Effervescent tablets "ACTS Long": instructions for use. Medicinal guide geotar acts long method of application

Active substance

Acetylcystein * (Acetylcysteinum)

ATX:

Pharmacological group

Nosological classification (ICD-10)

Composition

ACC ® Long

Description of the dosage form

Effervescent tablets, 100 mg, 200 mg: white, round, flat tablets, scored (200 mg), with a blackberry scent.

Effervescent tablets, 600 mg: white, round tablets, beveled, scored on one side, smooth surface, blackberry smell.

Appearance solution: when dissolving 1 table. in 100 ml of water, a colorless transparent solution with a blackberry smell is obtained.

pharmachologic effect

pharmachologic effect - mucolytic .

Pharmacodynamics

The presence of sulfhydryl groups in the structure of acetylcysteine \u200b\u200bcontributes to the rupture of disulfide bonds of acidic mucopolysaccharides of sputum, which leads to a decrease in the viscosity of mucus. It has a mucolytic effect, facilitates the discharge of sputum due to a direct effect on the rheological properties of sputum. The drug remains active in the presence of purulent sputum.

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.

Indications of the drug

Diseases of the respiratory system, accompanied by the formation of viscous, difficult to separate sputum:

acute and chronic bronchitis;

obstructive bronchitis;

laryngotracheitis;

pneumonia;

bronchiectasis;

bronchial asthma;

bronchiolitis;

cystic fibrosis;

sharp and chronic sinusitis;

otitis media (otitis media).

Contraindications

Common to all dosage forms (effervescent tablets 100, 200, 600 mg)

hypersensitivity in relation to acetylcysteine \u200b\u200bor other constituents of the drug;

pregnancy;

lactation.

Additionally for effervescent tablets 100, 200 mg:

peptic ulcer stomach and duodenum in the acute stage;

hemoptysis;

pulmonary bleeding.

Carefully: varicose veins esophageal veins, bronchial asthma, adrenal diseases, hepatic and / or renal failure.

Additionally for 600 mg effervescent tablets:

childhood (up to 14 years old).

Carefully: peptic ulcer of the stomach and duodenum in the acute stage; hemoptysis, pulmonary hemorrhage, esophageal varicose veins, bronchial asthma, adrenal diseases, hepatic and / or renal failure.

Application during pregnancy and lactation

For all dosage forms.

To ensure safety, due to insufficient data, the appointment of the drug during pregnancy and lactation is possible only if the intended benefit to the mother outweighs the potential risk to the fetus or infant.

Side effects

In rare cases, there are headache, inflammation of the oral mucosa (stomatitis) and tinnitus. It is extremely rare - diarrhea, vomiting, heartburn and nausea, decreased blood pressure, increased heart rate (tachycardia). In isolated cases, there are allergic reactionssuch as bronchospasm (mainly in patients with bronchial hyperreactivity), skin rash, pruritus and urticaria. In addition, there are isolated reports of the development of bleeding due to the presence of hypersensitivity reactions.

With development side effects you should stop taking the drug and consult a doctor.

Interaction

With the simultaneous use of acetylcysteine \u200b\u200band antitussives, mucus stagnation may occur due to suppression of the cough reflex. Therefore, such combinations should be selected with care. The synergism of the action of acetylcysteine \u200b\u200bwith bronchodilators is noted.

The simultaneous intake of acetylcysteine \u200b\u200band nitroglycerin can lead to an increase in the vasodilating effect of the latter.

Pharmaceutically incompatible with antibiotics (penicillins, cephalosporins, erythromycin, tetracycline and amphotericin B) and proteolytic enzymes.

Upon contact with metals, rubber sulphides are formed with a characteristic odor.

Reduces the absorption of penicillins, cephalosporins, tetracycline (they should be taken no earlier than 2 hours after ingestion of acetylcysteine).

Method of administration and dosage

Effervescent tablets 100 and 200 mg

Adults and adolescents over the age of 14 years: 2 tab. 100 mg 2-3 times a day or 1 table. 200 mg 2-3 times a day (400-600 mg acetylcysteine \u200b\u200bper day).

Children aged 6 to 14 years: 1 table. 100 mg 3 times a day or 2 tablets. 2 times a day, or 1/2 table. (200 mg) 3 times a day, or 1 table. 200 mg 2 times a day (300-400 mg of acetylcysteine \u200b\u200bper day).

