Talk:Acetylcysteine
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The article states that NAC helps boost the immune system. I contest this statement. I'm taking it out now. If someone wants to add it back, please give a reference.
- I provided reference from two RCTs showing that it increases immunity in AIDS. I invite you (or other contributors) to put back a similar statement (to "NAC helps boost the immune system") at the same place it was. You might wish to limit the sentence to AIDS. In the meantime, I'll try and find other research and trials on immunity at large (but you may want to check it out yourself). Pierre-Alain Gouanvic 17:01, 12 March 2007 (UTC) (I see that your intervention is 3 years old, so I'll probably have do the job (since you're perhaps not around anymore!). BTW, the study I provide dates to 2000.)
I added a couple references. If someone wants to really expand this article, these should be a good jump-off point. :-) Ksheka 23:48, May 9, 2004 (UTC)
- Ah, yes, the references. I could make head nor tails of the 30 references of all stripes and colours... I felt the sensible thing to do was to slash them all and start again. I've also expanded the drugbox. JFW | T@lk 21:32, 28 Nov 2004 (UTC)
In accordance with Wikipedia:WikiProject_Drugs naming policy, I propose we move this page to the INN acetylcysteine. If you have any concern with this proposal, please discuss it on this page. Matt 23:07, 21 Dec 2004 (UTC)
[edit] Merging Mucomyst into acetylcysteine
The content in Mucomyst is essentially duplicated in acetylcysteine. Andrew73 02:16, 23 October 2005 (UTC)
I just happened by here by accident, but I think this is a good candidate for a merge. Kit 19:13, 10 November 2005 (UTC)
Looks good to me! Kit 19:01, 11 November 2005 (UTC)
[edit] Liver failure
I've been told several times by our local liver unit to use NAc even in liver failure of non-paracetamol etiology. PMID 1904133 already mentions this (small series in 8 patients). PMID 14742832 disagrees. It's being trialled for acute liver failure. JFW | T@lk 19:37, 20 September 2006 (UTC)
[edit] Negative effects
Does this drug have any negative effects? I'm allergic to plane trees, and live between 2 of the biggest I've ever seen. Come Autumn I regularly get a mucus build-up in my sinuses which, if not treated results in a very frustrating and repetitive cough. I discovered Acetylcysteine on my travels to Italy and now keep a ready supply of it at home in Australia where it's a prescription only drug. Am I likely to be exposing myself to any side effects by using this drug every time I get a cold? 58.104.24.81 00:01, 8 June 2007 (UTC)
- Normal dosage by nebulization or direct tracheal instillation appears to be a couple of grams a day, sustained indefinitely. (The fraction absorbed into the metabolism is unclear.) So as long as you're not exceeding that level, it seems safe enough.
- The side effects listed for heavy users at http://www.cystic-fibrosis-symptom.com/mucosil.htm look pretty benign. Here's an article on Adverse reactions to acetylcysteine and effects of overdose, which includes two deaths, but they were already suffering from severe paracetamol overdose, so it's not clear what's to blame. Due to an easily-misread label, sometimes people got 10x the correct dose (60-80 grams IV rather than 6-8 g), and while this tended to make side effects more severe, some people had no adverse reactions at all.
- It's taken orally without prescription as a dietary supplement, and there are folks who take grams a week long-term due to its anti-oxidant properties. Boluses of 1200 mg/day are used to protect kidneys from radiocontrast substances.
- Oh! And here's the abstract of a paper Treatment of four siblings with progressive myoclonus epilepsy of the Unverricht-Lundborg type with N-acetylcysteine describing therapeutic use in humans at 4-6 g/day for 30 months. That was for a serious disorder which would make side effects tolerable, but it appears to be very hard to badly overdose.
- 71.41.210.146 06:09, 10 July 2007 (UTC)
PULMONARY HYPERTENSION IN MICE AT HIGH DOSE: Probably an overdose effect
Palmer et al ran a mouse study that showed that high dose NAC administration (19X the equivalent human dose) has an adverse effect of raising pulmonary artery blood pressure about 25%. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17786245 (Palmer. S-Nitrosothiols signal hypoxia-mimetic vascular pathology. J Clin Invest. 2007 September 4; 117(9): 2592–2601)
At 203x the equivalent dose it caused right sided heart enlargement. I doubt that this should be problematic given such high doses. I calculated that the usual dose of 600 mg would only raise PA blood pressure 1.3%, a trivial amount.
Mouse normal daily water consumption 15 ml/100 gm body weight/day Weight of a mouse 25g Daily water consumption of mouse =25g * .15 ml/g = 3.75 ml Dose NAC high 10 mg/ml * 3.75 ml = 37 mg. 37 mg * 0.001 g/mg * 1/25 g * 100 = 0.158% Low 1 mg/ml * 3.75 ml = 3.7 mg = 0.015 % body weight Human dose NAC 600 mg 600 mg * 0.001 g/mg * 1/77,110g * 100 = 0.000778% Dose comparison mouse to human high dose mouse = 203x human dose Low dose mouse = 19x human dose Low dose effect noted was to raise PA BP 23 points 19x dose raised BP 25% Adjusted dose would raise PA BP by only 1.3%. Not clinically significant because the diagnostic criteria PA in humans: = >25 mm Hg at rest. Normal is 14 mm Hg. PA hypertension is 50% increase. Abotnick
