Mucinac (N-Acetylcysteine (NAC))
Also sold as: Mucinac, Fluimucil, NAC, Acetadote (IV), Nac-600
Pregnancy
Cat B
Lactation
Safe
Schedule
H
Forms
Tablet effervescent 200mg, 600mg +3
Indications
- Mucus clearance: COPD, bronchiectasis, cystic fibrosis, viscid sputum
- Paracetamol (acetaminophen) overdose antidote — IV (LIFE-SAVING)
- Contrast-induced nephropathy prophylaxis
- Hepatoprotection in drug-induced liver injury (adjunct)
- Idiopathic pulmonary fibrosis (IPF) — adjunct (evidence limited)
Adult Dosing
Mucolytic (oral)
600 mg effervescent tablet dissolved in water, BD-TDS
Acute: 5-10 days. Chronic (COPD): long-term
Paracetamol overdose (IV — Rumack protocol)
Loading: 150 mg/kg IV over 1 hour, then 50 mg/kg over 4 hours, then 100 mg/kg over 16 hours (total 21 hours)
Start within 8-10 hours of overdose for maximum efficacy; still beneficial up to 24+ hours
Contrast nephropathy prophylaxis
600-1200 mg PO BD on day before and day of procedure
Pediatric Dosing
IV formulation for paracetamol overdose — consult poison centre for weight-based calculations in children
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Any | No adjustment for oral. IV: proceed normally — benefits outweigh risks in OD |
Hepatic Adjustment
No adjustment for mucolytic. In OD: proceed urgently regardless of liver status
Pregnancy & Lactation
Pregnancy: Category B
Safe in pregnancy for paracetamol OD (untreated OD far more dangerous). Mucolytic use — use cautiously in 1st trimester.
Lactation: Safe
Considered safe; used for paracetamol OD in lactating mothers.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Nitroglycerin (IV) | Additive hypotension — monitor BP | Moderate |
| Activated charcoal | Reduces oral NAC absorption — give NAC IV if charcoal given | Moderate |
DoctorScribe — AI Medical Scribe
Stop looking up Mucinac — just speak the prescription
"Mucinac as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Nausea
- Vomiting (IV loading dose)
- Flushing
- Rash (IV — anaphylactoid, usually mild)
- Unpleasant sulfur taste (oral)
Serious / Discontinue If
- Anaphylactoid reaction with IV NAC (bronchospasm, urticaria, hypotension — treat with antihistamine; rechallenge at slower rate)
Contraindications
- Hypersensitivity to NAC
- Active peptic ulcer (oral — relative)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Mucinac 600 | Cipla | 10 sachet ₹145 |
| Fluimucil 600 | Zambon | 10 sachet ₹195 |
| Nac-600 | Sun Pharma | 10 tab ₹125 |
| Mucinac IV 200mg/mL | Cipla | 30mL vial ₹185 |
Monitoring Required
- For OD: serum paracetamol levels, LFT, INR/PT every 12-24 hours
- Renal function (creatinine)
- During IV: vital signs, signs of anaphylactoid reaction
Patient Counseling Points
- Dissolve effervescent tablet completely in a glass of water before drinking
- Drink plenty of fluids during therapy
- Report any shortness of breath or rash (IV use)
- For paracetamol overdose: IV form is EMERGENCY treatment — go to casualty immediately
Stop Googling drug references mid-consultation
EasyClinic auto-flags Mucinac interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Kavitha Rao, MD (Pulmonology), Consultant
Last reviewed: 2026-04-01
References
- BNF — Acetylcysteine
- Rumack-Matthew Nomogram
- NACETYL Trial
- NICE Paracetamol Overdose Guidelines