Mucomist
Generic Name
Acetylcysteine
Manufacturer
Cipla Ltd.
Country
India
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| mucomist 600 mg respirator solution | ৳ 30.00 | N/A |
Description
Overview of the medicine
Mucomist 600 mg Respirator Solution contains Acetylcysteine, a mucolytic agent used to break down thick mucus in the respiratory tract, making it easier to cough up. It is often used in conditions like chronic bronchitis, cystic fibrosis, and emphysema. It also acts as an antidote for paracetamol overdose.
Uses & Indications
Dosage
Adults
Mucolytic (inhalation): 3-5 ml of 20% solution or 6-10 ml of 10% solution, 3-4 times daily. Paracetamol overdose (IV): Complex regimen over multiple infusions, typically initiated with 150 mg/kg over 15-60 minutes.
Elderly
Similar to adult dosage for mucolytic use, with caution. For paracetamol overdose, follow standard protocols.
Renal_impairment
No specific dose adjustment for mucolytic use. For paracetamol overdose, monitor carefully, dose adjustment may be needed.
How to Take
For mucolytic effect, administered via nebulization. The solution should be used with appropriate nebulizer equipment. For paracetamol overdose, typically administered intravenously, or orally if IV access is not possible.
Mechanism of Action
Acetylcysteine acts as a mucolytic by reducing the viscosity of pulmonary secretions. It achieves this by breaking the disulfide bonds in mucoproteins, allowing for easier expectoration. As an antidote for paracetamol poisoning, it acts by replenishing intracellular glutathione, which is essential for detoxifying a toxic metabolite of paracetamol (NAPQI).
Pharmacokinetics
Onset
Mucolytic effect: within 5-10 minutes (inhalation). Antidote: rapid response.
Excretion
Mainly renal as inactive metabolites and some unchanged drug.
Half life
Approximately 5.6 hours (total acetylcysteine), 2 hours (reduced acetylcysteine).
Absorption
Well absorbed orally, but bioavailability is low due to first-pass metabolism. For inhalation, local absorption in respiratory tract. For IV use, 100% bioavailability.
Metabolism
Primarily hepatic, deacetylation to cysteine and further metabolism.
Side Effects
Contraindications
- Hypersensitivity to Acetylcysteine or any component of the formulation
- Acute asthma (bronchospasm risk)
Drug Interactions
Antibiotics
In vitro inactivation of certain antibiotics (e.g., tetracyclines, cephalosporins, penicillins). Administer acetylcysteine and antibiotics separately by at least 2 hours.
Nitroglycerin
Concomitant use with nitrates (e.g., nitroglycerin) may potentiate the vasodilatory effect of nitrates.
Storage
Store below 30°C. Protect from light. Do not freeze. Discard any unused solution after opening the ampoule.
Overdose
Overdose of mucolytic acetylcysteine is unlikely due to its local administration via nebulization. However, excessive amounts can lead to increased secretions. For systemic overdose (e.g., IV in paracetamol poisoning if dosage error), symptoms may include nausea, vomiting, and anaphylactoid reactions. Management is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy category B. Animal studies have shown no evidence of harm, but human studies are limited. Use only if clearly needed. Excretion into breast milk is unknown; use with caution during lactation.
Side Effects
Contraindications
- Hypersensitivity to Acetylcysteine or any component of the formulation
- Acute asthma (bronchospasm risk)
Drug Interactions
Antibiotics
In vitro inactivation of certain antibiotics (e.g., tetracyclines, cephalosporins, penicillins). Administer acetylcysteine and antibiotics separately by at least 2 hours.
Nitroglycerin
Concomitant use with nitrates (e.g., nitroglycerin) may potentiate the vasodilatory effect of nitrates.
Storage
Store below 30°C. Protect from light. Do not freeze. Discard any unused solution after opening the ampoule.
Overdose
Overdose of mucolytic acetylcysteine is unlikely due to its local administration via nebulization. However, excessive amounts can lead to increased secretions. For systemic overdose (e.g., IV in paracetamol poisoning if dosage error), symptoms may include nausea, vomiting, and anaphylactoid reactions. Management is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy category B. Animal studies have shown no evidence of harm, but human studies are limited. Use only if clearly needed. Excretion into breast milk is unknown; use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, refer to product packaging for specific dates.
Availability
Pharmacies, hospitals
Approval Status
Approved by major regulatory bodies
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials support the efficacy of acetylcysteine as a mucolytic and as an antidote for paracetamol overdose. Ongoing research explores its role in other conditions due to its antioxidant properties.
Lab Monitoring
- For paracetamol overdose: Liver function tests (ALT, AST), PT/INR, serum creatinine, paracetamol levels, glucose, electrolytes.
Doctor Notes
- Assess patient's respiratory function before and during treatment.
- Administer in a well-ventilated area to minimize odor.
- Be prepared to manage bronchospasm, especially in asthmatic patients.
Patient Guidelines
- Use nebulizer as directed by your doctor.
- Do not mix with other medicines in the nebulizer unless advised by a healthcare professional.
- Clean your nebulizer equipment thoroughly after each use.
- Report any difficulty breathing or increased wheezing immediately.
Missed Dose Advice
If a dose for nebulization is missed, take it as soon as you remember. If it's almost time for the next dose, skip the missed dose and continue with your regular schedule. Do not double doses. For paracetamol overdose, strict adherence to the regimen is critical.
Driving Precautions
Acetylcysteine is generally not expected to affect the ability to drive or operate machinery.
Lifestyle Advice
- Maintain good hydration to help thin mucus naturally.
- Avoid smoking and exposure to respiratory irritants.
- Follow a healthy lifestyle with regular exercise and balanced diet.
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