Children aged 2 to 5 years: 1 table. 100 mg 2-3 times a day or 1/2 table. 200 mg 2-3 times a day (200-300 mg acetylcysteine \u200b\u200bper day).

Cystic fibrosis.

Patients with cystic fibrosis and weighing more than 30 kg, if necessary, may increase the dose to 800 mg of acetylcysteine \u200b\u200bper day.

Children over the age of 6 it is recommended to take 2 effervescent tablets 100 mg 3 times a day or 1 tab. 200 mg 3 times a day (600 mg acetylcysteine \u200b\u200bper day).

Children aged 2 to 6 - 1 table. 100 mg or 1/2 tab. 200 mg 4 times a day (400 mg acetylcysteine \u200b\u200bper day).

Additional fluid intake enhances the mucolytic effect of the drug. For short-term colds the duration of admission is 5-7 days. When chronic bronchitis and cystic fibrosis, the drug should be taken more long time to achieve a preventive effect against infections.

1 effervescent table 100 mg corresponds to 0.006 XE, 1 effervescent table. 200 mg corresponds to 0.006 XE.

ACC ® Long

Effervescent tablets.

Inside. In the absence of other appointments, it is recommended to adhere to the following dosages.

Adults and adolescents over 14 years old it is recommended to take 1 table once a day. ACTS ® Long (600 mg of acetylcysteine \u200b\u200bper day).

Effervescent tablets should be dissolved in one glass of water and taken after meals. The tablets should be taken immediately after dissolution; in exceptional cases, you can leave the solution ready for use for 2 hours.

Additional fluid intake enhances the mucolytic effect of the drug.

For short-term colds, the duration of admission is 5-7 days. For long-term illnesses, the duration of therapy is determined by the attending physician. In chronic bronchitis, the drug should be taken for a longer time to achieve a prophylactic effect in infections.

Indication for the sick diabetes mellitus:

1 effervescent table corresponds to 0.01 XE.

Overdose

With an erroneous or deliberate overdose, phenomena such as diarrhea, vomiting, stomach pains, heartburn and nausea are observed. To date, no serious and life-threatening side effects have been observed.

special instructions

Patients with bronchial asthma and obstructive bronchitis should be prescribed acetylcysteine \u200b\u200bwith caution under systematic monitoring of bronchial patency.

When treating diabetic patients, it must be borne in mind that effervescent tablets contain sucrose.

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

Instructions
by application medicinal product for medical use

Registration number:

P N008857-240914

Trade name of the drug:

ACC ® Long.

International non-proprietary name:

acetylcysteine.

Dosage form:

effervescent tablets.

Composition:

1 effervescent tablet contains: active substance: acetylcysteine \u200b\u200b- 600.00 mg; excipients: citric acid - 625.00 mg; sodium bicarbonate - 327.00 mg; sodium carbonate - 104.00 mg; mannitol -72.80 mg; lactose - 70.00 mg; vitamin C - 75.00 mg; sodium cyclamate - 30.75 mg; sodium saccharinate dihydrate - 5.00 mg; sodium citrate dihydrate - 0.45 mg; blackberry flavoring "B" - 40.00 mg.

Description: round flat-cylindrical tablets white, beveled and notched on one side, with a blackberry scent. There may be a slight sulfuric odor.
Reconstituted solution: a colorless transparent solution with a blackberry odor, possibly a faint sulfur odor.

Pharmacotherapeutic group:

mucolytic agent.

ATX code: R05СВ01.

Pharmacological properties

Pharmacodynamics
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 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 based on 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 prophylactic use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations of bacterial etiology in patients with chronic bronchitis and cystic fibrosis.

Pharmacokinetics
The absorption is high. Rapidly metabolized in the liver to form a pharmacologically active metabolite - cysteine, as well as diacetylcysteine, cystine and mixed disulfides. Bioavailability with oral administration is 10% (due to the presence of a pronounced effect of "first pass" through the liver). The time to reach the maximum concentration in blood plasma is 1-3 hours. Communication with blood plasma proteins is 50%. It is excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine). The half-life (T1 / 2) is about 1 hour, liver dysfunction leads to an extension of T1 / 2 to 8 hours. Penetrates through the placental barrier. Data on the ability of acetylcysteine \u200b\u200bto penetrate the blood-brain barrier and be excreted from breast milk absent.

