N-Acetyl Cysteine

Are there any interactions with medications?

Interaction Rating: Major Do not take this combination.

Nitroglycerin can dilate blood vessels and increase blood flow. Taking N-acetyl cysteine seems to increase the effects of nitroglycerin. This could cause increased chance of side effects including headache, dizziness, and lightheadedness.

Activated charcoal
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Activated charcoal is sometimes used to prevent poisoning in people who take too much acetaminophen and other medications. Activated charcoal can bind up these medications in the stomach and prevent them from being absorbed by the body. Taking N-acetyl cysteine at the same time as activated charcoal might decrease how well it works for preventing poisoning.

Dosing considerations for N-acetyl Cysteine.

The following doses have been studied in scientific research:

  • For acetaminophen (Tylenol) overdose: at the beginning of treatment, a first high dose of 140 mg/kg of a 5% solution of N-acetyl cysteine is given. The commercially available 10% and 20% solutions may be diluted with water, carbonated, or non-carbonated beverages, and given through a straw to lessen the unpleasant odor of N-acetyl cysteine. Seventeen additional doses of 70 mg/kg as a 5% solution are given every 4 hours, for a total dose of 1330 mg/kg over 72 hours.
  • For chest pain that is not relieved by rest (unstable angina): 600 mg of N-acetyl cysteine three times daily with a nitroglycerin patch.
  • For preventing sudden worsening of chronic bronchitis: doses of 200 mg twice daily, 200 mg three times daily, 300 mg slow-release twice daily, and 600 mg controlled-release twice daily have been used.
  • For treating chronic obstructive pulmonary disease (COPD): 600 mg of N-acetyl cysteine once daily, in addition to standard care, has been used for up to 6 months.
  • For treating a lung condition called fibrosing alveolitis that makes breathing difficult: 600 mg of N-acetyl cysteine 3 times daily.
  • For preventing damage to the bladder due to treatment with a cancer drug called ifosfamide: 1 to 2 grams of N-acetyl cysteine every 6 hours.
  • For reducing levels of homocysteine in the blood: 1.2 grams of N-acetyl cysteine daily.
  • For myoclonus epilepsy: 4-6 grams daily.
  • For reducing flu symptoms: 600 mg twice daily.
  • For reducing the risk of heart attacks and strokes in patients with end-stage kidney disease: 600 mg twice daily.
  • For skin wounds due to hemodialysis treatment: 200 mg four times daily or 600 mg twice daily.
  • For preventing kidney damage associated with the use of iopromide (Ultravist-300) for diagnostic tests: 400 to 600 mg of N-acetyl cysteine twice daily on the day before and on the day of iopromide administration, with IV saline (0.45%) 1 mL/kg body weight per hour for 12 hours before and 12 hours after iopromide administration.
  • For trichotillomania (hair-pulling): N-acetyl cysteine 1200 mg to 2400 mg daily has been used.
  • Healthcare providers give N-acetyl cysteine intravenously (by IV) for acetaminophen poisoning.

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