N-acetylcysteine

An amino acid senthetic derivate.

Phase of research

Potential treatment - pre-clinical evidence

How it helps

Other treatment

Drug status

Used to treat other disease

2
Supporting references
0
Contradictory references
25
AI-suggested references
8
Clinical trials

General information

N-acetylcysteine is a synthetic derivate of L-cysteine with antioxidant properties. It serves as a precursor to glutathione in the liver. N-acetylcysteine is also used as a mucolytic agent and experimentally displayed antiviral activity (NCIt).

N-acetylcysteine on DrugBank
N-acetylcysteine on PubChem
N-acetylcysteine on Wikipedia


Synonyms

Acetylcysteine


Marketed as

ACETADOTE; ACETYLCYSTEINE; FLUIMUCIL; LYSOX; MUCOLYSIN; MUCOMYST; PARVOLEX

 

Structure image - N-acetylcysteine

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


Supporting references

Link Tested on Impact factor Notes Publication date
Repurposing FDA-approved drugs for SARS-CoV-2 through an ELISA-based screening for the inhibition of RBD/ACE2 interaction
Small molecule In vitro
in vitro binding assay; HEK 293T cells; Vero E6 cells; Calu-3 cells 10.16

Disrupted ACE2-RBD (of SARS-CoV-2 spike protein) interaction and inhibited RBD binding to ACE2 on cell surface in vitro in dose-dependent manners. Did not inhibit viral entry, however.

Nov/18/2020
The Combination of Bromelain and Acetylcysteine (BromAc) Synergistically Inactivates SARS-CoV-2
Biophysical assay Protein factor Small molecule In vitro Mixed substance
in vitro biophysical assay; Vero cells; SARS-CoV-2 live virus 3.82

In a combined formulation with bromelain (“BromAc”) the compound was active against SARS-CoV-2 in vitro. It was observed to target both Envelope and Spike proteins.

Mar/06/2021

AI-suggested references

Link Publication date
l-Cysteine Stimulates the Effect of Vitamin D on Inhibition of Oxidative Stress, IL-8, and MCP-1 Secretion in High Glucose Treated Monocytes.
Feb/17/2021
Perspectives for the Use of N-acetylcysteine as a Candidate Drug to Treat COVID-19.
Mar/31/2020
Oral high-dose acetylcysteine: Effective against the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)?
Oct/28/2020
An in vitro study on anti-carcinogenic effect of remdesivir in human ovarian cancer cells via generation of reactive oxygen species.
Oct/07/2021
The Potential Mechanism of N-acetylcysteine in Treating COVID-19.
Dec/30/2020
Reactive oxygen species as an initiator of toxic innate immune responses in retort to SARS-CoV-2 in an ageing population, consider N-acetylcysteine as early therapeutic intervention
May/03/2021
A pilot study on intravenous N-Acetylcysteine treatment in patients with mild-to-moderate COVID19-associated acute respiratory distress syndrome
Jun/10/2021
Acetylcysteine for the Treatment of Suspected Remdesivir-Associated Acute Liver Failure in COVID-19: A Case Series
Oct/27/2020
The Mechanisms of the Growth Inhibitory Effects of Paclitaxel on Gefitinib-resistant Non-small Cell Lung Cancer Cells.
Sep/03/2021
N-acetycysteine: A potential therapeutic agent in COVID-19 infection.
Jul/24/2020
Intravenous N-Acetylcysteine in Management of COVID-19: A Case Series
Mar/24/2022
N-Acetylcysteine: A potential therapeutic agent for SARS-CoV-2
May/30/2020
Thiol-based chemical probes exhibit antiviral activity against SARS-CoV-2 via allosteric disulfide disruption in the spike glycoprotein
Aug/05/2021
Role of pirfenidone in TGF-beta pathways and other inflammatory pathways in acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection: a theoretical perspective
Apr/21/2021
Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteine.
Jul/22/2020
Harnessing adenosine A2A receptors as a strategy for suppressing the lung inflammation and thrombotic complications of COVID-19: Potential of pentoxifylline and dipyridamole
Jul/02/2020
The SARS-CoV-2 helicase as a target for antiviral therapy: Identification of potential small molecule inhibitors by in silico modelling
Apr/18/2022
Ex-vivo mucolytic and anti-inflammatory activity of BromAc in tracheal aspirates from COVID-19
Oct/18/2021
The function of SARS-CoV-2 spike protein is impaired by disulfide-bond disruption with mutation at cysteine-488 and by thiol-reactive N-acetyl-cysteine and glutathione
Nov/13/2020
Inhibition of ACE2 Expression by Ascorbic Acid Alone and its Combinations with Other Natural Compounds
May/10/2021
Inhibitory effects of specific combination of natural compounds against SARS-CoV-2 and its Alpha, Beta, Gamma, Delta, Kappa, and Mu variants
Jan/21/2022
Use of N-Acetylcysteine at high doses as an oral treatment for patients hospitalized with COVID-19
May/29/2020
COVID-19: The Potential Role of Copper and N-acetylcysteine (NAC) in a Combination of Candidate Antiviral Treatments Against SARS-CoV-2.
May/03/2020
Antioxidants and pentoxifylline as coadjuvant measures to standard therapy to improve prognosis of patients with pneumonia by COVID-19
Jun/24/2021
Nebulization of glutathione and N-Acetylcysteine as an adjuvant therapy for COVID-19 onset.
Aug/08/2021

