ACETYLCYSTEINE

Brand Name & Strength

Hidonac 5 g/25 ml

Reconstitution

Not required

Further Dilution

IV infusion

(for Paracetamol Poisoning and non-Paracetamol Acute Liver Failure) Please refer to

Administration & Infusion rate

IV infusion

(for Prevention of Contrast-Induced Nephropathy) Dilute 600 – 1200 mg in 50 – 100 ml NS

Diluent

D5

Administration & Infusion rate

IV infusion

(for Paracetamol poisoning) 150 mg/kg in 200 ml D5 over 15 min, followed by 50 mg/kg in 500 ml D5 over 4 hr, then 100 mg/kg in 1000 ml D5 over 16 hr

IV infusion

(for Prevention of Contrast-Induced Nephropathy) Administer over 30 – 60 min

IV infusion

(for non-Paracetamol Acute Liver Failure) 150 mg/kg in D5 over 15 min, followed by 50 mg/kg in D5 over 4 hr, then 6.25 mg/kg/hr in D5 for 67 hr

Storage & Stability

RT

(<25 oC)

Fridge

(2 – 8 oC)

After Reconstitution

- -

After dilution

24 hr -

Remarks

There are varying NAC regimes for prevention of contrast induced nephropathy, but the most commonly used regime in a meta-analysis of 10 studies is 600 – 1200 mg BD for 2 days (this is the oral tablet dose). It is important to note that the meta-analysis is inconclusive on the efficacy of NAC in preventing contrast induced nephropathy. In the study on IV NAC for non-paracetamol acute liver failure, no specific dilution was recommended for IV NAC. However, the dilution of IV NAC used for Paracetamol poisoning can be applied for this indication (as recommended by product leaflet).