Instructions for use ACC 200 powder. Indications for use

The drug is in powder form for the preparation of a solution for oral use. ACC 200- mucolytic agent.
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.

Indications for use

ACC 200 recommended for 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).

Mode of application

In the absence of other prescriptions, it is recommended to adhere to the following dosages ACC 200:
Mucolytic therapy:
Adults and adolescents over 14 years of age are recommended to take 1 sachet of ACC 200 mg 2 - 3 times a day (400 - 600 mg per day).
Children aged 6 to 14 years are recommended to take ACC 200 mg 3 times a day, ½ sachet or 2 times a day, 1 sachet (300 - 400 mg per day).
Children aged 2 to 5 years are recommended to take ½ sachet of ACC 200 mg 2 - 3 times a day (200 - 300 mg per day).
Cystic fibrosis:
Children over 6 years of age are recommended to take 1 sachet of ACC 200 mg (600 mg per day) 3 times a day. Children aged 2 to 5 years are recommended to take ½ sachet of ACC 200 mg 4 times a day (400 mg per day). 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. The granules should be dissolved in water, juice or iced tea and taken after meals.

Side effects

In rare cases, headaches, inflammation of the oral mucosa (stomatitis) and tinnitus are observed.
Extremely rare - diarrhea, vomiting, heartburn and nausea, drop in blood pressure, increase in 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.

Contraindications

Contraindications to the use of the drug ACC 200 are: hypersensitivity to acetylcysteine or other components of the drug, pregnancy, breastfeeding, children under 2 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.

Pregnancy

:
For safety reasons, due to insufficient data, the prescription of the drug ACC 200 during pregnancy and lactation is possible only if the expected benefit to the mother outweighs the potential risk to the fetus or infant.

Interaction 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).

Overdose

In case of mistaken or intentional overdose ACC 200 phenomena such as diarrhea, vomiting, stomach pain, heartburn and nausea are observed.
To date, no severe or life-threatening side effects have been observed.

Storage conditions

At a temperature not higher than 25°C. Keep out of the reach of children.

Release form

3 g of granulate in bags made of three-layer material (aluminium-paper-polythene).
20 or 50 sachets in a cardboard box.

Compound

1 bag of granules weighing 3 g ACC 200 for the preparation of a solution for oral administration contains: 200 mg of acetylcysteine.
Excipients: sucrose, ascorbic acid, saccharin, orange flavor.

Additionally

Instructions for patients with diabetes.
1 sachet ACC 200 mg corresponds to 0.23 BE.
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 the drug contains sucrose.
When working with the drug, you must use glass containers and avoid contact with metals, rubber, oxygen, and easily oxidized substances.

Main settings

Name:	ACC 200
ATX code:	R05CB01 -

Registration number: P N015474/01

Trade name of the drug: ACC®

International nonproprietary name: acetylcysteine.

Dosage form: granules for the preparation of solution for oral administration (orange).

Compound:

1 sachet contains:

active substance: acetylcysteine - 100.0/200.0 mg;
Excipients: sucrose at 2829.5/2717.0 mg; ascorbic acid -12.5/25.0 mg; saccharin - 8.0/8.0 mg; orange flavoring - 50.0/50.0 mg.

Description: homogeneous white granules without agglomerates with an orange smell.

Pharmacotherapeutic group: mucolytic agent.

ATX code: R05CB01.

Pharmacological properties

Pharmacodynamics

Acetylcysteine is a derivative of the amino acid cysteine. It has a mucolytic effect, facilitates the discharge of sputum due to a direct effect on the rheological properties of sputum. The action is due to the ability to break the disulfide bonds of mucopolysaccharide chains and cause depolymerization of sputum mucoproteins, which leads to a decrease in sputum viscosity. The drug remains active in the presence of purulent sputum.

It has an antioxidant effect based on the ability of its reactive sulfhydryl groups (SH groups) to bind to oxidative radicals and thus neutralize them. In addition, acetylcysteine promotes the synthesis of glutathione, an important component of the antioxidant system and chemical detoxification of the body. The antioxidant effect of acetylcysteine increases the protection of cells from the damaging effects of free radical oxidation, which is characteristic of an intense inflammatory reaction.

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

Pharmacokinetics

Absorption is high. Rapidly metabolized in the liver to form a pharmacologically active metabolite - cysteine, as well as diacetylcysteine; cystine and mixed disulfides. Bioavailability after oral administration is 10% (due to the presence of a pronounced “first pass” effect through the liver). The time to reach the maximum concentration (Cmax) in the blood plasma is 1-3 hours. The connection with blood plasma proteins is 50%. It is excreted primarily by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine). The half-life (T1/2) is about 1 hour, impaired liver function leads to an extension of T1/2 to 8 hours. Penetrates the placental barrier. There are no data on the ability of acetylcysteine to penetrate the blood-brain barrier and be excreted in breast milk.

Indications for use

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

acute and obstructive bronchitis;
, laryngotracheitis;
, lung abscess;
bronchiectasis;
bronchial asthma;
(COPD);
bronchiolitis, cystic fibrosis.

Acute and chronic sinusitis, inflammation of the middle ear (otitis media).

Contraindications

hypersensitivity to acetylcysteine or other components of the drug;
peptic ulcer of the stomach and duodenum in the acute stage;
hemoptysis, pulmonary hemorrhage;
sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose deficiency;
pregnancy;
breastfeeding period;
children under 2 years of age (for this dosage form).

