of the hepatotoxic effect of paracetamol.
There is a synergism between acetylcysteine and bronchodilators.
Acetylcysteine can be a cysteine donor and increase glutathione levels, which helps detoxify oxygen free radicals and certain toxic substances in the body. The simultaneous use of nitroglycerin and acetylcysteine can lead to an increase in the vasodilatory effect of nitroglycerin.
During contact with metals or rubber, sulfides with a characteristic odor are formed, so glassware should be used to dissolve the drug.

Contraindications:

Hypersensitivity to acetylcysteine or other components of the drug. Gastric ulcer and duodenum in the acute stage, hemoptysis, pulmonary hemorrhage.

Overdose:

So far, no cases of severe or life-threatening side effects have been identified, even with extreme overdose.
Symptoms: nausea, vomiting, diarrhea.
Treatment: symptomatic.

Storage conditions:

In a dry place, at a temperature not exceeding 25 °C. Close the tube tightly after taking the tablet. Keep out of the reach of children. The shelf life of the drug ACC® 200 is 3 years.

Vacation conditions:

Over the counter

Package:

Granules for making syrup (orange) 100 mg/5 ml. 30 or 60 g of granules in a dark glass bottle. 1 fl. with a measuring spoon in a cardboard box. The bottle has a circular mark and is sealed with a plastic screw cap with a first-opening control ring and a sealing gasket inside. On the top surface of the cap there is a diagram for opening the bottle.

Effervescent tablets, 100 mg, 200 mg. 20 or 25 tablets each. in an aluminum or plastic tube. 1 tube of 20 tablets. or 2 or 4 tubes of 25 tablets. in a cardboard box. 4 tablets each in strips made of 3-layer material: paper/PE/aluminium. 15 strips in a cardboard box.

Orange granules for solution for oral administration, 100 mg, 200 mg. 3 g of granulate in bags made of 3-layer material (aluminium/paper/polythene). 20 or 50 packs. in a cardboard box.

Granules for solution for oral administration, 200 mg, 600 mg. 6, 10 or 20 packs. in cardboard packaging.

Effervescent tablets, 600 mg. 6, 10 or 20 tablets each. in polypropylene tubes. 1 tube in a cardboard box.