**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.
**Drug Name:** ACC Long 600 mg effervescent tablets
**Manufacturer:**
ACC Long 600 mg effervescent tablets are primarily manufactured by Sandoz, a company belonging to HEXAL AG.
**Main Commentary Body:**
ACC Long 600 mg effervescent tablets contain acetylcysteine, a mucolytic agent used to thin and loosen viscous mucus in the airways. This action helps to facilitate the clearance of phlegm, making it easier to cough up and relieve congestion associated with various respiratory conditions.
* **Indications and Usage:**
ACC Long 600 mg effervescent tablets are indicated for the secretolytic therapy of acute and chronic bronchopulmonary diseases that are accompanied by impaired formation and transport of mucus. This includes conditions such as cold-induced bronchitis in adolescents over 14 years of age and adults.
* **Characteristics:**
The active substance in ACC Long is acetylcysteine, which belongs to a group of medicines called mucolytics. Acetylcysteine works by breaking down the disulfide bonds within the mucopolysaccharide chains in mucus, thereby reducing its viscosity and making it less sticky. This depolymerizing effect helps to liquefy the phlegm, allowing for easier expectoration. Additionally, acetylcysteine has antioxidant properties and contributes to the synthesis of glutathione, which is important for detoxification processes in the body.
* **Dosage and Administration:**
ACC Long 600 mg effervescent tablets are for oral administration. The tablets should be dissolved completely in a glass of drinking water and consumed immediately after meals.
* **Adults and adolescents from 14 years of age:** The usual dose is half an effervescent tablet twice daily or one effervescent tablet once daily, equivalent to 600 mg of acetylcysteine per day.
* **Duration of Use:** ACC Long should not be taken for more than 14 days without medical advice. If symptoms worsen or do not improve after 4-5 days, a doctor should be consulted.
* **Children:** Due to the high content of the active substance, ACC Long 600 mg is generally not recommended for children under 14 years of age. Lower doses or different formulations are available for younger children.
* **Contraindications:**
ACC Long 600 mg effervescent tablets should not be used in individuals with:
* Hypersensitivity or allergy to acetylcysteine or any of the other ingredients.
* Active peptic ulceration or a history of stomach ulcers.
* Children under 2 years of age, as mucolytics can lead to airway blockage in this age group due to their limited ability to cough up mucus.
* **Warnings and Precautions:**
* **Asthma:** Use with caution in asthmatic patients, as acetylcysteine can induce bronchospasm. If bronchospasm occurs, discontinue use immediately and seek medical attention.
* **Gastrointestinal Issues:** Caution is advised in patients with a history of stomach ulcers, as there is a theoretical risk that mucolytics may disrupt the gastric mucosal barrier.
* **Histamine Intolerance:** Prolonged treatment should be avoided in patients with histamine intolerance, as acetylcysteine affects histamine metabolism and may cause symptoms like headache, runny nose, or itching.
* **Sugar Content:** The effervescent tablets contain lactose and sorbitol. Patients with rare hereditary conditions of lactose/fructose or galactose intolerance should not take this medicine. It may also affect blood sugar control in diabetic patients.
* **Sodium Content:** The tablets contain sodium, which should be considered by patients on a controlled sodium diet or those with kidney disease.
* **Increased Secretions:** At the beginning of treatment, the thick phlegm may become more fluid, and its volume may increase. If unable to efficiently cough up this fluid, medical consultation is necessary.
* **Pregnancy and Breastfeeding:** Use during pregnancy and breastfeeding is generally not recommended due to limited data and should only be considered if clearly necessary and advised by a healthcare professional.
* **Severe Skin Reactions:** Very rare cases of severe skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported. If new skin or mucosal changes occur, discontinue use and seek immediate medical advice.
* **Nutrient Absorption and Metabolism (Pharmacokinetics):**
Following oral administration, acetylcysteine is rapidly and almost completely absorbed. It is then metabolized in the liver to cysteine, which is the pharmacologically active metabolite, as well as other disulfides. Due to a significant first-pass effect, the oral bioavailability of acetylcysteine is relatively low (approximately 10%). Maximum plasma concentrations are typically achieved within 1-3 hours. The mean terminal half-life in adults is about 5.6 hours. Acetylcysteine is largely protein-bound (66-97%), mainly to albumin. It is primarily eliminated via the urine, with a small portion recovered in feces.