Carefully:

a history of gastric and duodenal ulcers, arterial hypertension, bronchial asthma, obstructive bronchitis, and/or histamine intolerance (long-term use of the drug should be avoided, since acetylcysteine affects the metabolism of histamine and can lead to signs of intolerance, such as headache, vasomotor rhinitis, itching), varicose veins of the esophagus, diseases of the adrenal glands.

Use during pregnancy and breastfeeding

Data on the use of acetylcysteine during pregnancy and breastfeeding are limited, therefore the use of the drug during pregnancy is contraindicated. If it is necessary to use the drug during breastfeeding, the issue of stopping it should be decided.

Mode of application

The granules should be dissolved in water, juice or iced tea and taken after meals. Additional fluid intake enhances the mucolytic effect of the drug.

For short-term colds, the course duration is 5-7 days. For long-term illnesses, the course of therapy is determined by the attending physician. For chronic bronchitis, the drug should be taken for a longer period of time to achieve a preventive effect against infections. In the absence of other prescriptions, it is recommended to adhere to the following dosages:

Mucolytic therapy:

adults and adolescents over 14 years of age: 2 sachets of ACC® 100 mg or 1 sachet of ACC® 200 mg 2-3 times a day (400-600 mg per day);
children from 6 to 14 years old: 1 sachet 3 times a day or 2 sachets 2 times a day ACC® 100 mg (300-400 mg per day). ACC® 200 mg should be taken 3 times a day, 1/2 sachet or 2 times a day, 1 sachet (300-400 mg per day);
children from 2 to 6 years: 1 sachet of ACC® 100 mg or 1/2 sachet of ACC® 200 mg 2-3 times a day (200-300 mg per day).

Cystic fibrosis:

children over 6 years old: 2 sachets of ACC® 100 mg or 1 sachet of ACC® 200 mg 3 times a day (600 mg per day);
children from 2 to 6 years: 1 sachet of ACC® 100 mg or 1/2 sachet of ACC® 200 mg 4 times a day (400 mg per day);
patients weighing > 30 kg: if necessary, the dose can be increased to 800 mg.

Side effect

According to the World Health Organization (WHO), adverse effects are classified according to their frequency as follows: very often (> 1/10), often (> 1/100,<1/10), нечасто (>1/1000, <1/100), редко (>1/10000, <1/1000) и очень редко (<1/10000); частота неизвестна (частоту возникновения явлений нельзя определить на основании имеющихся данных).

Allergic reactions:

uncommon: skin itching, rash, exanthema, angioedema, decreased blood pressure, tachycardia;

very rare: anaphylactic reactions up to anaphylactic shock, Stevens-Johnson syndrome,

toxic epidermal necrolysis (Lyell's syndrome).

From the respiratory system:

rarely: bronchospasm (mainly in patients with bronchial hyperreactivity in bronchial asthma).

From the gastrointestinal tract:

uncommon: stomatitis, abdominal pain, nausea, vomiting, diarrhea, heartburn, dyspepsia.

From the senses:

uncommon: tinnitus.

Others:

very rarely: headache, fever, isolated reports of bleeding due to a hypersensitivity reaction, decreased platelet aggregation.

Overdose

Acetylcysteine when taken in doses of 500 mg/kg/day does not cause signs and symptoms of overdose. In case of an erroneous or intentional overdose, phenomena such as diarrhea, vomiting, stomach pain, heartburn and nausea are observed.

Treatment: symptomatic.

Interaction with other drugs

With the simultaneous use of acetylcysteine and due to suppression of the cough reflex, sputum stagnation may occur.

When used simultaneously with oral antibiotics (penicillins, tetracyclines, cephalosporins, etc.), they may interact with the thiol group of acetylcysteine, which can lead to a decrease in their antibacterial activity. Therefore, the interval between taking antibiotics and acetylcysteine should be at least 2 hours (except for cefixime and loracarbef):

Concomitant use with vasodilating agents and nitroglycerin may lead to increased vasodilatory effects.

special instructions

When treating patients with diabetes, it is necessary to take into account that the drug contains sucrose.

Instructions for patients with diabetes mellitus:

1 sachet of ACC® 100 mg corresponds to 0.24 XE.
1 sachet of ACC® 200 mg corresponds to 0.23 XE.

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

Cases of severe allergic reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome) have been very rarely reported with the use of acetylcysteine.

If changes occur in the skin and mucous membranes, you should immediately consult a doctor and stop taking the drug.

You should not take the drug immediately before bedtime (it is recommended to take the drug before 18.00).

Impact on the ability to drive vehicles and machinery

There is no data on the negative impact of the drug ACC® in recommended doses on the ability to drive vehicles and perform other activities that require concentration and speed of psychomotor reactions.

Special precautions when disposing of unused medicinal product There is no need for special precautions when destroying unused ACC® drug.

Release form

3 g of granules per bag made of a combined material (aluminum foil/paper/polyethylene). 20 and 50 sachets per cardboard box along with instructions for use.

Storage conditions

At a temperature not higher than 25 °C.

Keep out of the reach of children.

Best before date

Do not use after expiration date.

Vacation conditions

Over the counter.

Manufacturer

Sandoz d.d., Verovshkova 57, 1000 Ljubljana, Slovenia; Manufactured by: Lindopharm GmbH, Neustrasse 82, 40721 Hilden, Germany. Consumer complaints should be directed to Sandoz CJSC.

Instructions for use of the drug ACC 200 describe in detail its pharmacological action, dynamics, interaction with other drugs, the required dosage according to the release form and age conditions, as well as possible contraindications and side effects.

