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TL;DR
The review concludes that further clinical studies are needed to establish adequate dosages, routes of administration, and treatment protocols for NAC across the range of conditions it may address.
Antioxidants · 8 authors, 4 centres
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The review concludes that further clinical studies are needed to establish adequate dosages, routes of administration, and treatment protocols for NAC across the range of conditions it may address.
This narrative review synthesizes existing literature on N-acetylcysteine (NAC), an FDA-approved drug since 1963 also sold as an over-the-counter supplement. The authors cover NAC's pharmacokinetics, noting oral bioavailability of less than 10% due to first-pass metabolism, and its metabolism to cysteine used for glutathione synthesis. The review discusses NAC's safety profile, reporting that adverse effects range from mild (nausea, vomiting) to rare anaphylactoid reactions, particularly with intravenous administration, and that frequency of side effects is significantly higher with intravenous versus oral routes. The review notes that various human clinical studies have reported conflicting results and many studies were performed in vitro, highlighting the need for more clinical studies.