Indications for use

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, chronic obstructive pulmonary disease (COPD), bronchiolitis;
cystic fibrosis;
Acute and chronic sinusitis, otitis media (otitis media).

Contraindications

Hypersensitivity to acetylcysteine \u200b\u200bor other components of the drug;
peptic ulcer of the stomach and duodenum in the acute stage;
hemoptysis, pulmonary bleeding;
pregnancy;
lactation period;
children's age up to 14 years (for this dosage form);
lactase deficiency, lactose intolerance, glucose-galactose malabsorption.

Carefully: history of gastric ulcer and duodenal ulcer, 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 may lead to signs of intolerance, such as headache, vasomotor rhinitis, itching), esophageal varices, adrenal diseases, arterial hypertension.

Application during pregnancy and during breastfeeding

Data on the use of acetylcysteine \u200b\u200bduring pregnancy and breastfeeding are limited, therefore, the use of the drug during pregnancy is contraindicated.
If it is necessary to use the drug during lactation, the question of stopping breastfeeding should be resolved.

Methods of administration and doses

Inside, after eating.
Effervescent tablets should be dissolved in one glass of water. The tablets should be taken immediately after dissolution, in exceptional cases, you can leave the solution ready for use for 2 hours. Additional liquid intake enhances the mucolytic effect of the drug. For short-term colds, the duration of admission is 5-7 days. In chronic bronchitis and cystic fibrosis, the drug should be taken for a longer time to achieve a preventive effect.
In the absence of other prescriptions, it is recommended to adhere to the following dosages:
Mucolytic therapy:
Adults and children over 14 years old: 1 effervescent tablet 1 time per day (600 mg).

Side effect

According to the World Health Organization (WHO) unwanted effects classified according to their frequency of development as follows: very often (≥ 1/10), often (≥1 / 100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10000, <1/1000) и очень редко (<1/10000); частота неизвестна (частоту возникновения явлений нельзя определить на основании имеющихся данных).
Allergic reactions
infrequently: pruritus, rash, rash, urticaria; angioneurotic edema, decreased blood pressure, tachycardia;
very rarely: anaphylactic reactions up to anaphylactic 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).
From the senses
infrequently: noise in ears.
From the gastrointestinal tract
infrequently: stomatitis, abdominal pain, nausea, vomiting, diarrhea, dyspepsia.
Others
very rarely: headache, fever, isolated reports of the development of bleeding due to the presence of a hypersensitivity reaction, decreased platelet aggregation.

Overdose

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

Interaction with other medicinal products

With the simultaneous use of acetylcysteine \u200b\u200band antitussives due to suppression of the cough reflex, sputum stagnation can occur.
When used simultaneously with antibiotics for oral administration (penicillins, tetracyclines, cephalosporins, etc.), their interaction with the thiol group of acetylcysteine \u200b\u200bis possible, which can lead to a decrease in their antibacterial activity. Therefore, the interval between taking antibiotics and acetylcysteine \u200b\u200bshould be at least 2 hours (except cefixime and loracarbefa).
Simultaneous use with vasodilating agents and nitroglycerin can lead to increased vasodilator action.

special instructions

Note for patents with diabetes mellitus:
1 effervescent tablet corresponds to 0.001 XE.
When working with the drug, it is necessary to use glassware, avoid contact with metals, rubber, oxygen, easily oxidizing substances.
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, you should immediately consult a doctor, and stop taking the drug.
Patients with bronchial asthma and obstructive bronchitis should be prescribed acetylcysteine \u200b\u200bwith caution under systemic control of bronchial patency.
You should not take the drug immediately before bedtime (it is recommended to take the drug before 18.00).

Influence on the ability to drive vehicles, mechanisms

There are no data on the negative effect of ACTS ® Long in recommended doses on the ability to drive vehicles, mechanisms.

Special precautions for the destruction of unused medicinal product

There is no need for special precautions when disposing of unused ACC ® Long.
Close the tube tightly after taking the pill!

Release form

Effervescent tablets 600 mg
Primary packaging
6, 10 or 20 effervescent tablets in a polypropylene tube.
Secondary packaging
1 tube in a cardboard box along with instructions for use.

Storage conditions

In a dry, dark place at a temperature not exceeding 30 ° C.
Keep out of the reach of children.

Shelf life

3 years.
Do not use after the expiration date.

Vacation conditions

Without recipe.