Despite the fact that the medicine can be purchased without a prescription from your doctor, it is strongly recommended to undergo consultation and examination with a specialist to prescribe complete and objective treatment. In case of self-medication, a serious complication and worsening of the pulmonary infection may develop.

ACC 200 thins viscous mucus in the bronchi and upper respiratory tract, which is formed during a number of colds and viral diseases. It promotes its rapid removal from the respiratory system through intense coughing and expectoration. Acetylcysteine is sold by prescription from doctors for the following diagnoses:

obstructive or chronic bronchitis;
inflammation and fluid accumulation in the trachea;
bronchiolitis;
asthmatic bronchitis;
poor sputum production during ARVI - cystic fibrosis;
bronchiectasis;
upper respiratory tract diseases – sinusitis, laryngitis;
inflammation of the auditory organ – exudative otitis media of the middle ear;
COPD;
pneumonia;
lung abscess of various etymologies.

Release forms

ACC is a medicine that is used in the treatment of different age groups. For ease of use, there are several forms of release of the drug:

Effervescent tablets

volume 20 tablets, according to the composition of the active substance ACC 100 and ACC 200;
volume 10 pcs, tube packaging, active ingredient 600 mg – ACC-long.

Powder

ACC hot drink. Sold in packaged form: 20 pcs. – 200 mg and 6 pcs. – 600 mg.
ACC powder. Dosage is similar to standard 100 mg and 200 mg effervescent tablets; package contains 2 pcs.
ACC for children. The powder is enclosed in a 75 ml bottle with a dry dose of 30 g of powder and in a 150 ml bottle with the same amount of substance.

Instructions for use

ACC 200 is prescribed not only for the above established diagnoses, its use is also possible at temperatures caused by inflammatory processes in the body. The drug is strong and positive dynamics are observed already in the first hours of use.

The composition of the drug does not include many components: the main substance is acetylcysteine and several auxiliary components, depending on the form of release.

Effervescent tablets contain, along with acetylcysteine, ascorbic acid, sucrose, citrus flavoring, and saccharin.

Along with the main substance, the powder contains only sucrose.

The ACC Long release form has a large number of complementary components - this must be understood when treating people with health weakened by chronic diseases. ACC Long tablets contain citric and ascorbic acids, sodium in the form of citrate, carbonate, bicarbonate and cyclamate, saccharin, lactose, mannitol, and flavoring.

Children's ACC consists exclusively of the main substance - acetylcysteine.

The abstract contains information on the pharmacological action of the drug. The mucolytic effect is achieved by breaking the bisulfite binders of sputum mucopolysaccharides. This results in a noticeable thinning of the viscosity and the possibility of easier drainage of the liquid.

ACC has excellent absorption and immediately passes from the stomach through the channels to its destination. The maximum concentration of 2 µmol/l is achieved after 1-4 hours, depending on the susceptibility of the body.

Inactive metabolites are excreted in the urine; some amounts may be found in feces. The half-life depends directly on the functioning of the liver and can vary from 1 hour to 8 hours. It should be understood that acetylcysteine passes the placenta barrier and accumulates in the amniotic fluid.

Contraindications

There are several conditions of the body in which the use of ACC 200 is contraindicated:

individual intolerance and hypersensitivity to the active substance;
peptic ulcer;
intolerance to fructose and its derivatives;
internal bleeding in the lungs;
hemoptysis;
in childhood with hepatitis;
renal failure, due to the possible accumulation of nitrogen-containing components.

Also, ACC 200 is not compatible with some medications, as it may negatively affect their action:

tetracycline and derivatives based on it are not applicable in childhood;
antitussives;
nitroglycerine;
semisynthetic penicillin;
aminoglycoside antibiotics;
cephalosporin antibiotics;
interactions with erythromycin, amoxicillin, cefuroxime have not been sufficiently studied and give grounds for the recommendation to maintain a two-hour interval between the antibiotic and ACC.

During pregnancy and the lactation period, the drug is used only under the strict supervision of a doctor and if the threat to the mother exceeds the threat to the life of the child. During breastfeeding, you should stop breastfeeding during treatment.

Dosage

The dosage is prescribed exclusively by the attending physician and is individual; below are the average recommendations for the daily dose.

Treatment of cystic fibrosis is long-term – from 3 months to six months, with a course of treatment.

Body weight more than 30 kg – daily dose 800 mg;
Infants from the 10th day to 2 years - 50 mg 2-3 times a day;
Children 2-5 years old - daily dose of 400 mg, divided into 4 doses;
From 6 years – daily dose 600 mg.

For other types of diseases, the drug is prescribed for 5-7 days.

Children over 14 years of age and adults – daily dose 400-600 mg;
Infants from the 10th day to 2 years – 50 mg 2-3 times;
Children 2-5 years old - a daily dose of 200-300 mg is divided into 2 doses;
Children 6-14 years old - daily dose 300-400 mg, also in 2 divided doses.

ACC 200 should be dissolved in ½ glass of water, iced tea or juice and drunk after meals.

Side effects

If side effects are detected, you should consult a doctor to adjust the dosage or replace the drug with other cheap analogues of ACC 200.

Gastrointestinal tract: stomatitis, vomiting and nausea, severe loosening of stools, heartburn.

Central nervous system: noise effect in the ears, headaches.

Cardiovascular system: increased pressure, tachycardia.

Allergic reactions: bronchospasm, skin rashes, itching.

