ACC 200 tabs 200mg #20


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ACC 200 instruction

You can buy ACC 200 here


One effervescent tablet contains
active substance: acetylcysteine ​​200 mg,
excipients: anhydrous citric acid, sodium bicarbonate, sodium carbonate, ascorbic acid, sodium saccharin, sodium cyclamate, polyethylene glycol, blackberry flavor, wild berry flavor.


Tablets are white in color, round in shape, with a flat smooth surface, with a notch on one side, with a diameter of (18  0.2) mm and a height of (3.7  0.4) mm.
The solution of ACC 200 is from transparent to having a slight opalescence, without mechanical impurities.

Pharmacotherapeutic group

Medications for treating the symptoms of colds and coughs.
Expectorant preparations. Mucolytics. Acetylcysteine


After ingestion, acetylcysteine ​​is rapidly absorbed from the gastrointestinal tract (GIT) and metabolized in the liver to cysteine, a pharmacologically active metabolite, as well as diacetylcysteine, cystine and various mixed disulfides.
Due to the high “first pass” effect through the liver, the bioavailability of acetylcysteine ​​is very low (approximately 10%).
In humans, maximum plasma concentrations are reached after 1-3 hours. The maximum plasma concentration of the cysteine ​​metabolite is about 2 μmol / L. The binding of acetylcysteine ​​to plasma protein is approximately 50%.
Acetylcysteine ​​is excreted through the kidneys almost exclusively in the form of inactive metabolites (inorganic sulfates, diacetylcysteine).
The plasma elimination half-life is approximately 1 hour and is mainly determined by hepatic biotransformation. Therefore, impaired liver function leads to prolonged plasma half-elimination periods up to 8 hours.


Acetylcysteine ​​is a derivative of the amino acid cysteine. Acetylcysteine ​​has a secretolytic and secretory motor effect in the respiratory tract. It breaks the disulfide bonds between mucopolysaccharide chains and has a depolymerizing effect on DNA chains (with purulent sputum). Thanks to these mechanisms, the viscosity of sputum is reduced.
An alternative mechanism of acetylcysteine ​​is based on the ability of its reactive sulfhydryl group to bind chemical radicals and thereby neutralize them.
Acetylcysteine ​​enhances the synthesis of glutathione, which is important for the detoxification of toxic substances. This explains its antidote effect in case of paracetamol poisoning.
When used prophylactically, it has a protective effect on the frequency and severity of exacerbations of bacterial infections, which has been established in patients with chronic bronchitis and cystic fibrosis.

Indications for use

- secretolytic therapy for acute and chronic diseases of the bronchi and lungs, accompanied by impaired formation and excretion of sputum.

Dosage and administration

Adults and teenagers 14 years of age and older
1 effervescent tablet 2-3 times a day (equivalent to 400-600 mg of acetylcysteine ​​per day).
Children and adolescents aged 6 to 14 years:
1 effervescent tablet 2 times a day (equivalent to 400 mg of acetylcysteine ​​per day).
Children aged 2 to 5 years
½ effervescent tablet 2-3 times a day (equivalent to 200-300 mg of acetylcysteine ​​per day).
The duration of treatment depends on the disease and its severity and should be determined by the attending physician.
In case of chronic bronchitis and cystic fibrosis, long-term treatment should be carried out.
The secretolytic effect of ACC 200 is supported by adequate fluid intake.
Effervescent tablets are pre-dissolved in a glass of water, taken after meals.
Close the container tightly after removing the tablets!

Side effects

- allergic reactions (itching, urticaria, exanthema, angioedema edema, skin rash)
- tachycardia
arterial hypotension
- headache
- stomatitis, abdominal pain, diarrhea, vomiting, heartburn and nausea
- shortness of breath, bronchospasm - mainly in patients with increased reactivity of the bronchial system associated with bronchial asthma
Very rarely
- bleeding and hemorrhage partially associated with hypersensitivity reactions, decreased platelet aggregation
- anaphylactic reactions, up to anaphylactic shock


- hypersensitivity to acetylcysteine ​​or drug components
- peptic ulcer of the stomach and duodenum in the acute stage
- hemoptysis, pulmonary hemorrhage
- galactose intolerance
renal failure
- liver failure
- congenital lactase deficiency
- glucose-galactose malabsorption syndrome
- children under 2 years old
- pregnancy and lactation

Drug interactions

The simultaneous use of acetylcysteine ​​and antitussive agents can cause dangerous secretory stagnation due to a decrease in the cough reflex. For this reason, this combination therapy option should be based on a particularly accurate diagnosis.
The use of activated carbon can weaken the effect of acetylcysteine.
Tetracycline chloride should be administered separately and at least with a two-hour time interval.
Messages regarding the inactivation of antibiotics (semisynthetic penicillins, tetracyclines, cephalosporins and aminoglycosides) resulting from the simultaneous use of acetylcysteine ​​or other mucolytic drugs are based solely on laboratory experiments in which significant substances were directly mixed. Despite this, for safety reasons, oral antibiotics should be administered separately, with a two-hour time interval.
In cases of simultaneous administration of nitroglycerin (glycerol trinitrate) with acetylcysteine, an increase in its vasodilating effect and an inhibitory effect on platelet aggregation was observed. The clinical relevance of these data has not been established.

special instructions

The secretolytic effect of ACC 200 is supported by adequate fluid intake.
It is not recommended to take ACC 200 for more than 4-5 days without a doctor’s prescription.
Patients with impaired liver or kidney function should not be given ACC 200 in connection with an additional accumulation of nitrogen-containing compounds.
There are reports of the development of rarely occurring severe skin reactions, such as Stevens-Johnson syndrome and Lyell syndrome in connection with taking acetylcysteine. If changes appear on the skin and mucous membranes, you should stop taking acetylcysteine ​​and consult a doctor immediately.
Precautions should be observed when prescribing acetylcysteine ​​to patients with bronchial asthma, gastric ulcer, hypertension, adrenal disease, varicose veins of the esophagus.
When using ACC 200, special attention should be paid to patients suffering from histamine intolerance. Such patients should avoid long-term treatment, since ACC 200 affects the histamine metabolism and can lead to signs of intolerance to the drug, such as headaches, rhinorrhea and irritation.
The use of acetylcystine, especially at the beginning of treatment, can lead to excessive dilution of sputum in the bronchi, thereby causing an increase in its volume, if the patient cannot expectorate sputum, necessary measures should be taken (for example, postural drainage and suction).
One effervescent tablet contains 5.7 mmol (131.0 mg) of sodium. This should be taken into account when prescribing ACC 200 to patients on a low sodium diet (low salt diet).

Pregnancy and lactation

The appointment of the ACC 200 is not recommended, because there is no experience with use during pregnancy and lactation.
Features of the effect of ACC 200 on the ability to drive a vehicle or potentially dangerous mechanisms
ACC 200 does not affect the ability to drive vehicles and potentially dangerous mechanisms.


Symptoms: nausea, vomiting, diarrhea, hypersecretion is possible in children.
Treatment: symptomatic.

Release form and packaging

20 tablets in an aluminum tube.
1 tube together with instructions for use in the state and Russian languages ​​are put in a cardboard box.

Storage conditions

Store in a dry place at a temperature not exceeding 30 ° C.
Keep out of the reach of children!
Shelf life - 4 years.
Do not use after expiration date.

Terms of sell

You don't need a prescription to buy ACC 200.