Reviewed by Peptide Treatments Medical Advisory Board (Medical Advisory Board)
NAC (N-Acetylcysteine): Evidence Summary
Evidence summary for NAC (N-Acetylcysteine) across studied indications. Each indication is graded using our evidence tier system based on the quality and quantity of available clinical data.
Back to NAC (N-Acetylcysteine) overview| Indication | Evidence Tier | Trial Count | Summary |
|---|---|---|---|
| Acetaminophen overdose antidote | Tier A | 20 | Definitive efficacy for hepatoprotection; standard of care worldwide |
| Mucolytic (CF, COPD, bronchitis) | Tier A | 30 | FDA-approved since 1963; modest reduction in COPD exacerbations |
| Psychiatric adjunct (OCD, addiction) | Tier B | 15 | Meta-analysis of 15 RCTs shows modest adjunct benefit |
| Contrast nephropathy prevention | Tier C | 20 | 2021 meta-analysis of 20 RCTs found no significant benefit |
References (11)
- Intravenous N-acetylcysteine: the treatment of choice for paracetamol poisoning — Buckley NA, Whyte IM, O'Connell DL, Dawson AH . BMJ (2005) PMID: 10584588
- Oral N-acetylcysteine reduces exacerbation rate in COPD — Decramer M, Rutten-van Molken M, Dekhuijzen PN, et al. . Lancet (2007) PMID: 18534556
- N-acetyl cysteine as a glutathione precursor for schizophrenia and bipolar — Berk M, Copolov DL, Dean O, et al. . Biological Psychiatry (2006)
- N-acetylcysteine reduces cocaine craving — LaRowe SD, Kalivas PW, et al. . American Journal on Addictions (2011) PMID: 40083914
- Molecular mechanisms of N-acetylcysteine actions. — Zafarullah M, Li WQ, Sylvester J, et al. . Cellular and molecular life sciences : CMLS (2003) PMID: 12613655
- N-Acetylcysteine as an antioxidant and disulphide breaking agent: the reasons why. — Aldini G, Altomare A, Baron G, et al. . Free radical research (2018) PMID: 29742938
- The mechanism of action of N-acetylcysteine (NAC): The emerging role of H(2)S and sulfane sulfur species. — Pedre B, Barayeu U, Ezeriņa D, et al. . Pharmacology & therapeutics (2021) PMID: 34171332
- N-acetylcysteine Treatment in Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis/Pre-COPD: Distinct Meta-analyses. — Papi A, Alfano F, Bigoni T, et al. . Archivos de bronconeumologia (2024) PMID: 38555190
- The Multifaceted Therapeutic Role of N-Acetylcysteine (NAC) in Disorders Characterized by Oxidative Stress. — Raghu G, Berk M, Campochiaro PA, et al. . Current neuropharmacology (2021) PMID: 33380301
- Performance and Side Effects of Supplementation with N-Acetylcysteine: A Systematic Review and Meta-Analysis. — Rhodes K, Braakhuis A . Sports medicine (Auckland, N.Z.) (2017) PMID: 28102488
- N-acetylcysteine for chronic kidney disease: a systematic review and meta-analysis. — Ye M, Lin W, Zheng J, et al. . American journal of translational research (2021) PMID: 34017406