It is also possible to enhance the effect of combined use of expectorants. As a result, sputum stagnation occurs and the patient’s condition worsens.

Price

The cost of ACC 200 varies at different pharmacies, depending on several parameters:

release form;
quantity of the drug in the package;
pricing policy of pharmaceutical departments;
region of sale;
country of origin.

Taken together, these factors give a fairly wide range of prices for the drug from 111 rubles. up to almost 400 rub. per package. Based on this, you can choose a drug, dosage and quantity that is suitable for the financial condition of the family.

Analogs

Analogues of the drug are divided into 2 large groups according to the active substance - acetylcysteine; and on the treatment of symptomatic signs. The last gradation does not have something in common with all of the above possible diseases; basically, the analogs have common symptoms of sinusitis, tonsillitis and otitis media. A replacement for ACC 20 should always be prescribed by a doctor, based on external signs of the disease, laboratory tests and patient complaints.

Group by active substance

Acetylcysteine;
Fluimucil;
Acysteine;
Acestal;
Asibrox;
Vicks asset Expotomed.

Similar Treatable Diseases Group

Irs 19;
Fervex;
Wobeenzyme;
Niflumic acid;
Augmentin;
Ampicillin and its derivatives – sodium salt, trihydrate;
Ampiox;
Benzylpenicillin nitride salt;
Dioxycycline;
Azithromycin;
Oleandomycin phosphate;
Erythromycin;
Biseptol;
Poteseptil;
Sulfadimethoxine;
Kelfiprim;
Sulfapyridazine.

Overdose

Unfortunately, cases of overdose of ACC 200 in infants have been reported in pediatrics. Threats to life and health are not described, therefore, in case of dyspeptic disorder due to the large dose of medication, symptomatic treatment is recommended: gastric lavage, stool-fixing drugs, antiemetics.

Mucus, which has become less viscous, is evacuated much more easily and quickly from the breathing tubes, making room for air and a renewed mucous layer.

Among the drugs that can produce such an effect on bronchial sputum, ACC 200 powder is very popular. Instructions for use of water-soluble granules describe how to use this secretolytic and provide other important information about the medication.

Composition of ACC in sachets

Soluble ACC (powder) 200 in the form of small granular particles is packaged in sachets of 200 mg, each of which contains:

acetylcysteine (active ingredient);
additional ingredients - ascorbic acid, citrus and honey flavors, sucrose, saccharin.

The small granules look like a white or yellowish powder with a distinct honey and citrus odor.

Mechanism of action

According to the pharmacological action, ACC (powder) 200 mg belongs to the group of mucolytic expectorants that exhibit a mucolytic effect, facilitating the evacuation of sputum.

These effects are achieved by the direct effect of acetylcysteine on the rheological qualities (“fluidity”) of bronchial mucus. Acetylcysteine is effective even in the presence of pus in the sputum.

Method of use for cough

The instructions for using ACC granules list several pathologies accompanied by a cough reflex when the use of this powder is appropriate:

How to dilute ACC in granules to prepare a solution from 200 mg of powder is written in the instructions for use of the drug.

Instructions for use

Before diluting ACC 200 powder, you should first familiarize yourself with the rules for using this medication, because compliance with the dosage and timing of use is the most important component for successful treatment.

How to breed?

There is no special technology in how to dilute ACC 200 or any other dosage. In the instructions for ACC 200 (powder), the method of application is described as follows:

the bag of granules should be cut with scissors or carefully torn along the top edge;
pour the contents into a large cup;
pour the powder with hot water (200 ml).

To dissolve ACC 200 in the powder as quickly as possible, stir the solution with a teaspoon.

What water to dissolve in?

It is not without reason that the instructions for use emphasize how to dilute ACC 200 (powder) to obtain the most effective potency of the mixture. The water for diluting the granules must be hot.

How to use?

Pay attention to this nuance about the medication ACC 200 (powder) - how to drink it to achieve maximum effect.

The instructions indicate that the solution should be drunk immediately after preparation, that is, hot after eating.
Drinking a hot drink for colds and coughs will allow the active substances of the solution to be absorbed into the blood faster, and therefore more quickly exhibit mucolytic properties.
If the patient has a febrile condition (high temperature), the solution should be allowed to cool to warm or room temperature.
The instructions for use do not advise keeping the solution prepared but not drunk for longer than 3 hours.

Is there such information - when using the medication ACC (powder) 200, how to take other liquids: decoctions, infusions or teas? Yes, the instructions approve of the additional use of other warm liquids, emphasizing that they will help enhance the mucolytic effect of this drug.

How long can you drink?

Mucolytic drugs for cold coughs are usually taken for 5-7 days. For diseases with a long course, the dosage is determined by the doctor, and for the treatment of chronic diseases, long courses of taking ACC 200 mg (powder) are used. How long to take drugs for such a complex pathology as cystic fibrosis or chronic bronchitis depends on the factor of remission.

Important information for patients

Before using any drug, the patient should not, but simply must, read the special instructions in the annotation. It is important to know not only how to dilute ACC 200 powder according to the instructions for use, but also what undesirable effects may arise from its use. And the main thing is whether you or your child can take it at all. This question will be answered in the “Contraindications” section in the instructions for use of the powder.

This section contains a list of situations in which the use of ACC 200 granules is impossible:

In addition, ACC 200 is prohibited for use by patients with increased sensitivity to the active or additional ingredients.

