Acetylcysteine 100mg granules for oral solution sachets
Requires a prescription from a doctor or prescriber
Official documents, adverse reaction reporting, and safety monitoring
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Official medicine documents
Yellow Card
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Drug safety updates
MHRA alerts for Acetylcysteine
Safety monitoring data
Yellow Card reports
The MHRA Yellow Card scheme collects reports of suspected side effects from healthcare professionals and patients. View the Drug Analysis Profile (iDAP) for real-world adverse reaction data.
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Suspected adverse reactions reported for Acetylcysteine
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Submit a Yellow Card report to the MHRA
Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
The European Medicines Agency (EMA) collects suspected adverse reaction reports from across the EU/EEA through the EudraVigilance system. Search for safety data on this medicine.
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Suspected adverse reactions reported for Acetylcysteine
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EudraVigilance data is published by the European Medicines Agency (EMA). A suspected adverse reaction is not necessarily caused by the medicine.
2 branded products available
WHO defined daily dose (DDD)
500 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via the NHS dm+d supplementary mapping files (NHSBSA). Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(2)
Cough (acute): antimicrobial prescribing (NG120)
Idiopathic pulmonary fibrosis in adults: diagnosis and management (CG163)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
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Supply & safety information
Official UK regulator monitoring and safety alerts
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. Shortage and safety information sourced from MHRA drug safety updates (gov.uk, Crown Copyright under OGL v3.0).
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 37 · Randomised trials: 13 · 2003–2026
Showing the 50 most relevant studies, sorted by most relevant.
Act Investigators
Circulation, 2011
M. Decramer, M. R. Mölken, T. Troosters, et al.
Lancet, 2005
K. Gray, M. Carpenter, N. Baker, et al.
The American journal of psychiatry, 2012
A. Hardan, Lawrence K. Fung, Robin A. Libove, et al.
Biological psychiatry, 2012
F. Martinez
Yearbook of Pulmonary Disease, 2015
Jinping Zheng, F. Wen, C. Bai, et al.
The Lancet. Respiratory medicine, 2014
J. Grant, S. Chamberlain, S. Redden, et al.
JAMA psychiatry, 2016
Wei Zheng, Q. Zhang, D. Cai, et al.
Acta Psychiatrica Scandinavica, 2018
Caitlin O. B. Yolland, Donal Hanratty, E. Neill, et al.
Australian & New Zealand Journal of Psychiatry, 2019
M. Eddleston, J. Coyle
2013
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
5.6 hours
Mechanism
A number of possible mechanisms for the mucolytic activity of acetylcysteine have been proposed.
Food interactions
None known
Human targets
11 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
26.5 µg/mL
Half-life
5.6 hours
[A228093]
Protein binding
66-97%
[A228103]
Volume of distribution
0.47 L/kg
[L31383]
Metabolism
[A228088][A18144]
…
Elimination
13-38%
[A228148]
…
Clearance
0.11 L/h
[L31383]
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Acetylcysteine was granted FDA approval on 14 September 1963.[L31488]
[L31378][L31383][L31388][L31478]
Known interactions with other medicines. Always consult a healthcare professional.
Showing 50 of 65 interactions
[A228098]
Treat patients with symptomatic and supportive measures.
[L31383]
Hemodialysis may remove some acetylcysteine from circulation as it is somewhat protein bound.
[L31383]
In the case of acetaminophen overdoses, a portion of the drug is metabolized by CYP2E1 to form the potentially toxic metabolite N-acetyl-p-benzoquinone imine (NAPQI).[L31388] The amount of NAPQI produced in an overdose saturates and depletes glutathione stores.[L31388] The free NAPQI promiscuously binds to proteins in hepatocytes, leading to cellular necrosis.[L31388] Acetylcysteine can directly conjugate NAPQI or provide cysteine for glutathione production and NAPQI conjugation.[L31388]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[L31478]
[A228093]
[A228103]
[L31383]
[A228088][A18144]
[A228148]
[L31383]
Proteins and enzymes this drug interacts with in the body
PMID:7646467 PMID:9215686
Glutathione (gamma-glutamylcysteinylglycine, GSH) is the most abundant intracellular thiol in living aerobic cells and is required for numerous processes including the protection of cells against oxidative damage, amino acid transport, the detoxification of foreign compounds, the maintenance of protein sulfhydryl groups in a reduced state and acts as a cofactor for a number of enzymes .