Manufacturer

RU holder: Sandoz dd, Verovshkova 57, 1000 Ljubljana, Slovenia;
Produced by: Hermes Arzneimittel GmbH, Germany.

Consumer claims should be sent to Sandoz CJSC:
125315, Moscow, Leningradsky prospect, 72, bldg. 3

Indications for use

ACTS LONG is a drug designed to dilute viscous sputum and facilitate its removal from the respiratory tract.
ACC LONG is applied for all diseases of the respiratory system, which are accompanied by the formation of a thick and difficult to separate secretions, for example: acute bronchitis and exacerbation of chronic bronchitis, laryngitis, sinusitis, tracheitis, influenza, bronchial asthma and, as an additional therapy, cystic fibrosis.

How to take Azz Long

In the absence of other prescriptions, it is recommended to adhere to the following doses of ACC LONG.
Adults and children over 12 years old: one effervescent tablet, once a day.
The maximum duration of admission is 3-6 months with long-term treatment.
If your symptoms worsen or do not improve after 2 weeks of treatment, you should consult your doctor.
Cystic fibrosis: as mentioned above. Can be used in children from 6 years of age - one effervescent tablet once a day.
Mode of application
Dissolve the effervescent tablet in one glass of cold or warm water. The prepared solution must not be mixed with other preparations. The drug can be taken with or without food.

If you have exceeded the dose of ACC LONG
Until now, no serious side effects and signs of drug intoxication have been observed, even with a significant overdose.
If the dose of the drug is exceeded, irritation of the gastrointestinal tract may occur (for example, nausea, vomiting, diarrhea). Children are at risk of bronchial hypersecretion (excessive sputum production). In case of a suspected overdose of ACC LONG, you should consult your doctor.
If you forget to take ACTS LONG
If you missed one dose of ACC LONG or took too little dose, wait until the next dose is taken and continue taking the drug as indicated in the dosage recommendations. Do not double your dose to make up for a missed dose.
If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

Contraindications

Do not take ACC LONGif you are hypersensitive (allergic) to acetylcysteine \u200b\u200bor any other component of ACC LONG, as well as if you have an exacerbation of gastric or duodenal ulcer, galactose intolerance, lactase deficiency and glucose-galactose malabsorption.
ACC LONG should not be used to treat children under 12 years of age (6 years - with cystic fibrosis).

Special warnings and precautions for use

When taking ACC LONG, it is not recommended to use antitussive drugs.
Due to the risk of bronchospasm in patients with bronchial asthma and bronchial hyperreactivity, caution is recommended. If a hypersensitivity reaction or bronchospasm occurs, the drug should be discontinued immediately and appropriate measures should be taken. When treating with the drug, care should be taken if you suffer from bronchial asthma, if you have a history or currently have a stomach or intestinal ulcer, as well as a risk of gastrointestinal bleeding (for example, latent peptic ulcer or esophageal varices), since taking acetylcysteine \u200b\u200bmay induce vomiting.
Taking acetylcysteine, especially at the beginning of treatment, can lead to dilution of bronchial secretions (sputum). If the ability to cough up on his own is impaired (it is enough to cough up), appropriate measures should be taken to prevent dangerous sputum stagnation - bronchial drainage and aspiration.
Acetylcysteine \u200b\u200bleads to diamine oxidase (DAO) inhibition in vitro by 20-50%. Patients with histamine intolerance should be careful. In such patients, the use of long-term therapeutic courses should be avoided, since ACC LONG affects the metabolism of histamine and can cause symptoms of intolerance (for example, headache, runny nose, itching).
During the use of acetylcysteine, in very rare cases, the occurrence of severe skin reactions, such as Stevens-Johnson syndrome and Lyell's syndrome, has been observed. In case of changes in the skin and mucous membranes, you should immediately stop taking the drug and seek help from a doctor.
The presence of a slight sulfuric odor, which may appear upon opening the package, is characteristic of the active substance. The smell evaporates quickly and does not affect the effectiveness of the drug.
The drug is not recommended for use during pregnancy and during breastfeeding.
One effervescent tablet contains approximately 6.03 mmol (138.8 mg) sodium. This should be taken into account when using the drug in patients on a controlled sodium diet (low sodium / low salt).
Due to the presence of lactose in the preparation, ACC LONG is contraindicated in patients with rare hereditary galactose intolerance, with lactase deficiency or with impaired absorption of glucose-galactose.

