ESPA-NATS
ESPA-NATS: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: ESPA-NATS
ATX code: R05CB01
Active ingredient: acetylcysteine (Acetylcysteine)
Producer: Lindopharm GmbH (Germany)
Description and photo update: 2020-29-04
Prices in pharmacies: from 118 rubles.
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ESPA-NAC is an expectorant mucolytic agent.
Release form and composition
The drug is produced in the form of a powder for the preparation of a solution for oral administration: homogeneous, without foreign particles and agglomerates, almost white or white, with a fruity smell (3 g each in a sachet of three-layer material, 20 sachets in a cardboard box and instructions for using ESPA- NAC).
Composition for 1 sachet of the drug:
- active substance: acetylcysteine - 200 or 600 mg;
- additional components: orange flavor, sucrose, tartaric acid, colloidal silicon dioxide, sodium chloride.
Pharmacological properties
Pharmacodynamics
Acetylcysteine is a mucolytic agent that dilutes phlegm, increases its volume and facilitates evacuation; refers to derivatives of the amino acid cysteine. The action of the active substance is due to the ability of its constituent free sulfhydryl groups (SH-groups) to break intra- and intermolecular disulfide bonds of mucopolysaccharide chains. This effect provides a depolymerization of mucoproteins and a decrease in the viscosity of sputum, sometimes, however, this causes a significant increase in the volume of sputum, which requires aspiration of the contents of the bronchi.
ESPA-NAC demonstrates activity in mucous, purulent and mucopurulent sputum, does not affect immunity. Increases the production of less viscous sialomucins by goblet enterocytes, reduces the adhesion of bacteria to epithelial cells of the bronchial mucosa. The agent activates the mucous cells of the bronchi, which produce a secret that lyses fibrin. The active substance has a similar effect on the secretion produced against the background of inflammatory lesions of the ENT organs.
The drug has an antioxidant effect due to the ability of its SH-groups to interact with oxidative radicals and, as a result, to neutralize them. Acetylcysteine does not allow the inhibitory effect of HOC1-oxidant synthesized by the enzyme myeloperoxidase of active phagocytes in relation to the elastase inhibitor alpha-1-antitrypsin.
ESPA-NAC has some anti-inflammatory effect based on inhibition of the formation of free radicals and active oxygen-containing substances, which are responsible for the development of the inflammatory process in the lung tissue. Penetrating into the cell, acetylcysteine is converted by deacetylation into L-cysteine, which takes part in the synthesis of intracellular glutathione, a powerful antioxidant and cytoprotector. The active substance provides an increase in the production of intracellular glutathione, which plays an important role in redox processes, which explains the detoxifying effect of the drug against the background of paracetamol poisoning.
In patients with cystic fibrosis and chronic bronchitis, with the prophylactic use of ESPA-NAC, a decrease in the frequency and severity of exacerbations is recorded.
Pharmacokinetics
After oral administration, the absorption of the active substance is high. Bioavailability is approximately 10% due to the presence of a significant effect of the first passage through the liver with the formation of a pharmacologically active derivative - cysteine, as well as cystine and diacetylcystine.
The maximum value of the concentration (C max) of the drug in the plasma after oral administration is noted on average after 1-3 hours. The connection of acetylcysteine with plasma proteins is approximately 50%. It is excreted mainly by the kidneys in the form of inactive metabolites (diacetylcysteine, inorganic sulfates), a small part of the drug is eliminated unchanged with feces. The half-life (T 1/2) of the drug from the plasma is approximately 1 hour, with functional disorders of the liver, it increases to 8 hours. The substance passes through the placenta, accumulates in the amniotic fluid. There is no information on the penetration of acetylcysteine through the blood-brain barrier.
Indications for use
ESPA-NAC is recommended for use in the treatment of respiratory diseases, accompanied by the appearance of difficult to separate viscous sputum:
- laryngotracheitis, tracheitis;
- obstructive bronchitis, acute / chronic bronchitis;
- chronic obstructive pulmonary disease (COPD), bronchiolitis, bronchial asthma, bronchiectasis;
- pneumonia;
- cystic fibrosis.