Caution should be exercised when consuming ACC 200 granules when:

bronchial asthma (if severe exacerbation - prohibited!);
history of peptic ulcers;
diseases of the adrenal glands;
renal or hepatic insufficiency;
increased sensitivity to histamine;
hypertension.

It is also necessary to remember that taking drugs, especially long-term, can provoke undesirable effects in the form of allergic reactions, respiratory dysfunction, dyspeptic disorders and others. Severe side effects can be caused by an overdose.

What kind of reviews does the drug receive?

ACC (powder) has been present on the pharmacological market for several decades, and patients continue to write mostly positive reviews of this medication.

And yet there are several points that are named by consumers as disadvantages of this powder:

a list of contraindications (this scares some people off);
inability to use during pregnancy or breastfeeding;
prohibition on use in young patients (mothers of 2-3 year olds).

Everything else, including a pleasant taste and an affordable price, was named by the majority of those who used ACC 200 according to the instructions for use as the advantages of this drug.

ACC powder 600 mg

ACC at a dosage of 600 mg of acetylcysteine per sachet is designed for adult patients and is recommended for use once a day. Its taste may differ slightly from the powder discussed above, but the pharmacological properties are similar.

Prohibited for use by children and adolescents. You can read about the features of using the powder in this dosage in the separate instructions for use attached to the medication.

ACC granules 100 mg for children

For young patients over 2 years old, you can choose ACC in granules, packaged in 100 mg sachets. Before starting treatment, you should consult a doctor, clarify the nature of the cough (this can only be done by a specialist), and determine the duration of therapy. And be sure to read the instructions for use.

Useful video

For more information about the ACC line of drugs, see the following video:

Conclusion

The drug ACC 200 belongs to the group of mucolytic medications and is used in the treatment of coughs of various natures in patients over 6 years of age, in which difficult sputum discharge is observed.
Before use, you must read the instructions for use of the powder, find out how to dilute ACC 200, how to drink it, how long to treat and other important information.
The most correct step would be to visit a doctor, clarify the diagnosis and receive clear recommendations for treatment.

Do you have a question or experience regarding this issue? Ask a question or tell us about it in the comments.

ACC 200 INSTRUCTIONS

Prices for ACC 200

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.

ACC 200 is recommended for 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).

Children over 6 years of age are recommended to take 1 sachet of ACC 200 mg (600 mg per day) 3 times a day. Children aged 2 to 5 years are recommended to take ½ sachet of ACC 200 mg 4 times a day (400 mg per day). 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. The granules should be dissolved in water, juice or iced tea and taken after meals.

In rare cases, headaches, inflammation of the oral mucosa (stomatitis) and tinnitus are observed.

Extremely rare - diarrhea, vomiting, heartburn and nausea, drop in blood pressure, increase in 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.

Contraindications to the use of the drug ACC 200 are: hypersensitivity to acetylcysteine or other components of the drug, pregnancy, breastfeeding, children under 2 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.

For safety reasons, due to insufficient data, the use of ACC 200 during pregnancy and lactation is only possible if the expected benefit to the mother outweighs the potential risk to the fetus or infant.

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).

In case of an erroneous or intentional overdose of ACC 200, phenomena such as diarrhea, vomiting, stomach pain, heartburn and nausea are observed.

To date, no severe or life-threatening side effects have been observed.

At a temperature not higher than 25°C. Keep out of the reach of children.

3 g of granulate in bags made of three-layer material (aluminium-paper-polythene).

20 or 50 sachets in a cardboard box.

1 sachet of granules weighing 3 g ACC 200 for the preparation of an oral solution contains: 200 mg of acetylcysteine.

Excipients: sucrose, ascorbic acid, saccharin, orange flavor.

Instructions for patients with diabetes.

1 sachet of ACC 200 mg corresponds to 0.23 VE.

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 the drug contains sucrose.

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

Reviews ACC 200

All reviews about ACC 200

Analogues of ACC 200

Articles on the topic "Mucolytic"

Reviews about medicine. Catalogue of medicines, pharmacies, hospitals, physicians base.

ACC 200 powder for children: instructions for use

One of the very popular mucolytic drugs is ACC 200, so it is often prescribed for coughs with viscous sputum. But is this medicine suitable for children?

Release form

ACC 200 is produced in two forms:

Powder packaged in portioned bags weighing 3 grams. It is presented in homogeneous white granules that smell of honey and lemon. Orange powder is also available. One pack contains 20 packets of medicine.
Effervescent tablets. The manufacturer offers packages of 20 of these white round tablets with blackberry flavor.

Compound

The active substance in ACC 200 is acetylcysteine, of which each tablet or each serving package contains, as the name implies, 200 mg. ACC 200 powder also includes sucrose, sodium saccharinate, ascorbic acid and flavorings (lemon and honey). In addition to vitamin C and orange flavor, orange granules contain saccharin and sucrose for a sweet taste.

Additional substances in the tablets are citric acid, milk sugar, bicarbonate, saccharinate, sodium citrate and carbonate, mannitol, ascorbic acid and blackberry flavor.

Operating principle

The main effect of acetylcysteine, which is contained in ACC 200, is mucolytic. Such a substance directly affects sputum in the respiratory tract, changing its rheological properties. This is due to the ability to destroy the bonds of mucopolysaccharides in sputum, as a result of which the viscosity of the secretion decreases. In this case, the drug does not lose activity, even if there is pus in the sputum.

Acetylcysteine also has antioxidant properties, because it is able to neutralize oxidative radicals and stimulate the formation of glutathione. The result of this action will be an increase in cell protection and a decrease in the intensity of inflammation.

