DRUG SUPPLIED DOSE COMMENTS
n-ACETYLCYSTEINE (Paeds)
(Mucomyst, NAC)

Mechanism of action:

Acetaminophen antidote, Mucolytic



Ref: 1, 28, 32, 176, 680  



Last update: 2022-07-28		 oral solution:  
200 mg/mL (20%) 10 mL
100 mg/mL (10%) [BCCH]

injection: 200 mg/mL (20%) 10 mL, 30 mL

Acetaminophen Overdose:  
See Poison Manual.

Treatment of Distal Intestinal Obstruction Syndrome (DIOS) in Cystic Fibrosis  - Partial Obstruction Only
Acute treatment:
1 month - 2 yr: 400 -3000 mg PO once
2 - 6 yr: 2000 - 3000 mg PO once
7 yr and older: 4000 - 6000 mg PO once

PR: 100 mL of 10% solution as enema once daily to QID.

Maintenance:
1 month - 2 yr: 100 - 500 mg PO TID-QID
2 yr and older: 1000 - 3000 mg PO TID-QID

Prevention:
1 month - 2 yr: 100 - 200 mg PO TID
2 - 11 yr: 200 mg PO TID
12 yr and older: 200-400 mg PO TID

Irrigation of Urinary Catheter:
10 mL of a 10% solution  into catheter
 Side Effects:  local irritation, bronchospasm, hemoptysis, stomatitis, rhinorrhea, nausea/vomiting.

To make a 10% rectal solution, the 20% solution should be diluted with an equal volume of SWI or sterile NS.

5% - 10% solution recommended for patients up to 2 years; 10 - 20% solution for patients above 2 years.

For oral use, may dilute with water, saline, cola, orange juice.

Ensure adequate hydration when using to treat Distal Intestinal Obstruction Syndrome.



Standard Prescription:

n-acetylcysteine__% solution__mL nebulized__(frequency)

n-acetylcysteine 20% solution__mL PO__(frequency)

n-acetylcysteine 10% solution__mL enema PR__(frequency)

n-acetylcysteine 10% solution__mL irritation into urinary catheter x 1