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Cetylev oral, effervescent and EZChar

Determining the interaction of Cetylev oral, effervescent and EZChar and the possibility of their joint administration.

Check result:
Cetylev oral, effervescent <> EZChar
Relevance: 28.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

A number of studies have been conducted to determine whether activated charcoal absorbs N-acetylcysteine (NAC) and, if so, whether the interaction is clinically significant. No specific therapeutic blood level has been determined for NAC, so studies that show decreases in the area under the plasma concentration-time curve (AUC) may not be relevant. One study has indicated that a 6-gram charcoal dose would absorb 96.2% of an NAC dose. Other studies have found little difference in the AUC, C(max), or T(max) when NAC is administered alone or without charcoal. In vitro studies have suggested that NAC may reduce the adsorptive capacity of charcoal. The clinical significance of this finding is unclear. Much of the timing depends on the overdose situation. When the overdose has occurred within the last hour, it may be reasonable to give charcoal, then wait to administer NAC until the laboratory has determined blood acetaminophen levels.

References
  • Renzi FP, Donovan JW, Martin TG, Morgan L, Harrison EF "Concomitant use of activated charcoal and N-acetylcysteine." Ann Emerg Med 14 (1985): 568-72
  • Mann KV "Treatment of acetaminophen overdose when oral acetylcysteine therapy is not tolerated." Clin Pharm 7 (1988): 563-4
  • Spiller HA, Krenzelok EP, Grande GA, Safir EF, Diamond JJ "A prospective evaluation of the effect of activated charcoal before oral N-acetylcysteine in acetaminophen overdose." Ann Emerg Med 23 (1994): 519-23
  • Rose SR "Subtleties of managing acetaminophen poisoning." Am J Hosp Pharm 51 (1994): 3065-8
  • Brent J "Are activated charcoal-N-acetylcysteine interactions of clinical significance?" Ann Emerg Med 22 (1993): 1860-2
  • Smilkstein MJ "A new loading dose for N-acetylcysteine? The answer is no." Ann Emerg Med 24 (1994): 538-9
  • Watson WA, McKinney PE "Activated charcoal and acetylcysteine absorption: issues in interpreting pharmacokinetic data." DICP 25 (1991): 1081-4
  • North DS, Peterson RG, Krenzelok EP "Effect of activated charcoal administration on acetylcysteine serum levels in humans." Am J Hosp Pharm 38 (1981): 1022-4
  • Tenenbein PK, Sitar DS, Tenenbein M "Interaction between N-acetylcysteine and activated charcoal: implications for the treatment of acetaminophen poisoning." Pharmacotherapy 21 (2001): 1331-6
  • Holdiness MR "Clinical pharmacokinetics of N-acetylcysteine." Clin Pharmacokinet 20 (1991): 123-34
  • Perrone J, Hoffman RS, Goldfrank LR "Special considerations in gastrointestinal decontamination." Emerg Med Clin North Am 12 (1994): 285-99
Cetylev oral, effervescent

Generic Name: acetylcysteine

Brand name: Cetylev, Mucomyst-10

Synonyms: Cetylev (oral, effervescent), Cetylev

EZChar

Generic Name: charcoal

Brand name: Actidose-Aqua, Activated Charcoal, Charcoal Plus DS, EZChar, Insta-Char, Liqui-Char, Optimum Charcoal, Liqui-Char with Sorbitol, Charcocaps, Activated Charcoal with Sorbitol, Charcoaid 2000, Charcoaid-G, Char-Flo with Sorbitol, Charcoaid, Charcodote, Char-Flo Aqueous Base, Actidose-Aqua Advance, JL. Bragg's Medicinal Charcoal, Medicoal, Karbons, Carbomix, Carbosorb X, Charcotabs, Healthstream Activated Charcoal, Charcotrace, Chem Mart Nasal Decongestant Capsule, Pharmacia Carbosorb, Norit, Eucarbon, Active Carbon

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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