How to dilute ACC powder: instructions for use for children. ACC cough: instructions for use, analogues, reviews

ACC: instructions for use

Compound

Description

Indications for use

Respiratory diseases accompanied by the formation of viscous sputum difficult to separate: acute and chronic bronchitis, obstructive bronchitis, laryngotracheitis, pneumonia, bronchiectasis, bronchial asthma, bronchiolitis, cystic fibrosis.

Acute and chronic sinusitis, inflammation of the middle ear (otitis media). Contraindications:

Hypersensitivity to acetylcysteine ​​or other components of the drug, pregnancy, lactation, children under 2 years of age.

With caution - peptic ulcer of the stomach and duodenum in the acute stage; hemoptysis, pulmonary bleeding, varicose veins of the esophagus, bronchial asthma, adrenal disease, liver and / or kidney failure.

Pregnancy and lactation period:

As a safety precaution, due to insufficient data, prescribing 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.

Dosage and administration

Mucolytic therapy:

2 sachets of ACC 100 mg 2 times a day (300-400 mg per day). ACC 200 mg should be taken

3 times a day for 1/2 sachet or 2 times a day for 1 sachet (300-400 mg per day).

Cystic fibrosis:

For patients with cystic fibrosis and weighing more than 30 kg, if necessary, it is possible to increase the dose to 800 mg of acetylcysteine ​​per day.

The granules should be dissolved in water, juice or iced tea and taken after meals. Additional fluid intake enhances the mucolytic effect of the drug.

With short-term colds, the duration of administration is 5-7 days. In case of long-term diseases, the duration of therapy is determined by the attending physician. In chronic bronchitis and cystic fibrosis, the drug should be taken for a longer time to achieve a preventive effect in infections. Note for diabetic patients:

1 sachet of ACC 100 mg corresponds to 0.24 BE.

1 sachet of ACC 200 mg corresponds to 0.23 BE.

Side effect

In rare cases, headaches, inflammation of the oral mucosa, stomatitis and tinnitus are observed. Extremely rare - J diarrhea, vomiting, heartburn and nausea, a drop in blood pressure, an increase in heart rate (tachycardia).

In isolated cases, allergic reactions are observed, such as bronchospasm (mainly in patients with bronchial hyperreactivity), skin rash, itching and urticaria. In addition, there are isolated reports of the development of bleeding due to the presence of hypersensitivity reactions.

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

Overdose

With an erroneous or deliberate overdose, such phenomena as diarrhea, vomiting, stomach pain, heartburn and nausea are observed. So far, no severe and life-threatening side effects have been observed. Interaction with other means:

With the simultaneous use of acetylcysteine ​​and antitussives, due to the suppression of the cough reflex, mucus stagnation may occur. Therefore, such combinations should be chosen with caution.

Simultaneous administration of acetylcysteine ​​and nitroglycerin can lead to an increase in the vasodilating effect of the latter. Pharmaceutically incompatible with antibiotics (penicillins, cephalosporins, erythromycin, tetracycline.

Application features

Patients with bronchial asthma and obstructive bronchitis should be prescribed acetylcysteine ​​with caution under the systematic control of bronchial patency.

In the treatment of patients with diabetes, it must be taken into account that the drug contains sucrose.

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

Release form

Storage conditions

Best before date

Terms of dispensing from pharmacies

Self-medication can be harmful to your health.
It is necessary to consult a doctor, and also read the instructions before use.

You are an active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle and your body will delight you throughout your life. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and severe emotional overload. Try to minimize contact with sick people, in case of forced contact, do not forget about protective equipment (mask, washing hands and face, cleaning the respiratory tract).

Pharmachologic effect:
The active substance is acetylcysteine, a cysteine ​​derivative (amino acid). It has a mucolytic, expectorant effect due to the rupture of bisulfide bonds of sputum mucopolysaccharides. This depolymerizes mucoproteins and increases the viscosity of bronchial secretions. As a result, mucociliary clearance increases and sputum discharge improves. Acetylcysteine ​​has an antioxidant and pneumoprotective effect, which is associated with the binding properties of sulfhydryl groups. It is an antidote for acute poisoning with aldehydes, paracetamol and phenols (the detoxifying effect is possible due to increased production of glutathione).

Acetylcysteine ​​with internal use is almost immediately completely absorbed from the gastrointestinal tract. The active metabolite is cysteine, which is formed in the liver. Further, the metabolism of acetylcysteine ​​passes through the formation of diacetylcysteine, cystine. The end product of metabolism is mixed disulfides.