PMID:10369661
Participates in ophthalmate biosynthesis in hepatocytes (By similarity)
PMID:11133847 PMID:11417227 PMID:14722095 PMID:15151999 PMID:34880232 PMID:35245456 PMID:35352032
Provides L-cystine for the maintenance of the redox balance between extracellular L-cystine and L-cysteine and for the maintenance of the intracellular levels of glutathione that is essential for cells protection from oxidative stress (By similarity). The transport is sodium-independent, electroneutral with a stoichiometry of 1:1, and is drove by the high intracellular concentration of L-glutamate and the intracellular reduction of L-cystine .
PMID:11133847 PMID:11417227
In addition, mediates the import of L-kynurenine leading to anti-ferroptotic signaling propagation required to maintain L-cystine and glutathione homeostasis .
PMID:35245456
Moreover, mediates N-acetyl-L-cysteine uptake into the placenta leading to subsequently down-regulation of pathways associated with oxidative stress, inflammation and apoptosis .
PMID:34120018
In vitro can also transport L-aspartate .
PMID:11417227
May participate in astrocyte and meningeal cell proliferation during development and can provide neuroprotection by promoting glutathione synthesis and delivery from non-neuronal cells such as astrocytes and meningeal cells to immature neurons (By similarity). Controls the production of pheomelanin pigment directly (By similarity)
PMID:20434986 PMID:20797629 PMID:21138416 PMID:30337470 PMID:9346484
Acts as a part of the canonical IKK complex in the conventional pathway of NF-kappa-B activation .
PMID:9346484
Phosphorylates inhibitors of NF-kappa-B on 2 critical serine residues .
PMID:20434986 PMID:20797629 PMID:21138416 PMID:9346484
These modifications allow polyubiquitination of the inhibitors and subsequent degradation by the proteasome .
PMID:20434986 PMID:20797629 PMID:21138416 PMID:9346484
In turn, free NF-kappa-B is translocated into the nucleus and activates the transcription of hundreds of genes involved in immune response, growth control, or protection against apoptosis .
PMID:20434986 PMID:20797629 PMID:21138416 PMID:9346484
In addition to the NF-kappa-B inhibitors, phosphorylates several other components of the signaling pathway including NEMO/IKBKG, NF-kappa-B subunits RELA and NFKB1, as well as IKK-related kinases TBK1 and IKBKE .
PMID:11297557 PMID:14673179 PMID:20410276 PMID:21138416
IKK-related kinase phosphorylations may prevent the overproduction of inflammatory mediators since they exert a negative regulation on canonical IKKs .
PMID:11297557 PMID:20410276 PMID:21138416
Phosphorylates FOXO3, mediating the TNF-dependent inactivation of this pro-apoptotic transcription factor .
PMID:15084260
Also phosphorylates other substrates including NAA10, NCOA3, BCL10 and IRS1 .
PMID:17213322 PMID:19716809
Phosphorylates RIPK1 at 'Ser-25' which represses its kinase activity and consequently prevents TNF-mediated RIPK1-dependent cell death (By similarity). Phosphorylates the C-terminus of IRF5, stimulating IRF5 homodimerization and translocation into the nucleus .
PMID:25326418
Following bacterial lipopolysaccharide (LPS)-induced TLR4 endocytosis, phosphorylates STAT1 at 'Thr-749' which restricts interferon signaling and anti-inflammatory responses and promotes innate inflammatory responses .
PMID:38621137
IKBKB-mediated phosphorylation of STAT1 at 'Thr-749' promotes binding of STAT1 to the ARID5A promoter, resulting in transcriptional activation of ARID5A and subsequent ARID5A-mediated stabilization of IL6 .
PMID:32209697
It also promotes binding of STAT1 to the IL12B promoter and activation of IL12B transcription PMID:32209697
Enzymes involved in drug metabolism — important for understanding drug interactions
Proteins that transport this drug across cell membranes
PMID:10358072 PMID:15159445 PMID:17412826
Shows broad substrate specificity, can transport both organic anions such as bile acid taurocholate (cholyltaurine) and conjugated steroids (dehydroepiandrosterone 3-sulfate, 17-beta-glucuronosyl estradiol, and estrone 3-sulfate), as well as eicosanoids (prostaglandin E2, thromboxane B2, leukotriene C4, and leukotriene E4), and thyroid hormones (T4/L-thyroxine, and T3/3,3',5'-triiodo-L-thyronine) .
