Release form: Solid dosage forms. Pills.

General characteristics. Structure:

Pharmacological properties:

Indications for use:

Important! Check out the treatment

Method of administration and dosage:

Application features:

Side effects:

Interaction with other medicinal products:

Contraindications:

Overdose:

Storage conditions:

In a dry, dark place at a temperature not exceeding 30 ° C. Close the tube tightly after taking the pill. Keep out of the reach of children. The shelf life of the drug ACC Long is 3 years.

Vacation conditions:

Without recipe

Packaging:

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

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

Mucolytic drug

Active substance

Release form, composition and packaging

ACC 100

◊ Effervescent tablets white, round, flat-cylindrical, with a blackberry smell; there may be a faint sulfur smell; the recovered solution is colorless transparent with a blackberry smell; a slight sulfuric odor is possible.

Excipients: anhydrous citric acid - 679.85 mg, - 194 mg, sodium carbonate anhydrous - 97 mg, mannitol - 65 mg, anhydrous lactose - 75 mg, ascorbic acid - 12.5 mg, sodium saccharinate - 6 mg, sodium citrate - 0.65 mg, blackberry flavor "B" - 20 mg.

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

◊ Effervescent tablets white, round, flat-cylindrical, with a line on one side, with a blackberry scent; there may be a faint sulfur smell; reconstituted solution - colorless transparent with a blackberry odor; a slight sulfuric odor is possible.

Excipients: anhydrous citric acid - 558.5 mg, sodium bicarbonate - 200 mg, sodium carbonate anhydrous - 100 mg, mannitol - 60 mg, anhydrous lactose - 70 mg, - 25 mg, sodium saccharinate - 6 mg, sodium citrate - 0.5 mg, blackberry flavor "B" - 20 mg.

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

ACC Long

◊ Effervescent tablets white, round, flat-cylindrical, with a chamfer and a line on one side, with a blackberry scent; there may be a faint sulfur odor; the recovered solution is colorless transparent with a blackberry smell; a slight sulfuric odor is possible.

Excipients: anhydrous citric acid - 625 mg, sodium bicarbonate - 327 mg, sodium carbonate - 104 mg, - 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.

10 pieces. - polypropylene tubes (1) - cardboard packs.
20 pcs. - polypropylene tubes (1) - cardboard packs.

pharmachologic effect

Acetylcysteine \u200b\u200bis 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 mucoproteins in sputum, which leads to a decrease in the viscosity of sputum. The drug remains active in the presence of purulent sputum.

It has an antioxidant effect due to the ability of its reactive sulfhydryl groups (SH-groups) to bind to oxidative radicals and thus neutralize them.

In addition, acetylcysteine \u200b\u200bpromotes the synthesis of glutathione, an important component of the antioxidant system and chemical detoxification of the body. The antioxidant effect of acetylcysteine \u200b\u200bincreases the protection of cells against the damaging effects of free radical oxidation inherent in an intense inflammatory response.

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

Absorption and distribution

The absorption is high. Oral bioavailability is 10%, which is due to the pronounced effect of the "first pass" through the liver. The time to reach C max in the blood is 1-3 hours.

Plasma protein binding - 50%. Penetrates the placental barrier. There are no data on the ability of acetylcysteine \u200b\u200bto penetrate the BBB and be excreted in breast milk.

Metabolism and excretion

It is rapidly metabolized in the liver to form a pharmacologically active metabolite - cysteine, as well as diacetylcysteine, cystine and mixed disulfides.

It is excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine). T 1/2 is about 1 hour.

Pharmacokinetics in special clinical situations

Liver dysfunction leads to an increase in T 1/2 to 8 hours.

Indications

- diseases of the respiratory system, accompanied by the formation of viscous, difficult to separate sputum (acute and chronic bronchitis, obstructive bronchitis, tracheitis, laryngotracheitis, pneumonia, lung abscess, bronchiectasis, bronchial asthma, COPD, bronchiolitis, cystic fibrosis);

- acute and chronic sinusitis;

- otitis media.