Due to the presence of ascorbic acid in the composition of the drug use with caution in: deficiency of glucose-6-phosphate dehydrogenase, hemochromatosis, sideroblastic anemia, thalassemia, hyperoxaluria, oxalosis, kidney stones.
Ascorbic acid increases the risk of crystalluria during treatment with short-acting salicylates and sulfonamides, slows down the excretion of acids by the kidneys, increases the excretion of drugs with an alkaline reaction (including alkaloids), and reduces the concentration in the blood of oral contraceptives.
Ascorbic acid can distort the results of various laboratory tests (blood glucose, bilirubin, transaminase activity, LDH). High doses of ascorbic acid can give false negative results on fecal occult blood tests.

Taking other drugs

Tell your doctor or pharmacist if you are / are using or have recently taken / used any other medicines, including over-the-counter medicines.
The addition of other medicines to acetylcysteine \u200b\u200bpreparations should be avoided. Concomitant use of acetylcysteine \u200b\u200band activated charcoal during intoxication therapy may reduce the effectiveness of acetylcysteine.
The reports received to date on the ability of acetylcysteine \u200b\u200bor other mucolytics to inactivate antibiotics are exclusively experimental in vitro, in which the respective substances are mixed directly with each other. However, for safety reasons, oral antibiotics should be taken separately from acetylcysteine, at least 2 hours apart.
The simultaneous intake of acetylcysteine \u200b\u200band nitroglycerin can lead to an increase in the vasodilator and antiplatelet effect of the latter.
The simultaneous use of acetylcysteine \u200b\u200band carbamazepine can lead to a decrease in the concentration of carbamazepine to subtherapeutic. Acetylcysteine \u200b\u200bis incompatible with most drugs containing metals and is inactivated by oxidants.
Interactions associated with ascorbic acid
Ascorbic acid, when used simultaneously, reduces the chronotropic effect of isoprenaline. With prolonged use, the interaction of disulfiram-ethanol can be disrupted. Increases the toxicity of amygdalin when taken together. Reduces the therapeutic effect of antipsychotics (phenothiazine derivatives), tubular reabsorption of amphetamine and tricyclic antidepressants. Increases blood concentration of benzylpenicillin and tetracyclines.
Improves intestinal absorption of iron preparations; may increase the excretion of iron when used simultaneously with deferoxamine, as a result of which ascorbic acid should not be taken during the first month of treatment with deferoxamine. The simultaneous intake of ascorbic acid and aluminum hydroxide can increase the absorption of aluminum.

Pregnancy and breastfeeding

Pregnancy
Until now, there is not enough data on the use of acetylcysteine \u200b\u200bby pregnant women. Therefore, taking the drug ACTS LONG is not recommended during pregnancy and during breastfeeding.
Breast-feeding
There is no data on the ability of acetylcysteine \u200b\u200bto pass into breast milk. Therefore, taking the drug ACTS LONG is not recommended during pregnancy and during breastfeeding.

Impact on the ability to drive vehicles or work with machinery

Special studies on the effect of the drug on the ability to drive transport and other mechanisms have not been conducted.

Important information about some of the ingredients

One effervescent tablet contains 6.03 mmol (138.8 mg) sodium. This should be taken into account when using the drug in patients on a controlled sodium diet.
One effervescent tablet of ACTS LONG contains 75 mg of ascorbic acid, which corresponds to the recommended daily intake of vitamin C.

Possible side effects

Like all medicines, ACC LONG can cause side effects, although not everybody gets them.
During treatment with ACTS LONG, hypersensitivity reactions, angioedema, urticaria, itching, and rash may occur. If the first signs of hypersensitivity appear, you should immediately stop taking the drug and seek medical attention.
The following adverse reactions have been reported:
Uncommon (may affect up to 1 in 100 people): stomatitis, abdominal pain, nausea, vomiting, diarrhea, heartburn, fever, tachycardia, hypotension, headache, tinnitus.
Rare (may affect up to 1 in 1,000 people): dyspepsia, shortness of breath, bronchospasm.
Very rare (may affect up to 1 in 10,000 people): anaphylactic shock, anaphylactic / anaphylactoid reactions, hemorrhage.
Frequency unknown (based on available data, incidence cannot be determined): swelling of the face.
In predisposed patients, hypersensitivity reactions of the skin and respiratory system may develop, in patients with bronchial hyperreactivity and bronchial asthma, bronchospasm may occur (see "Special warnings and precautions for use"). Very rarely, cases of severe skin reactions such as Stevens-Johnson syndrome and Lyell's syndrome have been reported in association with the use of acetylcysteine.
A decrease in the aggregation of blood platelets in the presence of acetylcysteine \u200b\u200bhas been confirmed by various studies. The clinical significance of this phenomenon has not yet been established.
Exhaled air can develop an unpleasant odor, possibly from the release of hydrogen sulfide.
Adverse reaction reporting
If you have any adverse reactions, it is recommended to consult your doctor. This recommendation applies to any possible adverse reactions, including those not listed in the instructions for use of the drug. By reporting adverse reactions, you can help provide more information on the safety of this medicine.