Bioavailability is 10%. Cmax is determined for internal use after 1-3 hours. Plasma proteins bind 50% of acetylcysteine. The maximum concentration of the pharmacologically active metabolite in the blood is 2 µmol/l.

Inactive metabolites are excreted in the urine (inorganic sulfates, diacetylcysteine), however, a non-cordial amount of acetylcysteine ​​is excreted unchanged in the feces.

The half-life of acetylcysteine ​​depends on biotransformation in the liver. In liver failure, it is 8 hours, while normally it is 1 hour. It passes through the hematoplacental barrier and can accumulate in the fetal waters.

ACC (ACC) method of administration and dose:
The daily dose for the treatment of cystic fibrosis in patients weighing more than 30 kg is used up to 800 mg.
Children from the 10th day of life and up to 2 years old use 50 mg 2-3 r / s.
At the age of 2-5 years - 400 mg per day, divided into 4 doses.
From 6 years old - 600 mg / s (divided into 3 doses). Treatment is continued for a long time, courses for several months (3-6).
In all other cases, the daily dose for children from 14 years of age and adults is 400-600 mg.
From 6 to 14 years old - 300-400 mg (divided into 2 doses).
2-5 years - 200-300 mg (divided into 2 doses).
Children from the 10th day of life and up to 2 years old use 50 mg 2-3 r / s. In acute diseases without complications, the product is prescribed for 5-7 days. In the case of the presence of complications or in the case of a chronic course, course treatment is possible (up to 6 months).

ACC is taken after a meal. The tablet or the contents of the sachet must be dissolved in half a glass of liquid (cold tea, water, juice).

ACC (ACC) contraindications:
Hypersensitivity to acetylcysteine ​​and excipients
peptic ulcer
hereditary fructose intolerance
Pulmonary bleeding or hemoptysis
In pediatric practice - with hepatitis and renal failure (the threat of accumulation of nitrogen-containing products).

ACC (ACC) side effects:
From the gastrointestinal tract - stomatitis, nausea, vomiting, diarrhea, heartburn.
From the side of the central nervous system - headache, tinnitus.
From the side of the CCC - arterial hypotension, increased heart rate.

Allergic reactions - bronchospasm (especially with bronchial hyperreactivity), rash and itching of the skin. Often the cause of hypersensitivity to the product is the presence of propyl and methyl parahydroxybenzoate in the composition.

Pregnancy:
There is no embryotoxic effect in acetylcysteine, however, during pregnancy, as well as during breastfeeding, it is prescribed only if there are indications under the supervision of a physician.

Overdose:
In pediatric practice, cases of hypersecretion in infants are described. Side effects that threaten life and health are not described. In case of overdose (dyspeptic disorders), symptomatic therapy is prescribed.

Use with other medicinal products:
Tetracycline and its derivatives (except doxycycline) cannot be used together with ACC in pediatrics.
During experimental in vitro studies, there were no cases of inactivation of other types of antibacterial products. However, it is recommended to observe the interval between taking ACC and antibiotic at least 2 hours. In vitro, the incompatibility of acetylcysteine ​​with semi-synthetic penicillins, aminoglycoside and cephalosporin antibiotics has been proven. Such studies have not been conducted with erythromycin, amoxicillin and cefuroxime.

Simultaneous use of antitussive drugs can lead to stagnation of the secretion of the respiratory tract.

The use of nitroglycerin may enhance the vasodilating effect in the aftermath.

Release form:
ACC 100, 200- effervescent tablets of 20 pcs.
ACC hot drink- powder for preparing a hot drink for internal use - 200 mg (20 sachets) and 600 mg (6 sachets).
ACC-long- effervescent tablets (600 mg), 10 pcs. in a tube.
ACC powder for the preparation of a solution for oral administration - 100, 200 mg, 2 pcs. in a pack.

ACC for children- powder for the preparation of a solution for oral administration 30 g in a 75 ml vial (20 mg / ml) and 60 g in a 150 ml vial (20 mg / ml).

Storage conditions:
In places inaccessible to children. Temperature not more than 30°С. The finished solution should be stored for no more than 12 days in the refrigerator (at a temperature of 2-8°C).

ACC (ACC) composition:
Effervescent tablets: acetylcysteine ​​and auxiliary components (ascorbic acid, sucrose, saccharin, flavoring).