Contraindications

- peptic ulcer of the stomach and duodenum in the acute phase;

- hemoptysis;

- pulmonary bleeding;

- pregnancy;

- lactation period (breastfeeding);

- children up to 14 years old (ACC Long);

- children up to 2 years old (ACC 100, ACC 200);

- lactase deficiency, lactose intolerance, glucose-galactose malabsorption;

- hypersensitivity to drug components.

Carefullythe drug should be used in patients with a history of gastric ulcer and duodenal ulcer; with bronchial asthma, obstructive bronchitis; hepatic and / or renal failure; histamine intolerance (long-term use of the drug should be avoided, since acetylcysteine \u200b\u200baffects 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; arterial hypertension.

Dosage

The drug is taken orally after meals. Effervescent tablets should be dissolved in 1 glass of water. The tablets should be taken immediately after dissolution, in exceptional cases, you can leave the finished solution for 2 hours. Additional liquid intake enhances the mucolytic effect of the drug.

Adults and adolescents over 14 years old It is recommended to prescribe the drug 200 mg (2 tab. ACC 100, 1 tab. ACC 200) 2-3 times / day, which corresponds to 400-600 mg of acetylcysteine \u200b\u200bper day, or 600 mg (ACC Long) 1 time / day.

The drug is recommended to take 1 tab. (ACC 100) or 1/2 tab. (ACTS 200) 2-3 times / day, which corresponds to 200-300 mg of acetylcysteine \u200b\u200bper day.

When cystic fibrosischildren over the age of 6 the drug is recommended to be taken in 2 tabs. (ACC 100) or 1 tab. (ACTS 200) 3 times / day, which corresponds to 600 mg of acetylcysteine \u200b\u200bper day. Children aged 2 to 6 - 1 tab. (ACC 100) or 1/2 tab. (ACTS 200) 4 times / day, which corresponds to 400 mg of acetylcysteine \u200b\u200bper day.

When short-term colds the duration of admission is 5-7 days. When chronic bronchitis and cystic fibrosis the drug should be used for a longer period to prevent infections.

Side effects

According to the WHO, adverse effects are classified according to their frequency of development as follows: very often (≥1 / 10), often (≥1 / 100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10 000, <1/1000), очень редко (<10 000), частота неизвестна (частоту возникновения нельзя определить на основании имеющихся данных).

Allergic reactions: infrequently - itching, rash, exanthema, urticaria, angioedema; very rarely - anaphylactic reactions up to shock, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).

From the respiratory system: rarely - shortness of breath, bronchospasm (mainly in patients with bronchial hyperreactivity in bronchial asthma).

On the part of the cardiovascular system:infrequently - lowering blood pressure, tachycardia.

From the digestive system: infrequently - stomatitis, abdominal pain, nausea, vomiting, diarrhea, heartburn, dyspepsia.

On the part of the organ of hearing: infrequently - tinnitus.

Others: infrequently - headache, fever; in isolated cases - the development of bleeding as a manifestation of a hypersensitivity reaction, a decrease in platelet aggregation.

Overdose

Symptoms: in case of an erroneous or deliberate overdose, such phenomena as diarrhea, vomiting, stomach pains, heartburn, nausea are observed.

Treatment: carrying out symptomatic therapy.

Drug interactions

With the simultaneous use of acetylcysteine \u200b\u200band antitussives due to suppression of the cough reflex, sputum stagnation may occur.

With the simultaneous use of acetylcysteine \u200b\u200band antibiotics for oral administration (penicillins, tetracyclines, cephalosporins, etc.), the latter may interact with the thiol group of acetylcysteine, which can lead to a decrease in antibacterial activity. Therefore, the interval between taking antibiotics and acetylcysteine \u200b\u200bshould be at least 2 hours (except for cefixime and loracarbef).

