![]() However, at higher doses (≥1200mg), acetylcysteine also acts as an antioxidant through complex mechanisms which can combat conditions of oxidative stress. In vitro, cysteine derivatives act by breaking disulphide bridges between macromolecules, which leads to a reduction in mucus viscosity.(1) Acetylcysteine makes bronchial mucous less viscous. In hospital settings, it is also used as an antidote for paracetamol overdose (IV formulation at doses of up to 150mg/kg) and in nebulized format in patients with acute bronchopulmonary disease (pneumonia, bronchitis, tracheobronchitis). It has a well-established safety profile and is still commonly used orally at doses of 600mg/day as a mucolytic. N-acetylcysteine (NAC) was introduced in the 1960s as a mucolytic drug for chronic respiratory diseases. ![]() Clinical trial evidence for the use of NAC as an antioxidant in influenza and other acute viral respiratory tract infections is very limited and therefore difficult to draw any concrete conclusions without further trial evidence.A search on 3rd April 2020 did not reveal any COVID-specific evidence for NAC, so we have fallen back on evidence in other acute respiratory disorders.On behalf of the Oxford COVID-19 Evidence Service TeamĬentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health SciencesĬorrespondence to N-acetylcysteine (NAC) has been proposed for use in the therapy and/or prevention of several respiratory diseases and of diseases involving an oxidative stress including COVID-19. ![]() N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19
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