N-ACETYLCYSTEINE IN IDIOPATHIC PULMONARY …

1 N-ACETYLCYSTEINE IN IDIOPATHIC PULMONARY fibrosis GP information . Background In patients with IDIOPATHIC PULMONARY fibrosis (IPF), an imbalance occurs between oxidants (which damage the lungs) and anti-oxidants (which protect the lungs). A naturally occurring anti-oxidant is glutathione. Reduced amounts of glutathione are found in the lungs of patients with IPF. It is possible to replenish levels of glutathione by administering a precursor, N-ACETYLCYSTEINE . Recent studies suggest this has a additive effect to conventional treatment and may slow the decline in lung function in particular.

2 No mortality benefit has, as yet, been shown. N-ACETYLCYSTEINE is currently unlicensed in the United Kingdom, but is increasingly being used as evidence accumulates as to its benefits. Pharmacy info: Proprietary name ACC 600. Form 600mg soluble tablets of acetylcysteine Other ingredients Microcrystalline cellulose, Citric acid, Lactose monohydrate, Magnesium stearate, Maize starch, Sodium cyclamate, Saccharin sodium and Lemon flavourings. Pack size 100 tablet packs Manufacturer Hexal Supplier IDIS Ltd. Millbank House 171-185 Ewell Road tel 01932 824000.

3 Surbiton, fax 01932 824200. Surrey KT6 6AX. Cost Approximately per month Formulary status Approved by NHS Grampian Formulary for restricted use for the treatment of patients with IDIOPATHIC PULMONARY fibrosis . It is classified 3a unlicensed product and 8d treatment may be initiated in the community on the recommendation of a consultant/specialist with experience in the treatment of IDIOPATHIC PULMONARY fibrosis . Initiation is limited to chest physicians working in the interstitial lung disease clinic. Dosing 1 tablet (600mg) three times daily.

4 Total daily dose 1800mg. References 1. MacNee W, Rahman I. Oxidants / antioxidants in IDIOPATHIC PULMONARY fibrosis . Thorax 1995;50. :S53-8. 2. Cantin AM, Hubbard RC, Crystal RG. Glutathione deficiency in the epithelial lining fluid of the lower respiratory tract in IDIOPATHIC PULMONARY fibrosis . Am Rev Respir Dis 1989;139:370-372. A Copland. Pharmacy Dept. ARI. 19/01/10. 3. Demedts M et al. High dose acetyl cysteine in IDIOPATHIC PULMONARY fibrosis NEJM 2005; 353: 2229- 42. A Copland. Pharmacy Dept. ARI. 19/01/10. ACC 600 ( acetylcysteine ) - PATIENT information LEAFLET.

5 What is in my medication? Tablets containing 600mg of acetylcysteine . Other ingredients are Microcrystalline cellulose, Citric acid, Lactose monohydrate, Magnesium stearate, Maize starch, Sodium cyclamate, Saccharin sodium and Lemon flavourings. Why am I getting it? acetylcysteine is used in several lung problems. It can be used to thin spit (sputum), which can sometimes make it easier to cough up. Typically this is used if you have a condition such as chronic obstructive PULMONARY disease (COPD, sometimes called emphysema). acetylcysteine can also be used in other lung conditions, such as IDIOPATHIC PULMONARY fibrosis (sometimes called cryptogenic fibrosing alveolitis), and evidence is accumulating in studies to suggest it can protect the lungs in this condition.

6 When should I not take acetylcysteine ? You must not take this medicine if you are known to be allergic to acetylcysteine or any of the other ingredients. You should not take this medicine if you are pregnant of breast-feeding. This medicine must be used with caution if you have a condition called phenylketonuria. What about my other medication? Do not take this medicine with any cough medicines. Do not take this medicine within 2 hours of taking tetracycline (an antibiotic). This medicine must be used with caution if you are taking any nitrate based medicines such as glyceryl trinitrate (used in the treatment of angina).

7 Please inform your doctor of any medicines which you are taking and, if in doubt, speak, your doctor or pharmacist. What dose should I take of acetylcysteine ? For adults, the dose prescribed by your doctor can vary and generally you will be prescribed 1 tablet 3 times a day. How should I take acetylcysteine ? Each tablet should be dissolved in a glass of water, and swallowed after food. Diluting juice may be added to the water to improve the taste. How long should I use acetylcysteine ? Your doctor will decide how long you should take this medicine, treatment may be for a prolonged period.

8 Are there any side effects with acetylcysteine ? Side effects are uncommon with this medicine however you may experience heartburn, stomach ache, nausea, vomiting and diarrhoea. Consult your doctor in the event of over dosage. A Copland. Pharmacy Dept. ARI. 19/01/10.