Dvace 200 is prescribed for the treatment of acute and chronic diseases of the bronchopulmonary system, accompanied by increased sputum production.
Composition
Active ingredient: acetylcysteine.
1 effervescent tablet contains 200 mg of acetylcysteine.
Excipients: maltodextrin, anhydrous citric acid, sodium bicarbonate, orange flavoring, leucine, sodium saccharin.
Contraindication
Hypersensitivity to acetylcysteine or to other components of the drug. Gastric and duodenal ulcer in the acute stage, hemoptysis, pulmonary hemorrhage, severe exacerbation of bronchial asthma.
Method of application
Adults
400–600 mg per day, divided into 1–3 doses, depending on clinical conditions.
Children
2–6 years: 200–400 mg per day, divided into 1–3 doses;
6–12 years: 400–600 mg per day, divided into 1–3 doses;
from 12 years of age - doses as for adults.
Effervescent tablets 200 mg are dissolved in 1/3 cup of water.
Additional fluid intake enhances the mucolytic effect of the drug.
The duration of the course of treatment is determined by the doctor individually, depending on the nature of the disease (acute or chronic). The drug should not be taken for more than 4–5 days without consulting a doctor.
Application features
Patients with bronchial asthma should be closely monitored during treatment due to the possible development of bronchospasm. In the event of bronchospasm, treatment with acetylcysteine should be discontinued immediately.
There are isolated reports of severe skin reactions (Stevens-Johnson and Lyell syndromes) when taking acetylcysteine, therefore, in the event of changes in the skin or mucous membranes, the use of the drug should be immediately discontinued and a doctor should be consulted regarding its further use.
It is recommended to use the drug with caution in patients with a history of gastric and duodenal ulcers, especially in case of concomitant use of other drugs that irritate the gastric mucosa.
Acetylcysteine should be prescribed with caution to patients with liver or kidney diseases to avoid the accumulation of nitrogen-containing substances in the body.
The use of acetylcysteine, especially at the beginning of treatment, can cause liquefaction of bronchial secretions and increase their volume. If the patient is unable to cough up sputum effectively, postural drainage and bronchoaspiration are necessary.
Acetylcysteine affects histamine metabolism, so long-term therapy should not be prescribed to patients with histamine intolerance, as this may lead to symptoms of intolerance (headache, vasomotor rhinitis, itching).
Mucolytics can cause bronchial obstruction in children under 2 years of age. Due to the physiological characteristics of the respiratory system in children of this age group, the ability to clear respiratory secretions is limited. Therefore, mucolytics should not be used in children under 2 years of age.
A slight sulfuric odor is not a sign of a change in the properties of the medicinal product, but is specific to the active substance.
Pregnancy
Clinical data on the use of acetylcysteine in pregnant women are limited. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/fetal development, parturition or postnatal development.
Children
Use for children over 2 years of age.
Drivers
There is no evidence that acetylcysteine affects the ability to drive and use machines.
Overdose
There are no data on cases of overdose with oral administration of acetylcysteine.
Side effects
From the organs of hearing and vestibular apparatus: infrequently - tinnitus. From the respiratory system, chest organs and mediastinum: rarely - dyspnea, bronchospasm (mainly in patients with bronchial hyperreactivity associated with bronchial asthma); frequency unknown - rhinorrhea. From the gastrointestinal tract: infrequently - vomiting, diarrhea, stomatitis, abdominal pain, nausea, heartburn; rarely - dyspepsia; frequency unknown - bad breath. From the nervous system: infrequently - headache. From the heart: infrequently - tachycardia, arterial hypotension. From the vascular system: rare - hemorrhages. From the blood and lymphatic system: frequency unknown - anemia; cases of bleeding during the use of acetylcysteine, sometimes due to hypersensitivity reactions, have been reported. From the immune system: infrequently - hypersensitivity; rare - anaphylactic shock, anaphylactic/anaphylactoid reactions. Skin and subcutaneous tissue disorders: uncommon - urticaria, rash, angioedema, pruritus; frequency unknown - exanthema, eczema, angioedema. General disorders and administration site conditions: uncommon - hyperthermia; frequency unknown - facial edema.
In very rare cases, there have been reports of individual severe skin reactions (Stevens-Johnson syndrome and Lyell's syndrome) in association with acetylcysteine. In most cases, at least one other drug is more likely to be the cause of the mucocutaneous syndrome. Therefore, if any new changes appear on the skin or mucous membranes, you should consult a doctor and immediately discontinue acetylcysteine.
Interaction
Activated charcoal reduces the effectiveness of acetylcysteine.
Acetylcysteine is pharmacologically incompatible with antibiotics and proteolytic enzymes. When used simultaneously with antibiotics such as tetracyclines (except doxycycline), ampicillin, amphotericin B, cephalosporins, aminoglycosides, their interaction with the thiol group of acetylcysteine is possible, which leads to a decrease in the activity of both drugs. Therefore, the interval between the use of these drugs should be at least 2 hours. This does not apply to cefixime and loracarbef.
Storage conditions
Store in the original packaging, in a tightly closed tube, at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Shelf life - 2 years.