Simultaneous use with vasodilators and nitroglycerin can lead to an increase in the vasodilator effect.

special instructions

In bronchial asthma and obstructive bronchitis, acetylcysteine \u200b\u200bshould be administered with caution under systematic monitoring of bronchial patency.

With the use of acetylcysteine, cases of severe allergic reactions such as Stevens-Johnson syndrome and Lyell's syndrome have been reported very rarely. If changes occur in the skin and mucous membranes, the patient should immediately stop taking the drug and consult a doctor.

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

You should not take the drug immediately before bedtime (the preferred time of admission is before 18.00).

1 effervescent tablet ACTS 100 or ACTS 200 corresponds to 0.006 XE, 1 effervescent tablet ACTS Long - 0.001 XE.

No special precautions are required when disposing of unused ACC effervescent tablets.

Influence on the ability to drive vehicles and use mechanisms

There are no data on the negative effect of the drug on the ability to drive vehicles and mechanisms, when used in recommended doses.

Pregnancy and lactation

Due to insufficient data, the use of the drug during pregnancy is contraindicated.

If necessary, the use of the drug during lactation should decide on the termination of breastfeeding.

Childhood use

The use of the drug is contraindicated in children under 14 years of age (for ACC Long), in children under 2 years of age (for ACC 200).

The shelf life is 3 years.

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

Active substance: acetylcysteine

Hexal (Germany)

Composition and form of release.1 sachet (ACC hot drink) with 3 g of granulate for preparation of hot drink contains acetylcysteine \u200b\u200b200 or 600 mg; in a box of 20 and 6 sachets, respectively.
1 sachet of granulate for oral solution - 100 or 200 mg; the package contains 20 sachets.
1 effervescent tablet - 100 (ACC 100), 200 (ACC 200) or 600 (ACC long) mg; in a package of 20 (ACC 100 and ACC 200) or 10 (ACC-long) pieces.
1 ampoule (3 ml of solution) - 300 mg; in a package of 5 ampoules of 3 ml.

Pharmachologic effect.Expectorant, mucolytic. Destroys substances (acidic mucopolysaccharides), on which the viscosity of phlegm depends, increases its fluidity and facilitates separation. Increases the synthesis of endogenous antioxidants (for example, glutathione) that protect the respiratory system from the toxic effects of poisons (aldehydes, phenols, other chemical agents) and other adverse environmental factors (tobacco smoke).

Features and differences from other drugs of the group or other dosage forms.Liquefies phlegm without significantly increasing its volume. Well absorbed when taken orally. The action develops in 30-90 minutes and lasts 2-4 hours.

Indications. Diseases occurring with the release of viscous, thick phlegm : acute and chronic bronchitis , tracheitis , pneumonia , laryngitis , sinusitis , cystic fibrosis , tuberculosis , bronchiectasis ; primary renal amyloidosis , tracheostomy , surgical operations (prevention of complications), trauma chest (prevention pneumonia), after bronchoscopy, treatment with cyclophosphamide, as an antidote (antidote) for paracetamol poisoning.

Warnings and Precautions.The drug should not be taken in case of individual hypersensitivity or intolerance to cow's milk, children and adolescents under 14 years of age (ACC-Long), with gastric ulcer and duodenal ulcer in the acute phase, a tendency to bleeding (hemoptysis, pulmonary hemorrhage).
It is prescribed with caution to patients with diseases of the liver, kidneys and adrenal glands.

