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Components:
Acetylcysteine
Method of action:
All Other Therapeutic Products, Antioxidant, Cough And Cold Preparations, Expectorant, Hepatoprotective, Mucolytic, Ophthalmologicals
Available in countries
Medically reviewed by Militian Inessa Mesropovna, PharmD. Last updated on 2019.09.18

Name of the medicinal product

ACC Hot

Qualitative and quantitative composition

Acetylcysteine

Therapeutic indications

The information provided in Therapeutic indications of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Therapeutic indications in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Mucolytic adjuvant in the therapy of respiratory disorders associated with thick, viscous, mucus hypersecretion.

Dosage (Posology) and method of administration

The information provided in Dosage (Posology) and method of administration of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Posology

Adults and adolescents over the age of 12 years

200 mg (1 sachet) 3 times a day. Maximum recommended daily dose 600 mg/day.

The duration of therapy is dependent on the nature and severity of the illness, and should be decided by the doctor treating the patient for adults and adolescents.

Abundant fluid intake supports the mucolytic effect of ACC Hot.

Method of administration

Dissolve the contents of one sachet completely in a glass containing a little water just before use, stirring as needed with a teaspoon.

Contraindications

The information provided in Contraindications of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Contraindications in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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ACC Hot 200 mg Powder for Oral Solution must not be used when:

- Phenylketonuria is present, as the product contains aspartame.

Special warnings and precautions for use

The information provided in Special warnings and precautions for use of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Special warnings and precautions for use in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Patients with bronchial asthma should be closely monitored during therapy; if' bronchospasm occurs, treatment with ACC Hot 200 mg Powder for Oral Solution should be discontinued immediately.

Administration of ACC Hot, especially at the beginning of treatment, may liquefy bronchial secretions and, at the same time, increase their volume. If the patient is unable to expectorate efficiently, to avoid retention of secretions postural drainage and tracheal suction should be used.

There are no studies on the efficacy and safety of ACC Hot 200 mg three times daily in adolescent population. However, mild to severe adverse reactions have been reported with the use of IV ACC Hot in adults and adolescents.

This medicine contains sorbitol. Patients with rare hereditary problems of fructose intolerance should not take this medicine.

This medicine contains aspartame, which is a source phenylalanine. This may be harmful to people with phenylketonuria.

This medicine contains a colouring agent called sunset yellow (Ell0), which may cause allergic reactions.

ACC Hot can cause interference with the colorimetric assay method for the determination of salicylates.

ACC Hot can interfere with tests for ketones in urine.

Upon opening the sachet the powder may smell of sulphur (rotten egg smell). This is a normal characteristic of the active substance. Upon addition of water the solution will have a citrus odour.

Effects on ability to drive and use machines

The information provided in Effects on ability to drive and use machines of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Effects on ability to drive and use machines in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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No studies on the effects on the ability to drive or use machines have been performed. ACC Hot 200 mg Powder for Oral Solution has no known effect on the ability to drive and use machines.

Undesirable effects

The information provided in Undesirable effects of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Undesirable effects in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Adverse reactions are listed below, by system organ class and frequency.

System Organ Class

Frequency/ Adverse Reactions

Uncommon

(> 1/1,000, < 1/100)

Rare

((>1/10,000, < 1/1,000)

Very rare

(< 1/10,000)

Not known

Immune system disorders

Hypersensitivity

Anaphylactic shock, anaphylactic/ anaphylactoid reaction

Nervous system disorders

Headache

Ear and labyrinth disorders

Tinnitus

Cardiac disorders

Tachycardia

Vascular disorders

Hypotension

Haemorrhage

Respiratory, thoracic and mediastinal disorders

Bronchospasm, dyspnoea

Gastrointestinal disorders

Vomiting, diarrhoea, stomatitis, abdominal pain, nausea

Dyspepsia

Skin and subcutaneous tissue disorders

Urticaria, rash, angioedema, pruritus

General disorders and administration site conditions

Fever

Oedema of the face

The occurrence of serious skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported in temporal association with the use of ACC Hot. In most of these cases reported at least one other drug was administered at the same time, which may have possibly enhanced the described mucocutaneous effects.

In case of the recurrence of skin and mucosal lesions, medical advice should be sought at once and the use of ACC Hot terminated immediately.

In case of recurrence skin and mucosal lesions, medical advice should be sought at once and the use of ACC Hot terminated immediately.

A decreased blood platelet aggregation in the presence of ACC Hot has been confirmed by various studies. The clinical relevance has not yet been clarified to date.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

Overdose

The information provided in Overdose of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Overdose in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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An acute overdose of ACC Hot can cause gastrointestinal symptoms such as nausea, vomiting and diarrhoea.

Treatment of Overdose

Treatment of overdose is to be symptomatic and supportive treatment as indicated by the patient's clinical condition.

