PHARMACOLOGICAL APPLICATIONS AND PHARMACOKINETIC MODIFICATIONS OF N-ACETYLCYSTEINE

NAC, an acetylated cysteine compound, is a proteinogenic acid. Being a glutathione recurs or NAC is rather unique because of the multifaceted chemical properties of the cysteinyl thiol group of the molecule. This critical review focuses on the pharmacological applications and pharmacokinetic modifications of NAC to provide a better understanding. NAC was earlier used as a mucolytic agent in various respiratory illnesses and is now widely used as the specific antidote for acetaminophen overdose. In course of time, it has proven to be beneficial in many conditions such as HIV infection, COPD exacerbations, heart diseases, treatment of pulmonary fibrosis, Alzheimer’s, and Parkinson’s disease; helps in the prevention of contrast-induced kidney damage during procedures, etc. Preliminary studies also suggest NAC maintains a major role as cancer chemo protective, adjunct in the eradication of Helicobacter pylori, prophylaxis of gentamicin-induced hearing loss in patients, and also found to have some clinical usefulness as a chelating agent in the treatment of acute heavy metal poisoning. Despite its beneficial traits with limited side effects, bioavailability remains a major concern. Hence different pharmacokinetic modifications of NAC like N-acetyl cysteine amide (NACA), N-acetyl-L-cysteine ethyl ester (NACET), Liposomal-N-acetyl cysteine, Effervescent tablet of N-acetyl cysteine, Acetyl cysteine oral inhalation, etc may ameliorate this major drawback. As a result, to develop a more well-designed and reliable indication; to optimize the dose of NAC, larger controlled trials with longer follow-up sections is demanded in the future. Thus, this review brings forward comprehensive knowledge about the possibilities to introduce NAC as a protective and tolerable medication for these various conditions.