Also ESPA-NAC is indicated for the treatment of acute and chronic sinusitis, inflammation of the middle ear (otitis media).
Contraindications
Absolute:
- hemoptysis, pulmonary bleeding;
- stage of exacerbation of gastric ulcer and 12 duodenal ulcer;
- glucose-galactose malabsorption, fructose intolerance, sucrase / isomaltase deficiency (the product contains sucrose);
- pregnancy, lactation period;
- age up to 2 years - for a dosage of 200 mg; up to 14 years (in the treatment of cystic fibrosis - up to 6 years) - for a dosage of 600 mg;
- hypersensitivity to any component of the drug.
Relative (it is recommended to use ESPA-NAC with extreme caution):
- bronchial asthma, obstructive bronchitis;
- hepatic and / or renal failure;
- arterial hypertension;
- varicose veins of the esophagus;
- a history of indication of gastric ulcer and 12 duodenal ulcer;
- adrenal gland diseases;
- intolerance to histamine (it is required to avoid prolonged use of ESPA-NAC, since acetylcysteine affects the metabolic processes of histamine and can cause signs of intolerance in the form of vasomotor rhinitis, headache, itching).
ESPA-NATS, instructions for use: method and dosage
ESPA-NAC powder is taken orally after meals, dissolving the required dose in 200 ml of hot water (1 glass).
Recommended doses and frequency of administration for a dosage of 200 mg, in the absence of other prescriptions:
- children from 2 to 6 years old: 100 mg (½ sachet) 2-3 times / day;
- children from 6 to 14 years old: 200 mg (1 sachet) 2 times / day;
- adolescents over 14 years old and adults: 200 mg (1 sachet) 2-3 times / day.
In case of cystic fibrosis, children 2–6 years old are prescribed ESPA-NAC at a dose of 200 mg 2 times / day, over 6 years old - 3 times / day in the same dose.
ESPA-NAC at a dosage of 600 mg for adults, adolescents over 14 years old (in the treatment of cystic fibrosis - for children over 6 years old) is recommended to take 600 mg (1 sachet) 1 time / day.
With short colds, the course is 5-7 days. With cystic fibrosis and chronic bronchitis, the drug should be used for a longer period to prevent infections. In the case of long-term illnesses, the course of treatment is established by the attending physician.
To enhance the mucolytic effect of the drug during treatment, you should consume a sufficient amount of liquid.
Side effects
- respiratory system: extremely rarely - pulmonary bleeding as a manifestation of a hypersensitivity reaction;
- gastrointestinal tract (GIT): rarely - nausea, vomiting, stomatitis, heartburn, dyspepsia, abdominal pain, diarrhea;
- cardiovascular system: rarely - lowering blood pressure (BP), tachycardia;
- sense organs: infrequently - tinnitus;
- allergic reactions: rarely - itching, urticaria, skin rash, exanthema, bronchospasm (mostly in patients with a hyperreactive bronchial system against the background of bronchial asthma), angioedema; extremely rarely - anaphylactic reactions, including anaphylactic shock; toxic epidermal necrolysis, Stevens-Johnson syndrome (a causal relationship with the use of the drug has not been identified);
- others: rarely - fever, headache; isolated cases - the development of bleeding due to the presence of hypersensitivity reactions, a decrease in platelet aggregation.
Overdose
With oral administration of acetylcysteine in a daily dose of up to 11.6 g for 3 months, life-threatening symptoms of intoxication were not identified. When the drug was administered orally at a dose below 0.5 g / kg, there were no signs of poisoning. Overdose symptoms may include nausea, heartburn, vomiting, stomach pain, diarrhea. Hypersecretion may develop in newborns.
Treatment is symptomatic.
special instructions
The powder should be dissolved in glassware, avoiding contact with rubber (due to the formation of sulfides with a characteristic odor), metals, oxygen, and easily oxidizing substances.