Video presentation of the drug ACC 200:

Can it be given to children?

The instructions for use clarify that the use of acetylcysteine is permitted from the age of two. In this case, a single dose for children under 6 years of age is usually 100 mg of the active substance, so you have to divide the sachet or tablet in half. The drug ACC 200 is designed for ages over 6 years.

Indications

Doctors prescribe ACC 200 if necessary to improve sputum separation and thin it. The medicine is prescribed in childhood for:

Pneumonia.
Bronchiolitis or bronchitis.
Chronic lung diseases, including obstructive ones.
Bronchiectasis.
Otitis media.
Sinusitis.
Cystic fibrosis.
Abscess in the lung.

Contraindications

The drug should not be taken in the following situations:

If the child has intolerance to acetylcysteine or other components of the medicine.
If a peptic ulcer has worsened.
If there is blood in the sputum.
If the baby has glucose-galactose malabsorption.
When pulmonary hemorrhage is detected.

Prescribing a medication requires increased attention from a doctor if the child has bronchial asthma, high blood pressure, or kidney, adrenal or liver diseases have been identified. The granules should not be given to children with fructose intolerance or sucrase deficiency.

Effervescent tablets are contraindicated in cases of lactose intolerance or lactase deficiency.

Side effects

ACC 200 can provoke an allergy, which manifests itself in children as a skin rash, low blood pressure, itching, swelling, urticaria or tachycardia. An anaphylactic reaction is very rare.
The respiratory system of children can react to ACC with shortness of breath, and in bronchial asthma the medicine can cause bronchospasm.
In some children, under the influence of ACC, the digestive system may suffer, which is manifested by dyspepsia, heartburn, nausea, loose stools, stomatitis, vomiting or abdominal pain.
Occasionally, taking ACC provokes headaches, tinnitus, fever or bleeding.

Instructions for use and dosage

ACC 200 powder should be diluted and given to the child to drink after meals. For one sachet, take half a glass of liquid, which can be represented not only by water, but also by cool tea or juice. Effervescent tablets are diluted only with water.

The prepared solution should be drunk as soon as possible after preparation. Due to the presence of ascorbic acid in the composition, the diluted medicine can be stored for up to two hours after it is diluted with liquid.

The dose of the medicine will depend on age:

At 2-6 years of age, the child is given mg of acetylcysteine per day. Since the daily dosage is divided into 2 times, the single dose will be mg. In most cases, half a sachet of ACC 200 is taken at one time. If tablets are used, then for a child under 6 years old, break the effervescent tablet into halves and mix only 1/2 with water. However, at this age it is more convenient to use the medicine ACC 100.
At the age of 6-14 years, the daily dosage will be mg of acetylcysteine, so a single dosage is most often represented by a whole sachet or a whole effervescent tablet ACC 200, and the medicine is taken 2 times a day.
Children over 14 years of age are given mg of acetylcysteine per day, dividing this dosage into 1-3 doses. At this age, it is already acceptable to use the medicine ACC Long.

The duration of treatment with ACC 200 should be determined by the doctor, but in acute pathologies without complications, the drug is often prescribed for 5-7 days.

Overdose

If the dosage of ACC for a child is too high, the baby’s body will react to the drug with nausea, loose stools or vomiting. Symptomatic therapy can help in such a situation.

Interaction with other drugs

It is not recommended to dissolve ACC tablets or powder in the same glass with any other medications.
When taking activated carbon, the activity of acetylcysteine will decrease.
It is unacceptable to prescribe ACC 200 and any antitussive medications, since a suppressed cough reflex can cause mucus stagnation in the bronchi.
When ACC and bronchodilators are prescribed, their effectiveness increases.
Some antibiotics (cephalosporins, penicillins, tetracycline) lose their antimicrobial activity when interacting with acetylcysteine, so you should pause between such medications, taking them at least 2 hours apart.
The simultaneous administration of ACC 200 and nitroglycerin or other vasodilating drugs causes a more pronounced vasodilating effect.

Terms of sale

To purchase ACC 200 at a pharmacy, you do not need a doctor's prescription. The average cost of a package with 20 sachets is 130 rubles.

Storage conditions and shelf life

The temperature at the storage location of ACC 200 should not exceed +25°C. ACC 200 sachets have a shelf life of 4 years from the date of release, while effervescent tablets have a shelf life of only 3 years. After removing the effervescent tablet from the tube, check the tightness of the package.

Reviews

Mostly positive reviews are left about the drug ACC 200. Mothers who gave this drug to their babies for coughs noted fairly high effectiveness and a low incidence of side effects. The product facilitates the removal of phlegm and speeds up recovery. At the same time, the taste does not cause protest among most children.

Analogs

Instead of ACC, you can use other medications with the same main component, for example, the Swiss drug Fluimucil or the domestic drug Acetylcysteine. It is also possible to replace it with other drugs with a mucolytic effect, for example, carbocisteine or ambroxol.

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ACC 200

ACC release form, composition and packaging

◊ Effervescent tablets white, round, flat, scored, with the smell of blackberries.

Citric acid anhydride - 558.5 mg, sodium bicarbonate, mannitol - 60 mg, ascorbic acid - 25 mg, lactose anhydride - 70 mg, sodium citrate - 0.5 mg, saccharin - 6 mg, blackberry flavoring "B" - 20 mg.

4 things. - strips (15) - cardboard boxes.

