Last update: Jan. 15, 2019

N-acetylcysteine (NAC)

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

An amino acid with mucolytic properties. It is used orally to treat respiratory catarrh and, at high doses, in the detoxification of paracetamol overdose intravenously and orally.

Since the last review we have not found published data related to breastfeeding.

Its low oral bioavailability complicates transfer to infant plasma via breastmilk, except in premature babies and the immediate neonatal period when there may be increased intestinal permeability.

It is used in newborns and small infants as a mucolytic agent and, at high doses, for detoxification following paracetamol overdose (Brener 2013, Bajorek 2012, Aiyagari 2010, Walls 2007). It is used in various neonatal diseases (Aiyagari 2010, Emil 2004) and is found in combination with other amino acids in intravenous solutions in parenteral nutrition (Soghier 2006).

Since it is virtually devoid of toxicity and is commonly used in neonatology, even at high doses, it is very unlikely to cause problems in breastfeeding (Briggs 2017).

It is considered to be one of the mucolytics of choice during breastfeeding (Schaefer 2007, p 644).

Alternatives

We do not have alternatives for N-acetylcysteine (NAC) since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

N-acetylcysteine (NAC) is also known as Acetylcysteine. Here it is a list of alternative known names::


N-acetylcysteine (NAC) in other languages or writings:

Tradenames

Main tradenames from several countries containing N-acetylcysteine (NAC) in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability 4 - 10 %
Molecular weight 163 daltons
Protein Binding 83 %
VD 0,33 - 0,59 l/Kg
pKa 9,52 -
Tmax 0,5 - 2 hours
T1/2 2 - 6,25 hours

References

  1. Brener P, Ballardo M, Mariani G, Ceriani Cernadas JM. Medication error in an extremely low birth weight infant: paracetamol overdose. Arch Argent Pediatr. 2013 Abstract Full text (link to original source) Full text (in our servers)
  2. CINFA-AEMPS. Acetilcisteina. Ficha técnica. 2013 Full text (in our servers)
  3. Bajorek S, Basaldua R, McGoogan K, Miller C, Sussman CB. Neonatal gastric lactobezoar: management with N-acetylcysteine. Case Rep Pediatr. 2012 Abstract Full text (in our servers)
  4. DGF. Dirección General de Farmacia. Servicio Canario de la Salud. Listado de fármacos considerados de Utilidad terapéutica Baja (UTB). 2011 Full text (in our servers)
  5. Aiyagari R, Gelehrter S, Bove EL, Ohye RG, Devaney EJ, Hirsch JC, Gurney JG, Charpie JR. Effects of N-acetylcysteine on renal dysfunction in neonates undergoing the arterial switch operation. J Thorac Cardiovasc Surg. 2010 Abstract
  6. Walls L, Baker CF, Sarkar S. Acetaminophen-induced hepatic failure with encephalopathy in a newborn. J Perinatol. 2007 Abstract
  7. FDA-Cumberland Pharm. Acetylcysteine. Drug Summary. 2006 Full text (in our servers)
  8. Soghier LM, Brion LP. Cysteine, cystine or N-acetylcysteine supplementation in parenterally fed neonates. Cochrane Database Syst Rev. 2006 Abstract
  9. Emil S, Nguyen T, Sills J, Padilla G. Meconium obstruction in extremely low-birth-weight neonates: guidelines for diagnosis and management. J Pediatr Surg. 2004 Abstract
  10. Área de Gestión de Farmacia. Subdirección General de Atención Primaria. Instituto Nacional de la Salud (INSALUD). Utilidad terapéutica de los medicamentos financiados por el Sistema Nacional de Salud. 2001 Full text (in our servers)
  11. Holdiness MR. Clinical pharmacokinetics of N-acetylcysteine. Clin Pharmacokinet. 1991 Abstract
  12. Olsson B, Johansson M, Gabrielsson J, Bolme P. Pharmacokinetics and bioavailability of reduced and oxidized N-acetylcysteine. Eur J Clin Pharmacol. 1988 Abstract
  13. Borgström L, Kågedal B, Paulsen O. Pharmacokinetics of N-acetylcysteine in man. Eur J Clin Pharmacol. 1986 Abstract

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