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Acetylcysteine (Mucomyst®)

By: Dr. Dawn Ruben

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Overview

  • Acetylcysteine is a derivative of the amino acid cysteine. Though the exact mechanism of action of acetylcysteine is not known, it is believed that the drug reduces sulfide-based links in the proteins of mucus. This results in thinning the mucus, making it easier to be removed from the body by coughing or suction.
  • Another effect of acetylcysteine is seen in the treatment of acetaminophen poisoning. When acetaminophen is ingested in toxic levels, it will bind to gluathione, resulting in liver damage and the production of abnormal hemoglobin. Acetylcysteine provides an alternate substance for the acetaminophen to bind to, resulting in minimizing liver and hemoglobin damage.
  • Acetylcysteine is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

    Brand Names or Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Mucomyst® (Apothecon), Mucosil-10® (Dey Labs) and generics
  • Veterinary formulations: None

    Uses of Acetylcysteine

  • Acetylcysteine is used as an antidote to acetaminophen toxicity.
  • This drug is also used to reduce excessive production of mucus in the airways and eyes, particularly associated with upper respiratory infections.

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, acetylcysteine can cause side effects in some animals.
  • Acetylcysteine should not be used in animals with known hypersensitivity or allergy to the drug.
  • Since acetylcysteine can cause spasms of the lower airways, this drug should be used with caution in animals with lung disease that predisposes to airway spasms.
  • There are no contraindications for the use of acetylcysteine as an antidote for acetaminophen toxicity.
  • Acetylcysteine may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with acetylcysteine. Such drugs include activated charcoal.
  • Acetylcysteine has a very bad taste and foul sulfur odor. Nausea and vomiting are potential side effects. The bad taste of the drug can also cause drooling.

    How Acetylcysteine is Supplied

  • Acetylcysteine is available in 100 mg/ml and 200 mg/ml concentrations in 4 ml, 10 ml and 30 ml vials.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • For acetaminophen toxicity, acetylcysteine, diluted to a 50 mg/ml concentration, is given initially at a dose of 70 mg per pound (140 mg/kg) intravenous or orally. Four hours later, a lower dose of 35 mg per pound (70 mg/kg) is given intravenous or orally every 4 hours for 3 to 5 total treatments.
  • For treatment of excessive airway mucus accumulation, acetylcysteine is administered as a nebulization. It is aerosolized and inhaled at a concentration of 50 ml/hour for 30 to 60 minutes, twice a day.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.




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