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N-Acetylcysteine (Mucomyst)

Generic Name: N-Acetylcysteine

Brand Names: NAC, Mucomyst

Drug Class: Mucolytics

Available Dosage Forms: Nebulizer solution, tablet, effervescent tablet, and intravenous injection

N-Acetylcysteine: Uses, Side effects. NAC, Mucomyst
Courtesy: Unsplash

What is N-Acetylcysteine?

N-Acetylcysteine is an amino acid FDA approved for reversing hepatotoxicity following acute administration of acetaminophen and as a mucolytic agent for chronic obstructive pulmonary disease (COPD).1 The antioxidant property of NAC exerts beneficial effects on brain functions by modulating neurotransmission, inhibiting inflammation and oxidative stress.

Depression and other mood disorders can have exogenous and endogenous causes. Endogenous depression originates in response to oxidative stress, inflammation, and aberrations in neurotransmission pathways in the brain. Multiple studies involving depressed subjects treated with N-Acetylcysteine alone or as an adjunct to antidepressants reported alleviation in depressive symptoms and improved functional impairment.1

N-Acetylcysteine serves as an anti-inflammatory agent by reducing the expression of inflammatory pathways in the brain. The anti-inflammatory property of N-Acetylcysteine has been implicated in improving treatment-resistant depression associated with pronounced inflammation components.2 NAC has shown greater efficacy in severe depression when administered as an adjunct to antidepressant medications.

Animal studies have demonstrated that NAC might prove efficacious in the treatment of anxiety. It has been used to treat other neuropsychiatric conditions, including:


-Obsessive-compulsive disorder


-Bipolar disorder

-Cocaine dependence


How to use N-Acetylcysteine?

-The medication is most commonly prescribed as a concentrated solution

-Nebulizer converts the solution into an inhalable mist

-Only use glass or plastic nebulizers

-Add saline or water to the concentrated solution before use

-The prepared solution is to be used within an hour

-Avoid the use of hand bulb nebulizers

-Do not put the solution in a heated nebulizer

-Nebulize at least 3-4 times daily

-Clean the nebulizer after each use to prevent clogging

-Tablet formulations are also prescribed based on age, weight, and medical history

-It can also be taken as an intravenous injection

-Do not self-administer NAC


What are the side effects of N-Acetylcysteine?

The amino acid supplements have a broad safety profile. However, potential side effects include:

Gastrointestinal side effects:

-Stomach upset






Miscellaneous side effects:


-Muscle pain



-Nasal congestion

-Runny nose




Who should not use N-Acetylcysteine?

-Those with hypersensitivity to medication contents

-People with an increased risk of Gastrointestinal bleeding (oesophageal varices, peptic ulcers)

-Pregnant or breastfeeding women should consult their doctors before using N-Acetylcysteine



  1. Ooi SL, Green R, Pak SC. N-Acetylcysteine for the Treatment of Psychiatric Disorders: A Review of Current EvidenceBiomed Res Int. 2018;2018:2469486. Published 2018 Oct 22. doi:10.1155/2018/2469486
  2. Yang C, Bosker FJ, Li J, Schoevers RA. N-acetylcysteine as add-on to antidepressant medication in therapy refractory major depressive disorder patients with increased inflammatory activity: study protocol of a double-blind randomized placebo-controlled trial. BMC Psychiatry. 2018;18(1):279. Published 2018 Sep 4. doi:10.1186/s12888-018-1845-1

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