Pharmacodynamic properties

The information provided in Pharmacodynamic properties of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Pharmacodynamic properties in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Pharmacotherapeutic group: Mycolytics, ATC code: R05CB01

N-acetyl-L-cysteine (NAC), the active ingredient in ACC Hot 200 mg Powder for Oral Solution exerts an intense mucolytic-fluidizing action on mucous and mucopurulent secretions by depolymerizing the mucoproteic complexes and the nucleic acids which confer viscosity to the vitreous and purulent component of the sputum and other secretions.

Furthermore, ACC Hot exerts a direct antioxidant action, having a free thiol (- SH) nucleophilic group that is able to interact directly with electrophilic groups of oxidant radicals. Of particular interest is the recent finding that ACC Hot protects α1-antitrypsin enzyme inhibiting elastase from inactivation by hypochlorous acid (HOCl), a powerful oxidant agent produced by the myeloperoxidase enzyme of activated phagocytes. Due to its molecular structure, ACC Hot can readily cross cell membranes. Inside the cell, NAC is deacetylated to L-cysteine, an amino acid essential for glutathione synthesis (GSH).

GSH is a highly reactive tripeptide found ubiquitously in the various tissues of animals and is essential for the maintenance of functional capacity as well as cellular morphological integrity. It is the most important protective intracellular mechanism against oxidant radicals, both exogenous and endogenous, as well as toward numerous cytotoxic substances.

These features make ACC Hot 200 mg Powder for Oral Solution particularly suitable for the treatment of acute and chronic affections of the respiratory system, characterised by thick, viscous mucous and mucopurulent secretions.

There is no evidence on the efficacy and safety of mucolytic s including ACC Hot in acute bronchitis.

Pharmacokinetic properties

The information provided in Pharmacokinetic properties of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Pharmacokinetic properties in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Absorption

Following oral administration, ACC Hot is rapidly and almost completely absorbed and metabolised in the liver to cysteine (the pharmacologically active metabolite), diACC Hot, cysteine and further mixed disulphides.

Distribution

Due to the high first-pass effect, the bioavailability of orally administered ACC Hot is very low (approximately 10%). In humans, maximum plasma concentrations are achieved after 1-3 hours with the maximum plasma concentration of the metabolite cysteine in the range of approximately 2µmol/l. The protein binding of ACC Hot was determined to be about 50%.

Biotransformation

ACC Hot and its metabolites occur in three different forms in the organism: partially in free form, partially bound to proteins via labile disulphide bonds and partially as incorporated amino acid. ACC Hot is excreted almost exclusively in the form of inactive metabolites (inorganic sulphates, diACC Hot) via the kidneys. The plasma half-life of ACC Hot is approximately 1 hour and is mainly determined by the rapid hepatic biotransformation. Impaired hepatic function therefore leads to prolonged plasma half-lives of up to 8 hours.

Elimination

Pharmacokinetic studies with intravenous administration of ACC Hot revealed a distribution volume of 0.47 1/kg (in total) or 0.59 I/kg (reduced ACC Hot); the plasma clearance was determined to be 0.11 l/h/kg (in total) and 0.84 l/h/kg (reduced ACC Hot), respectively. The elimination half-life after intravenous administration is 30-40 minutes while excretion follows three-phase kinetics (alpha, beta and terminal gamma phase).

ACC Hot crosses the placenta and is detected in cord blood. No information is available regarding excretion in breast milk.

No knowledge is available concerning the behaviour of ACC Hot at the blood- brain barrier in humans

Pharmacotherapeutic group

The information provided in Pharmacotherapeutic group of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Pharmacotherapeutic group in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Mycolytics, ATC code: R05CB01

Preclinical safety data

The information provided in Preclinical safety data of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Preclinical safety data in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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Acute toxicity studies in rats and mice, by oral, intraperitoneal and intravenous administration showed ACC Hot to be of low toxicity. LD50 values greater than 7 g / kg in mice and 6 g / kg in rats have been reported. Chronic toxicity studies with ACC Hot in rats at doses up to 2000 mg/ kg/ day and dogs at doses up to 300 mg/ kg / day for periods up to 52 weeks demonstrate that ACC Hot is well tolerated, even at higher doses. In reproductive toxicity studies in rats and rabbits, the oral administration of doses up to 2000 mg / kg / day did not show changes in reproductive capacity, teratogenic effects or peri/postnatal toxicity.

Incompatibilities

The information provided in Incompatibilities of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Incompatibilities in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products.

Special precautions for disposal and other handling

The information provided in Special precautions for disposal and other handling of ACC Hot is based on data of another medicine with exactly the same composition as the ACC Hot of the medicine (Acetylcysteine). Be careful and be sure to specify the information on the section Special precautions for disposal and other handling in the instructions to the drug ACC Hot directly from the package or from the pharmacist at the pharmacy.
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No special requirements for disposal. Any unused product should be disposed of in accordance with local requirements.