Method of administration and dosage.Inside, after eating. The contents of 1 sachet are dissolved in 1 glass of water. The solution is prepared immediately before use. Adults and children over 14 years old - the contents of one sachet (200 mg) 2-3 times a day or 600 mg 1 time a day (ACC-Long) for 4-5 days. Children from 6 to 14 years old - 200 mg 2 times a day or 100 mg 2-3 times a day, from 2 to 6 years old - 100 mg 2-3 times a day, newborns and children under 2 years old (only indications for life and under medical supervision) - 10 mg / kg of body weight 2 times a day. The course of treatment is 5-14 days (determined by the doctor).
For cystic fibrosis, children over the age of 6 years - 200 mg 3 times a day, from 2 to 5 years - 100 mg 4 times a day. For infants, starting from the 10th day of life, 50 mg 3 times a day. For adults weighing more than 30 kg, the dose can be increased to 800 mg / day.
With intrabronchial administration - up to 300 mg / day. Intratracheally, 1 ml of a 10% solution is injected every hour. Intramuscularly (for respiratory tract injuries, coma, in children's practice) for adults 1-2 ml of 10% solution 2-3 times a day, for children over 1 year old - 0.5-1 ml of 10% solution 2 times a day.
If necessary, ACC can be administered intravenously (2-5 ml of 10% solution).

Side effects and possible complications.Gastrointestinal disorders, headache, allergic reactions. In patients with bronchial asthma and chronic obstructive bronchitis, bronchospasm may increase.

Interaction with other drugs, substances, drinks, products.Cannot be combined with antitussives (sputum stagnation in the respiratory tract is possible due to suppression of the cough reflex). Mixing with antibiotics and proteolytic enzymes should be avoided: when taken orally, the interval between antibiotics and ACC should be at least 2 hours, intramuscular injections should be done at some distance from each other.
With the simultaneous use of ACC and nitroglycerin, an increase in the effect of the latter may be observed.

ACTS Long: instructions for use and reviews

ACC belongs to a group of mucolytic agents, the name of which comes from the Greek "mucus", that is, mucus, and the therapeutic effect is to thin it. This drug can be safely called the most popular mucolytic in our pharmacies, hence the variety of its varieties, there are already nine of them for a minute. Basically, they differ in the form of release, but in the ordinary and "Long" the difference is more significant.

What is the difference between regular and Long?

To clearly understand the difference, first a few words about the similarities. Despite the described abundance, ACC is a monocomponent drug with one active ingredient - acetylcysteine... This substance has many other trade names (for example, which can be called the second most popular), and its main task is to reduce the viscosity of sputum. Thus, it is suitable for the symptomatic treatment of a whole range of respiratory diseases.

Available in three main forms:

1. effervescent tablets (Long, 200 and 100);
2. granules in sachets (100 and 200 mg for the preparation of a solution with orange flavor and 600 mg each for a neutral taste);
3. children's form in the form of syrup (100 mg / dose).

As you can see, the Long version is represented by effervescent tablets, but versions "100" and "200" also belong to them. The numbers mean the number of milligrams of acetylcysteine \u200b\u200bin one dose, and in the Long version this value is at least three times higher - 600 mg, which makes it the most powerful in terms of strength and duration of action.

Produced in Germany and Austriaand is produced by the Slovenian company Sandoz.

There is also a difference in the tastes of the ready-made solution - neutral for Long and blackberry for ordinary. So for those who have a negative attitude to flavorings, this is another criterion in favor of Long. Let's talk about the objective pros and cons later.

Strengthened version advantages and disadvantages

Of course, the advantages include the prolonged action, which allows adults to take only one effervescent tablet once a day after meals. In addition, in terms of the cost of six hundred milligrams of the drug, one Azz Long tablet is slightly more profitable than 3 x 200 mg or 6 x 100 mg.

The disadvantages include reduced fluid intake with a single dose, since an additional portion of fluid (within reasonable limits) enhances the mucolytic effect of acetylcysteine. Although if you do not forget to drink more during the day, then this drawback can be considered insignificant. Also, it should not be taken immediately before bedtime, in general, this indication applies to all drugs in the ACC line, but with an increased dosage it is better to be three times more alert.

It is important to remember that such a high dosage is allowed only for adults and adolescents at least 14 years old - this is the main difference in contraindications from other forms.

All ACC drugs should not be used in pregnant and lactating women, with pulmonary hemorrhage, hemoptysis, gastric ulcer and duodenal ulcer (in the acute stage), individual intolerance to acetylcysteine \u200b\u200bor auxiliary components.