For short-term use as a drug that dilutes the airway secretion and facilitates its expectoration in patients with symptoms of cold-related infection.
Composition:
1 tabl Effervescent contains 600 mg of acetylcysteine. The product contains isomalt, aspartame and sodium bicarbonate (1 table contains 183.4 mg of sodium).
Action:
Mucolytic drug. Acetylcysteine is a derivative of the cysteine amino acid. It works secretolithically (liquefies the secretion), which makes it easier to expel the secretions from the respiratory tract. It cleaves disulfide bonds in mucopolysaccharide chains and causes depolymerization of DNA chains (in purulent mucus). As a result of this action, the viscosity of the mucus decreases. The alternative mechanism of action of acetylcysteine results from the ability of reactive sulfhydryl groups (SH) to bind free radicals and detoxify them. In addition, acetylcysteine is involved in increasing the synthesis of glutathione, a substance essential for the detoxification of harmful factors. Acetylcysteine is almost completely absorbed when it is given as a solution. Intestinal acetylcysteine absorption is rapid. Cmax occurs after 60 min. Acetylcysteine undergoes partial deacetylation in the intestinal mucosa and rapid metabolic transformation after the first pass through the liver. The absolute bioavailability is 8-12% after doses of 200-1200 mg. Acetylcysteine reacts quickly with other thiol compounds of the serum, such as cysteine, glutathione and Acetylcysteine, forming acetylcysteinocysteine, acetylcysteinglutation and diacetylcysteine, respectively. After absorption of acetylcysteine in the gastrointestinal tract it undergoes deacetylation in the liver. The resulting compound, cysteine, is considered to be an active metabolite. After this stage, metabolic transformations of acetylcysteine are the same as cysteine. 20-30% of the administered dose of acetylcysteine is excreted in the urine.
Contraindications:
Hypersensitivity to acetylcysteine or to any of the excipients. Asthmatic condition. Phenylketonuria. Children under 2 years (acetylcysteine may cause airway obstruction in children under 2 years of age).
Precautions:
Patients with bronchial asthma must be strictly controlled during treatment with acetylcystein due to the possibility of bronchospasm. If this symptom is present, acetylcysteine should be discontinued immediately. In elderly patients or patients with respiratory failure, extreme caution should be exercised due to the reduced ability to cough up secretions. In patients with expectoration problems, additional respiratory physiotherapy should be applied (eg postural drainage). Due to the amount of active substance, the preparation should not be used in children and adolescents under 18 years of age. Caution is advised when using the drug in patients with a history of gastric or duodenal ulcers, especially if other medicines with known irritating effects on the gastric mucosa are used simultaneously. Due to the risk of severe skin reactions if changes occur in the skin or mucous membranes, the use of acetaminophenol should be discontinued and a doctor should be consulted immediately. Caution should be exercised in patients with histamine intolerance and long-term use of acetylcysteine should be avoided because acetylcysteine affects the metabolism of histamine and can cause intolerance (eg headache, rhinitis, pruritus). If concomitant use of acetylcysteine and oral antibiotics is necessary, these medicines should be taken at least 2 hours apart. The medicine contains 183.4 mg sodium per dose, which should be taken into account in patients with impaired renal function and in patients who control sodium in the diet. . The preparation contains aspartame, which is a source of phenylalanine, which may be harmful for patients with phenylketonuria. The preparation contains isomalt, which in the body is hydrolyzed to Glucose, mannitol and sorbitol - patients with malabsorption of glucose-galactose should not take the preparation.Do not use in patients with rare hereditary problems of fructose intolerance.
Pregnancy and lactation:
The drug can be used in pregnant women only after careful analysis of the risks and benefits. A decision should be made whether to stop breast-feeding or discontinue the drug taking into account the benefits of breastfeeding for the child and the benefits of treatment for the mother.
Side effects:
Uncommon: oral mucositis, vomiting, diarrhea, abdominal pain, nausea, headache, tinnitus, hypersensitivity reactions, tachycardia, urticaria, rash, angioneurotic edema, pruritus, fever, hypotension. Rare: dyspepsia, bronchospasm, shortness of breath. Very rare: anaphylactic shock, anaphylactic / anaphylactoid reactions, haemorrhage. Not known: face edema. There have been reports of very rare cases of severe skin reactions, including Stevens-Johnson syndrome and Lyell's syndrome, following administration of acetylcysteine. In most cases, at least one other drug has probably been involved in causing lesions on the skin and mucous membranes. In the course of various studies, decreased aggregation of platelets in the presence of acetylcysteine was observed, but at present it is not possible to determine the clinical significance of this phenomenon.
Dosage:
Orally. Adults: 1 tabl. sparkling once a day. It should not be used for more than 5 days without a doctor's recommendation. Use no later than 4 hours before bedtime due to the possibility of residual bronchi in the bronchi. It is recommended to take an increased amount of fluids during treatment. The effervescent tablet should be dissolved in 1/2 glass of water and drunk immediately after reconstitution.
(C)