Clinical trials

ID Title Status Phase Start date Completion date
NCT04374461 A Study of N-acetylcysteine in Patients With COVID-19 Infection Active, not recruiting Phase 2 May/01/2020 May/01/2023
  • Alternative id - 20-168
  • Interventions - Drug: N-acetylcysteine|Other: Peripheral Blood
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Memorial Sloan Kettering Cancer Center, New York, New York, United States
  • Study designs - Allocation: Non-Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 48
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Arm A: number of patients who are successfully extubated and/or transferred out of critical care due to clinical improvement|Arm B: number of patients who are discharged from the hospital due to clinical improvement
NCT04792021 Effect of N-acetylcysteine on Oxidative Stress in COVID-19 Patients Recruiting Phase 3 Mar/09/2021 Nov/01/2021
  • Alternative id - N-acetylcysteine in COVID 19
  • Interventions - Drug: N-acetylcysteine
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Al Assema Hospital, Cairo, Egypt
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Double (Participant, Care Provider)|Primary Purpose: Treatment
  • Enrollment - 60
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Change in TNF alfa level from baseline|Change in IL-6 level from baseline|Change in glutathione peroxidase level from baseline|Length of hospital stay|Need for mechanical ventilation
NCT04755972 Mucolytics in Patients on Invasive Mechanical Ventilation Due to Severe Acute Respiratory Syndrome Coronavirus 2 Completed Not Applicable Oct/01/2020 Jul/29/2021
  • Alternative id - 2181-147-01/06/M.S.-20-02
  • Interventions - Other: Inhalation of N-acetylcysteine|Other: Inhalation of 5% sodium chloride|Other: Inhalation of 8,4% sodium bicarbonate
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Clinical Hospital Centre Split, Split, Croatia
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Prevention
  • Enrollment - 175
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Difference between 4 arms regarding ventilator-associated pneumonia rate|Number of ventilator-free days|Mortality
NCT05074121 NAC for Attenuation of COVID-19 Symptomatology Not yet recruiting Phase 2 Mar/31/2022 Feb/01/2023
  • Alternative id -
  • Interventions - Drug: N-acetylcysteine|Other: Placebo
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Cambridge Health Alliance, Everett, Massachusetts, United States
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Triple (Participant, Care Provider, Investigator)|Primary Purpose: Treatment
  • Enrollment - 200
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Symptom severity|Symptom duration|Need for higher level of care/hospitalization
NCT04703036 Glutathione, Oxidative Stress and Mitochondrial Function in COVID-19 Recruiting Early Phase 1 Jan/11/2021 Dec/31/2023
  • Alternative id - H48057
  • Interventions - Dietary Supplement: Glycine|Dietary Supplement: N-acetylcysteine|Dietary Supplement: Alanine
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Baylor College of Medicine, Houston, Texas, United States
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Double (Participant, Investigator)|Primary Purpose: Other
  • Enrollment - 64
  • Age - 55 Years to 85 Years   (Adult, Older Adult)