Powder: acetylcysteine ​​and auxiliary components (sucrose).

ACC Long effervescent tablets: acetylcysteine ​​and auxiliary components (ascorbic acid, sodium citrate, saccharin, sodium cyclamate, lactose, citric acid, sodium carbonate, mannitol, sodium bicarbonate, flavoring).

ACC for children: acetylcysteine.

Additionally:
ACC is used with caution in gastric or duodenal ulcers.

When preparing a solution, a patient with bronchial asthma can inhale air with particles of the product, which causes irritation of the mucous membrane of the upper respiratory tract and can provoke reflex bronchospasm.

For the best mucolytic effect in the treatment with acetylcysteine, it is necessary to take a lot of liquid.

10 ml of the prepared oral solution contains 0.31 carbohydrate units, which should be taken into account for patients with diabetes.

Sorbitol has a slight laxative effect on the stool.

For newborns and children under 1 year of age, acetylcysteine ​​​​is used exclusively for health reasons under strict medical supervision. The recommended dosage (10 mg/kg body weight) must not be changed.
ACC 200 is not used at the age of up to 2 years.
ACC Long is not recommended for children under 14 years of age.

The speed of reaction when driving and working with machinery does not change when taking acetylcysteine.

Attention!
Before using the medication "ACC (ACC)" you need to consult a doctor.
The instructions are provided solely for familiarization with " ACC (ACC)».

In accordance with the instructions for medical use, tablets ACC®? should be dissolved in 1 glass of water and taken after meals.
Additional fluid intake enhances mucolytic effect of the drug.

How long can the prepared solution be stored?

The prepared solution should be taken immediately after dissolving the tablets or granules to prepare the solution. In exceptional cases, you can leave the solution ready for use for 2 hours.

What is the duration of taking ACC®?

For short term colds duration of admission is from 4-5 to 5-7 days.
In chronic bronchitis of various etiologies, the drug should be taken for a longer time under the supervision of a specialist. This will achieve a preventive effect.

In cystic fibrosis, acetylcysteine ​​is part of the basic therapy and is taken for a long time according to an individual scheme.

Are there any features of taking ACC® in conjunction with other drugs?

Acetylcysteine ​​is an active substance, so it is important to know how it interacts with other drugs:

• with the simultaneous use of acetylcysteine ​​and antitussives, due to the suppression of the cough reflex, sputum stagnation may occur, therefore such combinations are not recommended;
• simultaneous use with vasodilators and nitroglycerin may lead to increased vasodilating action;
• antibiotics are recommended to be taken no earlier than 2 hours after ingestion of acetylcysteine, so as not to reduce their absorption.

For more information about the interaction of the drug with other drugs, see the instructions for use.

By what signs can you understand that ACC® is working?

The following indicators are usually used as criteria for the effectiveness of mucolytic therapy in practice:

• cough productivity (subjective assessment: sputum began to cough up better);
• the time interval during which an unproductive (dry) cough 1 turned into a productive one;
• the duration of the detection of wheezing in the lungs (determined by a specialist);
• the duration of the period of illness in which obstruction persists in one of the sections of the respiratory tract (determined by a specialist).

At what age can you start taking ACC®?

ACC® can be used in children from 2 years of age in the form syrup, effervescent tablets (ACC® 100, ACC® 200) or granules for oral solution (orange) 100 mg and 200 mg.

Can ACC® be recommended for children with dry/unproductive cough (when sputum is not coughed up)?

If cough 1 that occurs at the peak of the ARVI season is accompanied by fever, intoxication, then DA-ACC® can be recommended at the onset of the disease. Since the appearance of a cough in this case is associated with inflammation of the respiratory tract, the accumulation of viscous sputum in the respiratory tract. ACC®, liquefying sputum, accelerates the transition from dry cough to productive and reduces the duration of the disease. 2

What is the difference between acetylcysteine ​​and ambroxol?

Both acetylcysteine ​​and ambroxol are mucolytic agents. If we compare ACC® with other mucolytics, including ambroxol, then the secretolytic effect of ACC® develops faster 3 . Ambroxol, having mainly a mucoregulatory effect, slowly reduces the viscosity of sputum. The therapeutic effect is also enhanced by the antioxidant properties of acetylcysteine ​​4,5 .

What is drainage gymnastics?

