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Details

Stereochemistry ABSOLUTE
Molecular Formula C6H14N2O2.C5H9NO3S
Molecular Weight 309.382
Optical Activity UNSPECIFIED
Defined Stereocenters 2 / 2
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of NACYSTELYN

SMILES

CC(=O)N[C@@H](CS)C(O)=O.NCCCC[C@H](N)C(O)=O

InChI

InChIKey=YLCSLYZPLGQZJS-VDQHJUMDSA-N
InChI=1S/C6H14N2O2.C5H9NO3S/c7-4-2-1-3-5(8)6(9)10;1-3(7)6-4(2-10)5(8)9/h5H,1-4,7-8H2,(H,9,10);4,10H,2H2,1H3,(H,6,7)(H,8,9)/t5-;4-/m00/s1

HIDE SMILES / InChI
Acetylcysteine (also known as N-acetylcysteine or N-acetyl-L-cysteine or NAC) is primarily used as a mucolytic agent and in the management of acetaminophen poisoning. Acetylcysteine likely protects the liver by maintaining or restoring the glutathione levels, or by acting as an alternate substrate for conjugation with, and thus detoxification of, the reactive metabolite. Nacystelyn (NAL), a recently-developed lysine salt of N-acetylcysteine (NAC) is known to have excellent mucolytic capabilities and is used to treat cystic fibrosis (CF) lung disease. NAC as a precursor to the antioxidant glutathione modulates glutamatergic, neurotrophic, and inflammatory pathways. The potential applications of NAC to facilitate recovery after traumatic brain injury, cerebral ischemia, and in treatment of cerebrovascular vasospasm after subarachnoid hemorrhage. Acetylcysteine serves as a prodrug to L-cysteine, which is a precursor to the biologic antioxidant, glutathione, and hence administration of acetylcysteine replenishes glutathione stores. L-cysteine also serves as a precursor to cystine, which in turn serves as a substrate for the cystine-glutamate antiporter on astrocytes hence increasing glutamate release into the extracellular space. Acetylcysteine also possesses some anti-inflammatory effects possibly via inhibiting NF-κB through redox activation of the nuclear factor kappa kinases thereby modulating cytokine synthesis. NAC is associated with reduced levels of inflammatory cytokines and acts as a substrate for glutathione synthesis. These actions are believed to converge upon mechanisms promoting cell survival and growth factor synthesis, leading to increased neurite sprouting.

CNS Activity

Curator's Comment: http://forum.parkinson.org/topic/20369-cerebrospinal-fluid-concentrations-of-n-acetylcysteine-after-oral-administration-in-parkinsons-disease/

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Nacystelyn

Approved Use

Unknown
Secondary
ACETADOTE

Approved Use

ACETADOTE, administered intravenously within 8 to 10 hours after ingestion of a potentially hepatotoxic quantity of acetaminophen, is indicated to prevent or lessen hepatic injury.

Launch Date

2004
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
26.5 μg/mL
11 g single, oral
dose: 11 g
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
0.68 mg/L
200 mg single, oral
dose: 200 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
2.57 mg/L
600 mg single, oral
dose: 600 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
3.47 mg/L
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
186 μg × h/mL
11 g single, oral
dose: 11 g
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
2.27 h
600 mg single, oral
dose: 600 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
18.1 h
11 g single, oral
dose: 11 g
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
23.5%
11 g single, oral
dose: 11 g
route of administration: Oral
experiment type: SINGLE
co-administered:
ACETYLCYSTEINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
11 g single, oral
Highest studied dose
Dose: 11 g
Route: oral
Route: single
Dose: 11 g
Sources:
healthy, adult
n = 29
Health Status: healthy
Age Group: adult
Population Size: 29
Sources:
1200 mg 2 times / day multiple, oral
Dose: 1200 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 2 times / day
Sources:
unhealthy
n = 20
Health Status: unhealthy
Condition: Trichotillomania
Population Size: 20
Sources:
Other AEs: Rash, Depression...
Other AEs:
Rash (below serious, 1 patient)
Depression (below serious, 1 patient)
Sources:
3000 mg multiple, oral (total daily dose)
Dose: 3000 mg
Route: oral
Route: multiple
Dose: 3000 mg
Sources:
unhealthy
n = 35
Health Status: unhealthy
Condition: Pathologic Skin Picking
Population Size: 35
Sources:
Other AEs: Nausea, Dry mouth...
Other AEs:
Nausea (below serious, 5 patients)
Dry mouth (below serious, 1 patient)
Constipation (below serious, 2 patients)
Dizziness (below serious, 1 patient)
Sources:
900 mg 3 times / day multiple, oral
Dose: 900 mg, 3 times / day
Route: oral
Route: multiple
Dose: 900 mg, 3 times / day
Sources:
unhealthy
n = 5
Health Status: unhealthy
Condition: Obsessive-Compulsive Disorder
Population Size: 5
Sources:
Other AEs: Skin rash...
Other AEs:
Skin rash (below serious, 1 patient)
Sources:
AEs