With viscous sputum, pediatricians often prescribe mucolytics. Among such means, ACC Long is very popular, but is such a medicine allowed in childhood?

Release form

The drug is available in the form of effervescent tablets.They are white and round in shape. Dissolving such a tablet in water, you get a clear liquid without color, which smells like blackberries. The tablets are packed in tubes made of polypropylene. One tube contains 10 or 20 effervescent tablets.

Composition

The main component in ACC Long is acetylcysteine. Each tablet contains 600 mg of this substance. Additionally, the tablets contain lactose, carbonate, citrate and sodium bicarbonate, citric acid, sodium saccharinate and cyclamate, mannitol, ascorbic acid and blackberry flavor.

Operating principle

The drug is a mucolytic agent and, after entering the body, affects the mucopolysaccharides in the sputum, reducing the viscosity of the mucus secreted by the bronchi. The drug is active even with purulent inflammation.

Can I give it to children?

The instructions for use contain information that ACC Long is not given to children under 14 years old, since the dosage of acetylcysteine \u200b\u200bin it is too large. For younger children, other forms of release with a reduced content of the active substance are suitable:

• Syrup.
• Soluble granules.
• Effervescent tablets.

At a dose of 100 mg, the drug is allowed from 2 years of age, and a dosage of 200 mg is prescribed from 6 years of age.

Indications

Contraindications

ACC Long should not be prescribed for:

• Intolerance to any component of the medication.
• Exacerbation of peptic ulcer.
• Hemoptysis.
• Bleeding from the lungs.
• Lactase deficiency.

The drug is given with caution in bronchial asthma, diabetes mellitus, impaired renal or liver function, as well as increased blood pressure and adrenal gland pathologies.

Side effects

The child's body almost does not react to ACC Long with side symptoms, if the drug is given after 14 years and in the correct dose.

Rare negative reactions to such a remedy are headaches, stomatitis, bronchospasm, pruritus, tinnitus, urticaria, bleeding. Some patients may have a decrease in blood pressure, diarrhea, nausea, heart palpitations, heartburn.

Instructions for use and dosage

A child over 14 years old is given 1 tablet of the drug per day.For the treatment of ARVI, the drug is used from 5 to 7 days, and for more serious pathologies, the duration of therapy should be determined by the doctor on an individual basis.

The tablet is immersed in a glass of clean water, wait for dissolution and drink immediately. This should be done after one of your meals. The prepared solution should not be stored longer than 2 hours. Mix ACC Long with water only in a glass container, since upon contact with metal or rubber, such a medicine will form sulfides (there will be an unpleasant odor).

Overdose

If you exceed the dose of ACC Long, it will lead to nausea, abdominal pain, diarrhea, heartburn or vomiting. In such a situation, symptomatic therapy is prescribed.

Interaction with other drugs

• If antitussive drugs are prescribed together with ACC Long, this can lead to stagnation of mucus in the bronchial tree.
• Nitroglycerin, taken together with ACC Long, has a stronger vasodilator effect.
• When acetylcysteine \u200b\u200bis taken, the absorption of penicillin antibiotics, as well as tetracyclines and cephalosporins, decreases. If these medications are prescribed together, their doses are separated in time, so that there is at least 2 hours of break between them.
• You cannot take ACC Long and proteolytic enzymes together.

Terms of sale

ACC Long is a non-prescription drug, so it can be freely purchased at the pharmacy. The average price of a tube with 10 tablets is 300-350 rubles.