In the presence of bronchial asthma and obstructive bronchitis, a mucolytic agent should be used with caution under regular monitoring of the patency of the bronchial tree.
Patients with diabetes should take into account that ESPA-NAC powder contains sucrose - 1 sachet of 200/600 mg contains 0.23 / 0.2 bread units (XE), respectively.
In patients with serious skin lesions, such as Lyell's or Stevens-Johnson's syndrome, in the early phase, body pain, rhinitis, sore throat, fever, and cough may occur. With symptomatic therapy in these cases, the erroneous use of mucolytic agents is possible.
There were isolated reports of the detection of Lyell and Stevens-Johnson syndromes in the period that coincided with the use of ESPA-NAC. If, during the course of treatment, the development of a rash, spots on the face and trunk is observed with possible further spread to other parts of the body, you should stop taking the drug and immediately consult a doctor, since these disorders may be signs of the development of the above syndromes.
Influence on the ability to drive vehicles and complex mechanisms
When treated with the drug in therapeutic doses, it does not adversely affect the ability to drive vehicles and control complex mechanisms.
Application during pregnancy and lactation
Data on the use of ESPA-NAC during pregnancy and during breastfeeding are limited; therefore, drug therapy in pregnant and breastfeeding women is contraindicated.
If it is necessary to treat with acetylcysteine during lactation, it is necessary to resolve the issue of transferring the child to artificial feeding.
Pediatric use
ESPA-NAC at a dosage of 200 mg is contraindicated for children under 2 years old, at a dosage of 600 mg for children under 14 years old (in the treatment of cystic fibrosis - for children under 6 years old).
With impaired renal function
In the presence of renal impairment, ESPA-NAC should be used with caution.
For violations of liver function
Patients with hepatic impairment should take ESPA-NAC with extreme caution.
Drug interactions
- proteolytic enzymes, antibiotics - cephalosporins, penicillins, tetracycline, erythromycin, amphotericin B: pharmaceutical incompatibility of these drugs with the drug is noted;
- antitussives: the risk of mucus stagnation is aggravated due to suppression of the cough reflex;
- nitroglycerin: the vasodilating effect of this substance is enhanced when combined with acetylcysteine and vasodilating agents;
- tetracycline, penicillins, cephalosporins: absorption of these drugs decreases, therefore it is recommended to take them no earlier than 2 hours after oral administration of acetylcysteine.
Analogs
Analogs of ESPA-NAC are Acetylcysteine, Eifa AC, Acestin, ACTS Long, Fluimucil, ACC, N-AC-ratiopharm, ACC Active, Mucocil Solution Tablets, Acetylcysteine-Teva, Acetylcysteine VERTEX, Acetylcysteine.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C, out of the reach of children.
Shelf life is 4 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about ESPA-NAC
According to rare reviews about ESPA-NAC, found on specialized sites, it is an effective mucolytic agent that facilitates the passage of viscous sputum and soothes cough. Patients note the pleasant taste of the drug, its good tolerance, and also low cost compared to other popular analogues.
Price for ESPA-NAC in pharmacies
The price of ESPA-NAC in the form of a powder for preparing a solution for oral administration can be (for 20 sachets of 3 g each): at a dosage of 200 mg - 120–150 rubles, at a dosage of 600 mg - 170–210 rubles.
ESPA-NAC: prices in online pharmacies
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Drug name Price Pharmacy |
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Espa-Nat 200 mg powder for solution for oral administration 3 g 20 pcs. 118 RUB Buy |
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Espa-Nat powder for prig solution for internal approx. 200mg pack. 3g 20 pcs. 121 RUB Buy |
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Espa-Nat 600 mg powder for preparation of oral solution 3 g 20 pcs. 149 r Buy |
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Espa-nat powder for prig solution for internal approx. 600mg pack. 3g 20 pcs. RUB 200 Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