PMID:10358072 PMID:10601278 PMID:10873595 PMID:11159893 PMID:12196548 PMID:12568656 PMID:15159445 PMID:15970799 PMID:16627748 PMID:17412826 PMID:19129463 PMID:26979622
Can take up bilirubin glucuronides from plasma into the liver, contributing to the detoxification-enhancing liver-blood shuttling loop .
PMID:22232210
Involved in the clearance of endogenous and exogenous substrates from the liver .
PMID:10358072 PMID:10601278
Transports coproporphyrin I and III, by-products of heme synthesis, and may be involved in their hepatic disposition .
PMID:26383540
May contribute to regulate the transport of organic compounds in testes across the blood-testis-barrier (Probable). Can transport HMG-CoA reductase inhibitors (also known as statins), such as pravastatin and pitavastatin, a clinically important class of hypolipidemic drugs .
PMID:10601278 PMID:15159445 PMID:15970799
May play an important role in plasma and tissue distribution of the structurally diverse chemotherapeutic drug methotrexate .
PMID:23243220
May also transport antihypertension agents, such as the angiotensin-converting enzyme (ACE) inhibitor prodrug enalapril, and the highly selective angiotensin II AT1-receptor antagonist valsartan, in the liver .
PMID:16624871 PMID:16627748
Shows a pH-sensitive substrate specificity towards prostaglandin E2 and T4 which may be ascribed to the protonation state of the binding site and leads to a stimulation of substrate transport in an acidic microenvironment .
PMID:19129463
Hydrogencarbonate/HCO3(-) acts as the probable counteranion that exchanges for organic anions PMID:19129463
PMID:11669456 PMID:11907186 PMID:14675047 PMID:22108572 PMID:23832370 PMID:28534121 PMID:9950961
Mediates the uptake of OA across the basolateral side of proximal tubule epithelial cells, thereby contributing to the renal elimination of endogenous OA from the systemic circulation into the urine .
PMID:9887087
Functions as a biopterin transporters involved in the uptake and the secretion of coenzymes tetrahydrobiopterin (BH4), dihydrobiopterin (BH2) and sepiapterin to urine, thereby determining baseline levels of blood biopterins .
PMID:28534121
Transports prostaglandin E2 (PGE2) and prostaglandin F2-alpha (PGF2-alpha) and may contribute to their renal excretion .
PMID:11907186
Also mediates the uptake of cyclic nucleotides such as cAMP and cGMP .
PMID:26377792
Involved in the transport of neuroactive tryptophan metabolites kynurenate (KYNA) and xanthurenate (XA) and may contribute to their secretion from the brain .
PMID:22108572 PMID:23832370
May transport glutamate .
PMID:26377792
Also involved in the disposition of uremic toxins and potentially toxic xenobiotics by the renal organic anion secretory pathway, helping reduce their undesired toxicological effects on the body .
PMID:11669456 PMID:14675047
Uremic toxins include the indoxyl sulfate (IS), hippurate/N-benzoylglycine (HA), indole acetate (IA), 3-carboxy-4- methyl-5-propyl-2-furanpropionate (CMPF) and urate .
PMID:14675047 PMID:26377792
Xenobiotics include the mycotoxin ochratoxin (OTA) .
PMID:11669456
May also contribute to the transport of organic compounds in testes across the blood-testis-barrier PMID:35307651
Proteins that carry this drug through the body
PMID:19021548
Major calcium and magnesium transporter in plasma, binds approximately 45% of circulating calcium and magnesium in plasma (By similarity).
Potentially has more than two calcium-binding sites and might additionally bind calcium in a non-specific manner (By similarity). The shared binding site between zinc and calcium at residue Asp-273 suggests a crosstalk between zinc and calcium transport in the blood (By similarity). The rank order of affinity is zinc > calcium > magnesium (By similarity).
Binds to the bacterial siderophore enterobactin and inhibits enterobactin-mediated iron uptake of E.coli from ferric transferrin, and may thereby limit the utilization of iron and growth of enteric bacteria such as E.coli .