There are special exercises aimed at improving sputum discharge - these are the so-called drainage exercises. To improve the drainage function of the bronchi are used special drainage provisions and forced expiration exercises.

Positional (postural) drainage is the use of a specific body position for better sputum discharge. Positional drainage is performed 2 times a day - in the morning and in the evening, but more often 1-2 hours after taking mucolytics. Within 20-30 minutes, the patient alternately takes positions that contribute to the maximum emptying of sputum from both lungs under the influence of gravity, so that it flows down the bronchi to the trachea and is more easily excreted when coughing.

In each position, the patient first performs 3-5 deep slow breaths, inhaling air through the nose, and exhaling through pursed lips. Then, after a slow deep breath, he coughs shallowly 3-4 times. Good results can be achieved by combining drainage positions with various methods of chest vibration over the drained lung.

1. Cough as a symptom of respiratory diseases, accompanied by the formation of viscous sputum that is difficult to separate.

2. Doctor, No. 8, 2010, p. 60-63

3. According to a comparative study involving 259 children with acute and chronic bronchopulmonary pathology under the age of 15 years (92 received acetylcysteine, 117 - abmroxol, 30 - bromhexine and 20 - mukaltin) it was found that on the 2nd day of the use of acetyl cysteine the cough becomes productive, on the 3rd day it decreased, on the 4th-5th day it disappeared. When taking Ambrokosla, the intensity of cough significantly decreased on the 4th day of therapy, and recovery occurred on the 5th-6th day. The action of bromhexine occurred on average 1-2 days later than abmroxol and 2-3 days later than acetyl cysteine. When prescribing Mukaltin, the cough was pronounced for 6-8 days and recovery occurred by 8-10 days from the onset of the disease.
Adapted from:
Zaitseva O.V. Rational choice of mucosal therapy in the treatment of respiratory diseases in children. RMJ, 2009, V.17, No. 19, p.1217-1222.

4. American Journal of Respiratory Medicine and Critical Care, 1997; (156):1897–1901

5. Instructions for the medical use of acetylcysteine ​​and ambroxol preparations, State Register of Medicines http://grls.rosminzdrav.ru/default.aspx, appeal dated 07/02/2018.

The drug "ACC" (in Russian, more often called ACC), is prescribed for coughing in the treatment of various types of colds. In addition, the drug is prescribed in the presence of allergic cough spasms, has several forms of release and dosage options, the choice of which depends on the age and weight of the patient. The longest duration of action is distinguished by ACC Long, the effect of which lasts for 12 hours. The last variation of the drug is taken only twice a day.

Cough spasms in their types can be both productive, in which sputum is released, and dry, most often manifested at the initial stage of a cold. Initially, the drug is positioned by manufacturers as a remedy for a wet cough, which helps to remove sputum from the respiratory system and makes breathing easier. However, ACC also helps with dry cough, bringing it to the productive stage.

In medical practice, it is customary to prescribe this medicine in various forms for the following ailments:

It should be borne in mind that the clinical benefit of this drug is possible only if it is used to treat ailments included in the list of those listed above. Thus, you should not try to stop the cough spasm with the help of ACC on your own. If the drug does not give any effect, then most likely the disease does not belong to the profile of its action.

How does the medicine work?

The drug "ACC" is considered an excellent way to deal with sputum that occurs in the cavity of the tract of the respiratory region, lungs and bronchi due to various kinds of infectious lesions. At the same time, sputum, trying to get out for natural reasons, provokes a cough, and often this substance turns out to be too viscous and dense, which leads to its too strong adhesion to the bronchi. With the help of "ACC" it is possible not only to fully establish, but also to advance the process of sputum discharge from the respiratory organs and its removal to the outside.

The main component of the drug is a derivative of cysteine, this amino acid directly affects the structure of sputum, changing its consistency. Mucus increases in its condition, easily detaches from the bronchi and is naturally excreted from the cavity of the respiratory tract. In connection with the removal of sputum, a healing process occurs, and the protective reactions of the mucous membranes are restored.

It is noteworthy that the action of "ACC" is aimed at eliminating not only the usual mucous sputum, but also the one in which purulent formations have already appeared. The drug is often used in conjunction with antibacterial drugs, since it facilitates the penetration of the latter into the mucous membrane of the respiratory system. It is important to observe the two-hour interval between medications. In addition to the active effect on sputum, cough medicine has antioxidant properties, respectively, acetylcysteine ​​greatly facilitates the course of any viral infection.