Storage conditions and shelf life

To store ACC Long, you need a dry place hidden from sunlight, where the temperature will not exceed + 30 ° C. From the moment of release, the tablets can be used for 3 years.

Description of the dosage form

Round flat-cylindrical tablets of white color, with a bevel, a line on one side, with a blackberry smell. There may be a slight sulfur odor.

The reconstituted solution is colorless transparent with a blackberry odor, possibly a faint sulfur odor.

Pharmacodynamics

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 disulfide bonds of mucopolysaccharide chains and cause depolymerization of mucoproteins in sputum, which leads to a decrease in its viscosity. The drug remains active in the presence of purulent sputum.

It has an antioxidant effect based on 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 prophylactic use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations of bacterial etiology in patients with chronic bronchitis and cystic fibrosis.

Pharmacokinetics

The absorption is high. It is rapidly metabolized in the liver to form a pharmacologically active metabolite - cysteine, as well as diacetylcysteine, cystine and mixed disulfides. Oral bioavailability is 10% (due to the presence of a pronounced effect of the first passage through the liver). T max in blood plasma is 1–3 hours. Communication with blood plasma proteins is 50%. It is excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine). T 1/2 is about 1 hour, impaired liver function leads to an extension of T 1/2 to 8 hours. Penetrates through the placental barrier. There are no data on the ability of acetylcysteine \u200b\u200bto penetrate the BBB and be excreted in breast milk.

ACTS Long: 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, chronic obstructive pulmonary disease;

bronchiolitis;

cystic fibrosis;

acute and chronic sinusitis;

otitis media (otitis media).

ACTS Long: Contraindications

hypersensitivity to acetylcysteine \u200b\u200bor other components of the drug;

peptic ulcer of the stomach and duodenum in the acute stage;

hemoptysis, pulmonary bleeding;

lactase deficiency, lactose intolerance, glucose-galactose malabsorption;

pregnancy;

period of breastfeeding;

children's age (up to 14 years old).

Carefully: a history of gastric ulcer and duodenal ulcer; varicose veins of the esophagus; bronchial asthma; obstructive bronchitis; diseases of the adrenal glands; hepatic and / or renal failure; histamine intolerance (long-term use of the drug should be avoided, because acetylcysteine \u200b\u200baffects the metabolism of histamine and can lead to signs of intolerance, such as headache, vasomotor rhinitis, itching); arterial hypertension.

Application during pregnancy and lactation

Data on the use of acetylcysteine \u200b\u200bduring pregnancy and breastfeeding are limited, therefore, the use of the drug during pregnancy is contraindicated.

If it is necessary to use the drug during lactation, the question of stopping breastfeeding should be resolved.

Method of administration and dosage

Inside, after meals, effervescent tablets should be dissolved in one glass of water and taken after meals. The tablets should be taken immediately after dissolution, in exceptional cases, you can leave the solution ready for use for 2 hours. Additional liquid intake enhances the mucolytic effect of the drug.

For short-term colds, the duration of admission is 5-7 days.

In chronic bronchitis and cystic fibrosis, the drug should be taken for a longer time to achieve a preventive effect.

In the absence of other prescriptions for mucolytic therapy, it is recommended to adhere to the following dosages: adults and children over 14 years old - 1 table. effervescent once a day (600 mg).

ACTS Long: Side effects

Adverse effects are given in accordance with the WHO classification by the frequency of their development as follows: very often (≥1 / 10), often (≥1 / 100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10000, <1/1000) и очень редко (<1/10000); частота неизвестна (частоту возникновения явлений нельзя определить на основании имеющихся данных).

Allergic reactions: infrequently - itchy skin, rash, exanthema, urticaria, angioedema, decreased blood pressure, tachycardia; very rarely - anaphylactic reactions up to anaphylactic 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).

From the senses: infrequently - tinnitus.

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

Others: very rarely - headache, fever, isolated reports of the development of bleeding due to the presence of a hypersensitivity reaction, a decrease in platelet aggregation.

Overdose

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

Treatment: symptomatic.

Interaction

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

With simultaneous use with antibiotics for oral administration (including penicillins, tetracyclines, cephalosporins), their interaction with the thiol group of acetylcysteine \u200b\u200bis possible, which can lead to a decrease in their antibacterial activity. Therefore, the interval between taking antibiotics and acetylcysteine \u200b\u200bshould be at least 2 hours (except for cefixime and loracarbef).