PMID:6234017
Does not prevent iron uptake by the bacterial siderophore aerobactin PMID:6234017
ATC R05CB01
ATC S01XA08
ATC V03AB23
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Show
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Acetylcysteine
Additional database identifiers
Drugs Product Database (DPD)
10303
ChemSpider
11540
BindingDB
50420190
PDB
SC2
ZINC
ZINC000003589203
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4624
GenAtlas
GSS
GeneCards
GSS
GenBank Gene Database
L42531
GenBank Protein Database
886284
UniProt Accession
GSHB_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:11059
GenAtlas
SLC7A11
GeneCards
SLC7A11
GenBank Gene Database
AB026891
GenBank Protein Database
5668545
Guide to Pharmacology
902
UniProt Accession
XCT_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:177
GenAtlas
ACY1
GeneCards
ACY1
GenBank Gene Database
L07548
GenBank Protein Database
178071
UniProt Accession
ACY1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:5960
GenAtlas
IKBKB
GeneCards
IKBKB
GenBank Gene Database
AF029684
GenBank Protein Database
2599558
Guide to Pharmacology
2039
UniProt Accession
IKKB_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:1974
GeneCards
CHUK
Guide to Pharmacology
1989
UniProt Accession
IKKA_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4586
GenAtlas
GRIN2B
GeneCards
GRIN2B
GenBank Gene Database
U90278
GenBank Protein Database
1899202
Guide to Pharmacology
457
UniProt Accession
NMDE2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4584
GenAtlas
GRIN1
GeneCards
GRIN1
GenBank Gene Database
D13515
GenBank Protein Database
219920
Guide to Pharmacology
455
UniProt Accession
NMDZ1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4585
GenAtlas
GRIN2A
GeneCards
GRIN2A
GenBank Gene Database
U09002
GenBank Protein Database
558749
Guide to Pharmacology
456
UniProt Accession
NMDE1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4588
GenAtlas
GRIN2D
GeneCards
GRIN2D
GenBank Gene Database
U77783
GenBank Protein Database
2444026
UniProt Accession
NMDE4_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:16767
GenAtlas
GRIN3A
GeneCards
GRIN3A
GenBank Gene Database
AJ416950
GenBank Protein Database
20372905
UniProt Accession
NMD3A_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:177
GenAtlas
ACY1
GeneCards
ACY1
GenBank Gene Database
L07548
GenBank Protein Database
178071
UniProt Accession
ACY1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:399
GenAtlas
ALB
GeneCards
ALB
GenBank Gene Database
V00494
GenBank Protein Database
28590
UniProt Accession
ALBU_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:10959
GenAtlas
SLCO1B1
GeneCards
SLCO1B1
GenBank Gene Database
AF060500
GenBank Protein Database
5051630
Guide to Pharmacology
1220
UniProt Accession
SO1B1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:10970
GenAtlas
hROAT1
GeneCards
SLC22A6
GenBank Gene Database
AF057039
GenBank Protein Database
3831566
Guide to Pharmacology
1025
UniProt Accession
S22A6_HUMAN
DrugBank citations
If you use DrugBank data in your research, please cite:
- DrugBank 6.02024Recommended citationKnox C., Wilson M., Klinger C.M., et alDrugBank 6.0: the DrugBank Knowledgebase for 2024Nucleic Acids Res. 2024 Jan 552(D1):D1265-D1275
- DrugBank 5.02018Wishart D.S., Feunang Y.D., Guo A.C., et alDrugBank 5.0: a major update to the DrugBank database for 2018Nucleic Acids Res. 2017 Nov 846(D1):D1074-D1082
- DrugBank 4.02014Law V., Knox C., Djoumbou Y., et alDrugBank 4.0: shedding new light on drug metabolismNucleic Acids Res. 2014 Jan 142(1):D1091-7
- DrugBank 3.02011Knox C., Law V., Jewison T., et alDrugBank 3.0: a comprehensive resource for 'omics' research on drugsNucleic Acids Res. 2011 Jan39(Database issue):D1035-41
- DrugBank 2.02008Wishart D.S., Knox C., Guo A.C., et alDrugBank: a knowledgebase for drugs, drug actions and drug targets.Nucleic Acids Research2008 Jan36(Database issue):D901-6
- DrugBank 1.02006Wishart D.S., Knox C., Guo A.C., et alDrugBank: a comprehensive resource for in silico drug discovery and exploration.Nucleic Acids Research2006 Jan 134(Database issue):D668-72