In fact, the drug eliminates the manifestation of symptoms characteristic of a severe flu, while simultaneously fighting cough spasms.

Instructions for use of tablets and powder ACC (ass) from dry cough

The correct dosage of the drug is calculated based on the type of ailment for which therapy is carried out, the age and weight of the patient. In addition, the dosages of "ACC" for dry cough for children and adults are different. When treating such a serious illness as cystic fibrosis, the daily dose of the drug is not more than 800 mg, provided that the patient's weight exceeds 30 kg. The duration of therapy can be very long and amount to at least 3-6 months. Treatment should be carried out only under the supervision of a doctor and taking into account the use of a complex of drugs.

For the treatment of dry-type cough spasm in other diseases of the respiratory tract for people over the age of 14, a dosage of 400 to 600 mg of the drug is indicated in the form of tablets or powder consistency at a time. If there is a too acute course of the disease, then taking drugs under the supervision of a doctor lasts at least a week. With a chronic illness, dry cough with the help of tablets or ACC powder can be treated for about six months.

According to the instructions for use, unless otherwise prescribed by the doctor, the drug is taken immediately after meals as an expectorant. The method of taking the medicine is as follows: powder or a certain number of tablets are dissolved in ½ glass of water or tea and drunk immediately.

The medication for children is carried out according to a different scheme, and here the important point is the type of drug regarding the dosage of the active component in it:

1. "ACC 100" is allowed from birth for the treatment of dry cough in infants. The dosage at the age of 2 years is 50 mg three times a day, then the dosage is increased to 100 mg in four doses, and after six years this medication should be taken at a dosage of 600 mg per day, which should be divided into three doses.
2. "ACC 200" is allowed only at the age of a child whose mark has exceeded 6 years, and the use of the drug is allowed only in the form of a solution. Do not use more than two sachets of powder dissolved in water during the course. For adolescents over the age of 14, the number of sachets is brought to three, which is equal to the adult dosage.
3. "ACC Long" is allowed only after 14 years, the daily dosage of this type of drug should not exceed 600 mg, and the patient should receive it at one time. The tablet dissolves in water and is taken immediately after a meal inside. The duration of storage of the solution does not exceed half an hour, otherwise the tablet needs to be re-dissolved for a new solution.

Children's cough syrup Ass

For the treatment of cough in children, manufacturers produce a special form of the drug "ACC" in the form of a syrup, the reception and tolerance of which is much lighter than the solution obtained on the basis of tablets or powder. The medicine in this form is also convenient in that it is ready for use and does not require additional dilution steps.

The calculation of the dosage of the syrup is carried out using a measuring cup, and it itself depends on the age and, accordingly, the weight of the child. In particular, 5 ml of the drug is equal to one quarter of a cup.

If the age of the child lies in the aisles from 2 to 6 years, then 5 ml should be taken no more than three times a day. After 7 years, the number of doses increases to 3-4, or it is permissible to use 10 ml at a time, but twice a day. After 15 years, the daily dose is 10 ml 3 times a day. As part of the drug there is also a special syringe for the convenience of calculating the dosage. Its use is very convenient for the treatment of very young children.

Contraindications and side effects

Like any medicine, ACC cough has its own contraindications, failure to comply with which can lead to side effects. According to the instructions developed by the drug manufacturers, it is forbidden to take it in the following cases:

• coughing up bloody mucus;
• bleeding in the lungs;
• fructose intolerance at the genetic level;
• individual intolerance to the main component of the drug and other substances in its composition;
• kidney failure, various liver diseases, especially hepatitis;
• the presence of a peptic ulcer.

As side effects when taking this drug, it is customary to consider such phenomena as various allergic reactions, heart palpitations, heartburn, a general disruption of the gastrointestinal tract, which manifests itself in the form of diarrhea and vomiting, headaches and tinnitus.

Allergic reactions are characteristic in the presence of individual intolerance to substances in the composition of the drug, in this case, immediate discontinuation of the drug is required due to the risk of Quincke's edema. In other cases, the study of the medicine did not lead to the identification of any situations in which its use would endanger human life. If any signs of side effects appear, you should immediately stop taking the drug and consult a doctor to adjust the treatment regimen.

The drug "ACC" is successfully used to treat various ailments, accompanied by a dry and productive cough. The drug and its dosage should be prescribed only by a doctor after the diagnosis.