AEs

AESignificanceDosePopulation
Depression below serious, 1 patient
1200 mg 2 times / day multiple, oral
Dose: 1200 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 2 times / day
Sources:
unhealthy
n = 20
Health Status: unhealthy
Condition: Trichotillomania
Population Size: 20
Sources:
Rash below serious, 1 patient
1200 mg 2 times / day multiple, oral
Dose: 1200 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 2 times / day
Sources:
unhealthy
n = 20
Health Status: unhealthy
Condition: Trichotillomania
Population Size: 20
Sources:
Dizziness below serious, 1 patient
3000 mg multiple, oral (total daily dose)
Dose: 3000 mg
Route: oral
Route: multiple
Dose: 3000 mg
Sources:
unhealthy
n = 35
Health Status: unhealthy
Condition: Pathologic Skin Picking
Population Size: 35
Sources:
Dry mouth below serious, 1 patient
3000 mg multiple, oral (total daily dose)
Dose: 3000 mg
Route: oral
Route: multiple
Dose: 3000 mg
Sources:
unhealthy
n = 35
Health Status: unhealthy
Condition: Pathologic Skin Picking
Population Size: 35
Sources:
Constipation below serious, 2 patients
3000 mg multiple, oral (total daily dose)
Dose: 3000 mg
Route: oral
Route: multiple
Dose: 3000 mg
Sources:
unhealthy
n = 35
Health Status: unhealthy
Condition: Pathologic Skin Picking
Population Size: 35
Sources:
Nausea below serious, 5 patients
3000 mg multiple, oral (total daily dose)
Dose: 3000 mg
Route: oral
Route: multiple
Dose: 3000 mg
Sources:
unhealthy
n = 35
Health Status: unhealthy
Condition: Pathologic Skin Picking
Population Size: 35
Sources:
Skin rash below serious, 1 patient
900 mg 3 times / day multiple, oral
Dose: 900 mg, 3 times / day
Route: oral
Route: multiple
Dose: 900 mg, 3 times / day
Sources:
unhealthy
n = 5
Health Status: unhealthy
Condition: Obsessive-Compulsive Disorder
Population Size: 5
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer

Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
strong [Inhibition 10000 uM]
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Nacystelyn, a novel lysine salt of N-acetylcysteine, to augment cellular antioxidant defence in vitro.
1997 Mar
Dose-finding and 24-h monitoring for efficacy and safety of aerosolized Nacystelyn in cystic fibrosis.
2002 Feb
Effects of PM10 in human peripheral blood monocytes and J774 macrophages.
2004 Dec 21
Patents

Sample Use Guides

hepatic injury: Acetadote should be administered within 8 hours from acetaminophen ingestion for maximal protection against hepatic injury for patients whose serum acetaminophen levels fall above the “possible” toxicity line on the Rumack-Matthew nomogram (line connecting 150 mcg/mL at 4 hours with 50 mcg/mL at 12 hours cystic fibrosis: patients inhaled either from two (4 mg) to eight puffs (16 mg) of a single dose of NAL from the range, administered in an open-label fashion, or 12 puffs of active NAL (24 mg) versus 12 puffs of placebo,
Route of Administration: Other
It was studied the alteration of cellular properties during in vitro hematopoietic differentiation of human iPSCs and the ability of N-acetylcysteine (NAC), a potent free radical scavenger, to prevent such alterations. IPSCs were differentiated towards hematopoietic cells in the presence of 1 mM NAC. Intracellular reactive oxygen species (ROS), nitric oxide (NO), senescence, apoptosis and mitochondrial membrane potential (MMP) were evaluated at 1 and 3 weeks of differentiation. NAC administration improved hematopoietic differentiation of iPSCs in terms of production of CD34, CD45 and CD43 positive cells.
Name Type Language
NACYSTELYN
Common Name English
ACETYLCYSTEINE LYSINE
Systematic Name English
L-LYSINE, COMPD. WITH N-ACETYL-L-CYSTEINE
Systematic Name English
N-ACETYLCYSTEINATE LYSINE
Systematic Name English
LYSINE ACETYLCYSTEINATE
Common Name English
LYSINE ACETYLCYSTEINATE SALT
Common Name English
LYSINE N-ACETYLCYSTEINATE
Common Name English
Classification Tree Code System Code
FDA ORPHAN DRUG 139200
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
EU-Orphan Drug EU/3/01/026
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
Code System Code Type Description
FDA UNII
8G1KV0RT1P
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
PRIMARY
CAS
89344-48-9
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
PRIMARY
EPA CompTox
DTXSID50237622
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
PRIMARY
SMS_ID
100000177222
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
PRIMARY
PUBCHEM
9883132
Created by admin on Fri Dec 15 15:25:44 GMT 2023 , Edited by admin on Fri Dec 15 15:25:44 GMT 2023
PRIMARY