* **Side Effects:**
Like all medicines, ACC Long can cause side effects, although not everybody gets them.
* **Common (may affect up to 1 in 10 people):** Nausea, vomiting, diarrhea, abdominal pain, stomatitis (inflammation of the mouth).
* **Uncommon (may affect up to 1 in 100 people):** Hypersensitivity reactions (e.g., rash, itching, urticaria, angioedema), headache, fever, hypotension (low blood pressure).
* **Rare (may affect up to 1 in 1,000 people):** Dyspnea (difficulty breathing), bronchospasm (tightening of airways).
* **Very Rare (may affect up to 1 in 10,000 people):** Severe skin reactions (e.g., Stevens-Johnson syndrome, Lyell's syndrome), severe allergic reactions (anaphylactic shock), bleeding.
* **Drug Interactions:**
* **Cough Suppressants:** Combined use with cough-relieving agents (antitussives) is not recommended, as it may lead to a dangerous accumulation of secretions due to the reduced cough reflex.
* **Nitroglycerin:** Acetylcysteine may enhance the vasodilatory effects of nitroglycerin, potentially leading to significant hypotension and headaches.
* **Activated Charcoal:** High doses of activated charcoal (used as an antidote) can reduce the effectiveness of acetylcysteine by decreasing its absorption.
* **Antibiotics:** It is advisable to take antibiotics at least two hours before or after ACC Long, as acetylcysteine can affect the efficacy of some antibiotics.
* **Other Medications:** Do not dissolve ACC Long effervescent tablets simultaneously with other medications in the same glass of water.
* **Patient Counseling:**
* Always dissolve the effervescent tablet completely in a glass of water before taking it.
* Take the medicine after meals.
* Do not exceed the recommended daily dose, as this can lead to gastrointestinal irritation.
* If symptoms persist or worsen after 4-5 days, or if you experience any severe side effects, consult your doctor or pharmacist immediately.
* Inform your healthcare provider about all other medications, supplements, or herbal remedies you are taking to avoid potential interactions.
* Store the tablets in a dry place below 25°C and keep them out of reach of children.
**Sources:**
1. Sandoz Patient Information Leaflet ACC® 600 (effervescent tablets): [https://bit.ly/acc600pil](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFvxnDF-sVFmnPuOY7ZqabJkly14VmoLgyoAfC9q1KZPSGscPzeTfEfKH1uRzgwgcqJZiHnA9B8aN-pks9vZLYT38NXp2zC4B1AVaE5KYavlF0R4ASJnfDlUwpZ0BEzxeRu9yOQpzUTn7rDa96uL17IczsWWXYXRuf0t9M46CrDO4BaW2CvAWrfzYm2QUakq7cP_v_msZg=)
2. MIMS Philippines - ACC: Dosages and Ingredients: [https://bit.ly/mimsacc](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQETf7EFVmi8ZiYZx0nbtdm1JjO3MU3zea5kj8de7r2gda0A5PG88LsCGbheWCS4N-wwUxu5k40CwgLhPUw7URhNDFtr5yXHwbnOQsx1PBDd8U77GNBgA4tUj7TP60mvqbMWj0s4Mz7K8MmHMefh5r7PJ5o=)
3. Sandoz - ACC® 600 (effervescent tablets) PIL (South Africa): [https://bit.ly/acc600sandoz](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQHEdUcjtmY1EukqCt3RYdnZo4v8WxX_YucdpRWuQCWPp86Dell5S7f4US11_ZhrndEzZ5a0CsPZ5qslHKUCA8eppm2KovcGE-3iYLS7D4W6vUf6js6mh9Xs8NMlxC1y_LNnGXKt_L0Z4hR8j_BEHd3AoG0YjqakFcxt7JP7EHzyYBzZCMDrOeGBIdR1NmaMIBlKfTE=)
4. Nahdi - ACC Long 600mg Effervescent Tablets: [https://bit.ly/nahdiacclong](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQEXeVr-GQhl--Mkmat43XJWsbKZh94jnJG3ZknUJx2WyfBao2diSyVIoZM428-g1cynWQ4j0i_1aS3wvyBBQCM8yG9jvvKHzEDsPwIUT9-c82hs3r3qF2YlMqT4LSroEmeSz5S5tnkx4XHRNlDSJWXLihn6Dfkg0ud7lp8Wl1TX3lD0XTAIMu4sGDny4goNrs0HSRg=)
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