20 pcs. - aluminum tubes (1) - cardboard boxes.

20 pcs. - plastic tubes (1) - cardboard boxes.

25 pcs. - aluminum tubes (2) - cardboard boxes.

25 pcs. - plastic tubes (2) - cardboard boxes.

25 pcs. - aluminum tubes (4) - cardboard boxes.

25 pcs. - plastic tubes (4) - cardboard boxes.

pharmachologic effect

Mucolytic drug. The presence of sulfhydryl groups in the structure of the acetylcysteine molecule promotes the rupture of disulfide bonds of acidic mucopolysaccharides of sputum, which leads to a decrease in the viscosity of mucus. It has a mucolytic effect, facilitates the discharge of sputum due to a direct effect on the rheological properties of sputum. 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.

Pharmacokinetics

Data on the pharmacokinetics of the drug ACC ® are not provided.

Dosage of the drug ACC 200

At cystic fibrosis Children over 6 years of age are recommended to take 2 tablets. (ACC 100) or 1 tablet. (ACC 200) 3 times/day, which corresponds to 600 mg of acetylcysteine per day. Children aged 2 to 6 years - 1 tablet. (ACC 100) or 1/2 tab. (ACC 200) 4 times/day, which corresponds to 400 mg of acetylcysteine per day. For patients weighing more than 30 kg with cystic fibrosis, the dose can be increased to 800 mg/day if necessary.

At short-term colds Duration of treatment is 5-7 days. At chronic bronchitis and cystic fibrosis the drug should be used for a longer period of time to prevent infections.

The drug should be taken after meals. Additional fluid intake enhances the mucolytic effect of the drug.

Effervescent tablets (ACC 100 and ACC 200) should be dissolved in 1/2 glass of water. Take immediately after dissolution; in exceptional cases, you can leave the prepared solution for 2 hours.

Drug interactions

With the simultaneous use of acetylcysteine and antitussives, dangerous mucus stagnation may occur due to suppression of the cough reflex (use the combination with caution).

When taking acetylcysteine and nitroglycerin simultaneously, the vasodilatory effect of nitroglycerin may be enhanced.

Synergism between acetylcysteine and bronchodilators has been noted.

Acetylcysteine reduces the absorption of cephalosporins, penicillins and tetracycline, so they should be taken orally no earlier than 2 hours after taking acetylcysteine.

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

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

Use of ACC 200 during pregnancy

Due to insufficient data, the use of the drug during pregnancy and lactation is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus or child.

Use in childhood

Contraindications: children under 6 years of age (the drug is in the form of granules for the preparation of a solution for oral administration 200 mg); children under 14 years of age (dosage forms containing acetylcysteine 600 mg).

ACC side effects

From the nervous system: rarely - headache, tinnitus.

From the digestive system: rarely - stomatitis; very rarely - diarrhea, vomiting, heartburn and nausea.

From the cardiovascular system: very rarely - decreased blood pressure, tachycardia.

Allergic reactions: in isolated cases - bronchospasm (mainly in patients with bronchial hyperreactivity), skin rash, itching and urticaria.

Others: in isolated cases - the development of bleeding as a manifestation of a hypersensitivity reaction.

Conditions and periods of storage of the drug ACC 200

The drug should be stored out of reach of children, in a dry place at a temperature not exceeding 25°C. Shelf life - 3 years.

After taking the tablet, the tube should be tightly closed.

Indications for use ACC 200

Respiratory diseases accompanied by increased formation of viscous, difficult to separate sputum (acute and chronic bronchitis, obstructive bronchitis, pneumonia, bronchiectasis, bronchial asthma, bronchiolitis, cystic fibrosis);

Acute and chronic sinusitis;

Special instructions when taking ACC 200

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

If adverse reactions develop, the patient should stop taking the drug and consult a doctor.

When dissolving the drug, it is necessary to use glass containers and avoid contact with metals, rubber, oxygen, and easily oxidized substances.

When treating patients with diabetes, it is necessary to take into account that 1 effervescent tablet ACC 100 and ACC 200 corresponds to 0.006 XE.

Impact on the ability to drive vehicles and operate machinery

There is no data on the negative effect of the drug in recommended doses on the ability to drive vehicles and perform other activities that require concentration and speed of psychomotor reactions.

Conditions for dispensing from pharmacies

The drug ACC 200 is approved for use as an over-the-counter product.

*The description of the drug is based on the officially approved instructions for use and approved by the manufacturer for the 2012 editions

ACC description and instructions provided by the Vidal reference book of medicines

Mention of the drug "ACC 200" in user posts:

Analogues of the drug ACC 200

Reviews about the drug ACC 200:

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ACC 200 powder(Pulvis ACC 200)

chemical name: N-acetylcysteine;

Basic physical and chemical characteristics: white powder with a citrus odor;

compound:

ACC 200 powder in 3 g sachets contains 200 mg of acetylcysteine;

other components: ascorbic acid (vitamin C), saccharin, sucrose, flavoring.

1 sachet ACC 200 includes 0.23 bread units.

Release form of the medicinal product. Powder for the preparation of solution for oral use.

Pharmacotherapeutic group. Mucolytic agents. ATS R05C B01.

Action of the medicine.

