ACC Sandoz Drug Interactions

Interaction studies have only been performed in adults.
Combined use of Acetylcysteine with antitussives (cough-relieving agents) may cause a dangerous secretory congestion due to the reduced cough reflex, so that an especially careful diagnosis is required for this combination treatment.
Antibiotics: Reports to date on an inactivation of antibiotics (tetracyclines, aminoglycosides, penicillins) due to acetylcysteine exclusively refer to in vitro experiments in which the relevant substances were mixed directly. Nevertheless for safety reasons, oral antibiotics should be administered separately and at an interval of at least 2 hours. This does not apply to cefixime and loracarbef.
Activated carbon in high doses: The use of activated charcoal may reduce the effect of acetylcysteine.
Acetylcysteine/glyceryl trinitrate: Co-administration of acetylcysteine can result in an enhancement of vasodilator and antiplatelet effects of glyceryl trinitrate (nitroglycerine).
If a common treatment with nitroglycerin and acetylcysteine is considered necessary, the patient should be monitored for a potential hypotension, which could be serious and may be indicated by headache.
Changes in the determination of laboratory parameters: Acetylcysteine may affect the colorimetric assay of salicylates; in urine tests, acetylcysteine may influence the results of the determination of ketone bodies.
The dissolution of acetylcysteine formulations together with other medicinal products is not recommended.