Acc 200 mg sachets

**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 200 mg sachets

**Manufacturer:**

ACC 200 mg sachets are primarily manufactured by Sandoz, a global pharmaceutical company. Other manufacturers may also produce generic versions of acetylcysteine in sachet form. Always refer to the product packaging for the specific manufacturer details.

**Main Commentary Body:**

ACC 200 mg sachets contain Acetylcysteine, a mucolytic agent used to thin and loosen mucus in the respiratory tract. This facilitates easier expectoration and helps relieve symptoms associated with various respiratory conditions characterized by thick, viscous mucus. It is commonly used in both acute and chronic bronchopulmonary diseases.

**Indications and Usage:**

ACC 200 mg sachets are indicated for the liquefaction of bronchial secretions and to facilitate expectoration in diseases of the respiratory system associated with the formation of very viscous mucus. These conditions include:

* Acute and chronic bronchitis

* Cystic fibrosis

* Bronchiectasis

* Emphysema

* Other bronchopulmonary diseases with thick mucus

It is also used as an antidote for paracetamol (acetaminophen) overdose, though this commentary focuses on its mucolytic use.

**Characteristics:**

Acetylcysteine, the active ingredient in ACC 200 mg sachets, is a derivative of the amino acid cysteine. Its mucolytic action is attributed to its ability to break down disulfide bonds in mucoproteins, thereby reducing the viscosity of mucus. This makes the mucus thinner and easier to clear from the airways. Acetylcysteine also possesses antioxidant properties, which may contribute to its therapeutic effects in respiratory diseases.

**Dosage and Administration:**

ACC 200 mg sachets are for oral administration. The contents of one sachet should be dissolved in a small amount of water and taken immediately after dissolution. The typical dosage is as follows:

* **Adults and adolescents (14 years and older):** 200 mg (1 sachet) two to three times daily, or 600 mg (3 sachets of 200 mg or 1 sachet of 600 mg if available) once daily. The maximum recommended daily dose is 600 mg.

* **Children (6 to 14 years):** 200 mg (1 sachet) two times daily (corresponding to 400 mg of acetylcysteine per day).

* **Children (2 to 5 years):** 100 mg (half a sachet) two to three times daily (corresponding to 200-300 mg of acetylcysteine per day). Use in children under 2 years should be under medical supervision.

**Contraindications:**

ACC 200 mg sachets should not be used in individuals with:

* Hypersensitivity to acetylcysteine or any of the excipients.

* Active peptic ulcer disease (due to the potential for increased risk of gastrointestinal bleeding).

* Children under 2 years of age for mucolytic use, unless specifically directed and monitored by a physician.

**Warnings and Precautions:**

* **Asthma:** Patients with asthma should be closely monitored during treatment with acetylcysteine due to the risk of bronchospasm. If bronchospasm occurs, treatment should be discontinued immediately.

* **Gastric Ulcers:** Caution is advised in patients with a history of gastric or duodenal ulcers.

* **Cough Reflex Suppression:** Concomitant use with antitussives (cough suppressants) is not recommended, as this may lead to a dangerous accumulation of mucus due to suppressed cough reflex.

* **Sulfur Odor:** Acetylcysteine may have a slight sulfur odor, which is normal and does not indicate product degradation.

* **Pregnancy and Lactation:** Consult a healthcare professional before use during pregnancy or breastfeeding.

**Nutrient Absorption and Metabolism:**

Following oral administration, acetylcysteine is rapidly and almost completely absorbed from the gastrointestinal tract. It undergoes extensive first-pass metabolism in the liver, where it is deacetylated to cysteine and then further metabolized. Peak plasma concentrations are typically achieved within 1 to 2 hours after a 200-400 mg oral dose. Acetylcysteine and its metabolites are primarily excreted via the kidneys. The elimination half-life is approximately 5.6 hours in adults.

**Side Effects:**

Common side effects of ACC 200 mg sachets are generally mild and may include:

* Nausea

* Vomiting

* Diarrhea

* Abdominal pain

* Heartburn

* Headache

* Tinnitus (ringing in the ears)

Less common or rare but serious side effects can include:

* Allergic reactions (e.g., rash, itching, hives, bronchospasm, angioedema)

* Anaphylactoid reactions

* Severe skin reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis)

If any severe or persistent side effects occur, discontinue use and seek immediate medical attention.

**Drug Interactions:**

* **Antitussives:** Concomitant use with cough suppressants may lead to mucus accumulation.

* **Antibiotics:** Acetylcysteine may reduce the efficacy of certain antibiotics (e.g., tetracyclines, aminoglycosides). It is advisable to administer antibiotics at least 2 hours before or after acetylcysteine.

* **Nitroglycerin:** Concomitant administration of acetylcysteine with nitroglycerin may potentiate the vasodilating and antiplatelet effects of nitroglycerin.

**Patient Counseling:**

* Dissolve the contents of the sachet completely in a glass of water before drinking.

* Do not exceed the recommended dose. Overdosing can lead to serious side effects.

* If symptoms do not improve or worsen after 4-5 days, consult a doctor.

* Inform your doctor or pharmacist about all other medications, supplements, and herbal products you are taking.

* If you experience any signs of an allergic reaction or difficulty breathing, stop taking the medication and seek immediate medical help.

* Keep out of reach of children.

* Store in a cool, dry place, away from direct sunlight.

**Sources:**

* [bit.ly/acc200_sandoz](https://www.acc-1.com/me-en/home/)

* [bit.ly/acetylcysteine_pil](https://www.medicines.org.uk/emc/product/2488/pil)

* [bit.ly/acetylcysteine_drugbank](https://go.drugbank.com/drugs/DB06151)