ACC- a mucolytic, expectorant drug that is used to dissolve 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 acetylcysteine is chemical in nature. Due to the presence of a free sulfhydryl group, the drug breaks the disulfide bonds of mucopolysaccharides and exhibits a depolymerizing effect on the DNA chains of purulent sputum. Thus, the viscosity of sputum decreases. AED It also has antioxidant pneumoprotective properties, which is due to the binding of chemical radicals by its sulfhydryl groups and, thus, their destruction. In addition, ACC helps increase the synthesis of glutathione, an important factor in chemical detoxification. This feature of acetylcysteine makes it possible to effectively use the latter in acute poisoning with paracetamol and other toxic substances (aldehydes, phenols, etc.).

Pharmacokinetics.

After oral administration, acetylcysteine is quickly and almost completely adsorbed. In the liver it is metabolized to cysteine - a pharmacologically active metabolite and diacetylcysteine, cystine and further - mixed disulfides. Bioavailability after oral use of acetylcysteine is very low (about 10%). In humans, peak concentrations after oral administration are achieved within 1-3 hours, with peak plasma concentrations of the cystine metabolite being within 2 µmol/L. ACC binds to plasma proteins by approximately 50 %. In the body, acetylcysteine and its metabolites can be detected in different forms: partly as a free substance, partly in connection with plasma proteins, partly as incorporated amino acids. ACC is excreted exclusively in the form of inactive metabolites (inorganic sulfates, diacetylcystine) by the kidneys. Only a small part of acetylcysteine is excreted unchanged in feces. The plasma half-life is approximately 1 hour and depends on the rate of biotransformation in the liver. In case of decreased liver function, the half-life is extended to 8 hours.

It has been experimentally confirmed that acetylcysteine can reach the placenta of rats and appear in the amniotic fluid. As for the determination of acetylcysteine and its metabolites in human placentas, in breast milk and the possibility of penetration through the blood-brain barrier, there are currently no sufficient studies.

Indications for use.

The drug is used for the treatment of acute and chronic pathologies of the bronchopulmonary system in diseases accompanied by increased sputum production with worsening expectoration:

Treatment of acute and chronic bronchitis;

Bronchiectasis;

Chronic obstructive bronchitis;

Bronchial asthma; and

Cystic fibrosis;

Tracheitis;

Laryngitis;

Sinusitis;

Inflammation of the middle ear with effusions.

Method of use and dose.

Adults and children over 14 years of age can use ACC at a dose of 400 - 600 mg acetylcysteine per day.

Children from 2 to 5 years old - daily ACC up to 200-300 mg of acetylcysteine per day.

For newborns, starting from the 10th day of life, and children under 2 years of age, it is recommended to use ACC 50 mg 2 - 3 times a day up to 100 - 150 mg per day. Therapy is started sequentially, gradually selecting an effective dose.

Cystic fibrosis

For patients with a body weight of more than 30 kg, the daily dose may be increased to 800 mg of acetylcysteine.

Children over 6 years of age take ACC 3 times a day, 200 mg (600 mg acetylcysteine).

For newborns, starting from the 10th day of life, and children under 2 years of age, it is recommended to use ACC 50 mg 2-3 times a day (150 mg per day). Therapy should be started sequentially.

For acute uncomplicated diseases, ACC is used for no more than 5-7 days. The duration of treatment for long-term diseases is determined separately. Treatment of chronic diseases is carried out over a long period of time or in courses of several months (up to 6 months). ACC is recommended to be taken after meals. To do this, the contents of the bag should be dissolved in 1/2 glass of water, juice or iced tea and drink the solution.

After preparing the solution, it must be drunk as soon as possible. In some cases, due to the presence of a stabilizer - ascorbic acid - in the preparation, the prepared solution can be left for approximately 2 hours before use. Additional fluid intake enhances the mucolytic effect of the drug.

Side effect.

In some cases, diarrhea, nausea, heartburn and vomiting may occur.

Sometimes there is headache, inflammation of the oral mucosa and tinnitus.

There are isolated reports of the occurrence of allergic reactions when using ACC, a decrease in blood pressure, bronchospasm (in patients with increased sensitivity of the bronchial system, for example, with), skin rashes that quickly disappear, itching, tachycardia.

At the first signs of hypersensitivity to ACC, you should stop using it.

Contraindications.

Today there are not enough observations regarding the use of acetylcysteine during pregnancy and breastfeeding; therefore, taking the drug during these periods is only possible as prescribed by a doctor.

For the treatment of newborns, ACC can be used only for health reasons under the strict supervision of a physician.

Interaction with others medicines.

Antibiotics

Tetracycline antibiotics (with the exception of doxycycline) are not recommended for use simultaneously with ACC. Cases of inactivation of antibiotics by acetylcysteine were observed exclusively during in vitro experiments with direct mixing of the latter. But for the safety of the patient, the oral use of antibiotics should not coincide with the intake of acetylcysteine and possibly with an interval of at least 2 hours.

Antitussives

When ACC is used simultaneously with other antitussive drugs, due to a decrease in the cough reflex, mucus stagnation may be dangerous.

Nitroglycerine

The simultaneous use of nitroglycerin and ACC may lead to an increase in the vasodilating effect of nitroglycerin.

Incompatibility With others drugs.

In vitro incompatibility was observed with semisynthetic penicillins, tetracyclines, cephalosporins, as well as aminoglycosides. There is no evidence of incompatibility with antibiotics such as amoxicillin, erythromycin and cefuroxime.

Overdose.

To date, there have been no cases of severe or life-threatening side effects, even in extreme overdose conditions.

Storage conditions and periods.

Shelf life - 3 years.

Do not use the drug after the expiration date indicated on the package.

Store medicines V places inaccessible to children!