Nežádoucí účinky
Interakce
Cyklofosfamid
- Snižuje účinek cyklofosfamidu při chemoterapii [1]
- Po požití alkoholu nepůsobí hepatoprotektivně, ale hepatotoxicky [1]
Homocystein
- In patients with hyperhomocysteinaemic CAD, folic acid and NAC lowered plasma homocysteine levels and improved endothelial function. The effects of both treatments in improvement of EDD were similar. [5]
- N-acetylcysteine treatment lowers plasma homocysteine but not serum lipoprotein(a) levels [6]
- N -Acetyl-cysteine reduces homocysteine plasma levels after single intravenous administration by increasing thiols urinary excretion [7]
Side effects
Nausea and vomiting
- Severe stomach/abdominal pain
- Black stools
- Vomit that looks like coffee grounds
Skin
- May occasionally become red and itchy
Non immune type of anaphylaxis
- May also occur
- Anaphylaxis-like reaction
- Occur more often in people given IV acetylcysteine despite serum levels of paracetamol not high enough to be considered toxic [1]
- 18% of patients
- Rash, hypotension, wheezing, and/or shortness of breath [1]
- Rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing [2]
- Lower rates of anaphylactoid reactions
- With slower rates of infusion [1]
Most commonly reported adverse effects i.v.
- Rash, urticaria, and itchiness
- Anafylaxis like reactions [1]
Inhalational formulations
- Nausea, vomiting
- Stomatitis
- Fever
- Rhinorrhea
- Drowsiness, clamminess
- Chest tightness
- Bronchoconstriction
- Infrequent, bronchospasm has been reported
- Unpredictably in some patients [1]
- Chest pain/tightness, trouble breathing [2]
Oral formulations
- Nausea, vomiting, rash, and fever [1]
Růst nádorů
- Prolonged ox. stress upregulates p53
- Provokes a pro-oxidant response
- Elicits the p53-dependent apoptotic processes
- Eliminate damaged cells
- Antioxidants can accelerate tumor growth
- By disrupting the ROS-p53 axis apoptosis, and autophagy
- Somatic mutations in p53 occur late in tumor progression
- May accelerate the growth of early tumors or precancerous lesions
- Smokers
- Patients with COPD
- Who receive NAC to relieve mucus production
- Not clear what dose(s) induced these effects
Plíce a srdce
- Large doses in a mouse model
- Could potentially cause damage to the heart and lungs
- Acetylcysteine was metabolized to S-nitroso-N-acetylcysteine (SNOAC) [1]
- Increased blood pressure in the lungs and right ventricle of the heart [1]
- Pulmonary artery hypertension in mice treated with acetylcysteine [1]
- Effect similar to that observed following a 3-week exposure to an oxygen-deprived environment (chronic hypoxia)
- SNOAC induced a hypoxia-like response [1]
- Expression of several important genes
- In vitro and in vivo [1]
Long-term treatment with acetylcysteine
- Have not yet been investigated
- Palmer and colleagues
- 20 grams per day
- Positive effects on age-diminished control of respiration (the hypoxic ventilatory response)
- Observed previously in human subjects at more moderate doses [1]
Poškození jater
- N-acetylcysteine prevented liver damage when taken before alcohol
- 4 hours after alcohol it actually made liver damage worse in a dose-dependent fashion [1]