  • Outcome measures - Change in Glutathione concentrations|Change in Interleukein 6 concentrations|Change in Ordinal scale|Change in oxidative stress|Change in marker of damage due to oxidative stress|Change in inflammatory cytokines|Change in mitochondrial energetics|Change in immune function|Change in cognition|Change in function|Change in fatigue|Change in circulating marker of memory
NCT04928495 Clinical Trial With N-acetylcysteine and Bromhexine for COVID-19 Not yet recruiting Phase 3 Jul/15/2021 Jun/09/2022
  • Alternative id - AVANTI-C19
  • Interventions - Drug: Vitamin C|Drug: N-acetylcysteine (NAC)|Drug: NAC + Bromhexine (BMX)
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Núcleo de Biomedicina - NUBIMED, Fortaleza, Ceará, Brazil
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 219
  • Age - 18 Years to 60 Years   (Adult)
  • Outcome measures - The time to recovery, defined at day 7 days follow up after enrollment, on which a patient met the criteria for category 1 or 2 on the four-category ordinal scale. [Time Frame: Day 7 follow up after enrollment.]|SARS-CoV-2 RNA viral load measurements change. [ Time Frame: Change between Day 1 and Day 7 follow up after enrollment. ]|Proportion of patients with qualitative serum IgM / IgG. [ Time Frame: Proportion of positive patients at Day 7 for IgM / IgG (N; %). ]|Biomarkers (IL-6, MCP-3, D-dimer, IL1-RA, IL-10, GCSF, TNF-α, MCP-1, IL-2R, MIP-1 alpha, IP-10, IL-8, NT-proBNP, Troponin I, CRP and procalcitonin) measurements change. [ Time Frame: Change between Day 1 and Day 14 follow up after enrollment. ]
NCT05258682 Safety of Nebulized Combination Therapy BromAc® in COVID-19 Respiratory Disease Not yet recruiting Phase 1|Phase 2 May/01/2022 Oct/30/2022
  • Alternative id - MUC-COV-003
  • Interventions - Drug: Bromelains|Drug: Acetylcysteine
  • Study type - Interventional
  • Study results - No Results Available
  • Locations -
  • Study designs - Allocation: N/A|Intervention Model: Single Group Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 30
  • Age - 18 Years to 75 Years   (Adult, Older Adult)
  • Outcome measures - Evaluate the treatment-emergent adverse events (AEs) of BromAc therapy following nebulised delivery|Proportion of participants that proceed to invasive ventilation for deterioration of COVID-19 (need for mechanical ventilation)|World Health Organisation (WHO) modified ordinal scale clinical score|Improvement or deterioration in oxygenation|All-cause mortality|Dose related toxicities|Treatment-emergent serious adverse events (SAEs)
NCT04419025 Efficacy of N-Acetylcysteine (NAC) in Preventing COVID-19 From Progressing to Severe Disease Completed Phase 2 Sep/23/2020 May/14/2021
  • Alternative id - CHA-IRB-1139/05/20
  • Interventions - Drug: N-acetylcysteine
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - CHA Cambridge Hospital, Cambridge, Massachusetts, United States|CHA Everett Hospital, Everett, Massachusetts, United States|CHA Respiratory Clinic, Somerville, Massachusetts, United States|CHA Somerville campus, Somerville, Massachusetts, United States
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 165
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Decrease in Respiratory Rate|Hospital length of stay (LOS)|Need for mechanical ventilation|Length of time intubated|Need for hospitalization|Recovery disposition