Fluimucil-300
Fluimucil 300 mg is an N-acetyl derivative of L-cysteine used primarily as a mucolytic agent. Although marketed for this purpose, evidence suggests that inhaled N-acetylcysteine may not be significantly more effective than hydration for clearing bronchial secretions. However, regular treatment with mucolytics such as N-acetylcysteine may reduce COPD exacerbations and improve health status in patients not receiving inhaled corticosteroids.
| Products | Fluimucil |
|---|---|
| Active constituent | N-Acetylcysteine |
| Concentration | 300 mg / ampoule |
| Dosage form | Ampoule |
| Route of administration | Inhalation / Intratracheal |
| Package | A box contains 5 ampoules |
Introduction
N-Acetylcysteine (NAC) is an N-acetyl derivative of L-cysteine. Although originally marketed as a mucolytic, inhaled NAC has shown limited evidence of superiority over hydration for clearing bronchial secretions. Nevertheless, guidelines suggest that in COPD patients not on inhaled corticosteroids, regular treatment with NAC may reduce exacerbations and improve health outcomes.
Mechanism of Action
As a mucolytic, NAC's free sulfhydryl groups react with the disulfide linkages of mucoproteins in bronchial secretions. This reaction causes depolymerization, reducing the viscosity of mucus and aiding in the clearance of secretions through coughing and mechanical means.
Pharmacokinetics
Inhalation Route: After oral inhalation, most of the dose undergoes a sulfhydryl-disulfide reaction, with minimal absorption from the pulmonary epithelium.
Intratracheal Route: Similarly, after intratracheal instillation, most of the dose reacts via sulfhydryl-disulfide reaction with limited absorption.
Indications & Dosage
Fluimucil is indicated as adjunctive treatment for chronic obstructive pulmonary disease (COPD), tuberculosis, bronchiectasis, and primary amyloidosis of the lung.
Nebulization Dosage
Adults: 6 to 10 mL of 10% solution via nebulization 3 to 4 times daily. Dosage range is 2 to 20 mL every 2 to 6 hours.
Infants and Children: 6 to 10 mL of 10% solution via nebulization 3 to 4 times daily, with lower doses preferred for infants.
Direct Intratracheal Instillation Dosage
Adults: 1 to 2 mL of 10% solution administered directly into the trachea every hour. For tracheostomy patients, instill directly into the tracheostomy.
Administration
Administer via nebulization or direct intratracheal instillation, considering patient condition and response to treatment.
Adverse Reactions
- Bronchospasm
- Gastrointestinal disturbances (nausea, vomiting)
- Allergic reactions (urticaria, rash)
Monitoring Parameters
Monitor for bronchospasm, particularly in patients with a history of asthma. Regular assessment of lung function may be warranted.
Use in Specific Populations
Pregnancy: NAC crosses the placenta; monitor for potential effects.
Breast-feeding: NAC is present in breast milk; monitor infants for gastrointestinal disturbances.
References
Fluimucil (N-acetylcysteine) package insert.
Guidelines for the use of mucolytics in COPD.