Hidonac inj 5 g/25 mL
Hidonac inj 5 g/25 mL
Packaging: 25 ml/Bottle (Glass)
Toxic Epidermal Necrolysis
The beneficial effects of n-acetylcysteine in toxic epidermal necrolysis have been ascribed to its glutathione replenishing property, inhibition of tumor necrosis factor-α and IL-1 (the most prominent cytokines in the pathogenesis of this disease) and blockade of cutaneous lymphocyte antigen that directs the inflammatory cells to the skin.
Drug reaction with eosinophilia and systemic symptoms
N-acetylcysteine acts by detoxifying reactive oxygen species produced by the offending drug, which have been implicated in the disease pathogenesis and hence the drug is effective only when given early.
Trichotillomania is an abnormal habit and impulse control disorder characterized by a sense of tension immediately before pulling hair or when trying to resist pulling and relief of this tension after hair pulling. The mechanism of action of n-acetylcysteine in trichotillomania is believed to be the reduction of glutamate levels in the nucleus accumbens.
Skin Picking Disorder and Prurigo
Skin picking or dermatotillomania has been classified as a distinct entity different from obsessive compulsive disorders. These effects are due to the antioxidant and glutamate modulatory effects of n-acetylcysteine.
Varying levels of improvement in the appearance of skin and skin picking was seen in patients of subacute prurigo who received n-acetylcysteine.
Nail tic disorders include nail biting or onychotillomania and onychophagia. N-acetylcysteine has been shown to reduce the symptoms of nail biting in case reports due to its effect on glutamate modulation.A double-blind, placebo-controlled trial showed that the nail length in group taking n-acetylcysteine increased significantly more than the nail length of the placebo group after 1 month of treatment.
Diseases with disturbed epidermal barrier/keratinization disorders
The effect is due to the anti-proliferative effects of n-acetylcysteine which diminishes the hyperkeratosis of lamellar ichthyosis and improves the skin barrier function.
Administration of n-acetylcysteine in drinking water led to increased expression of cell adhesion molecules vital for the formation of skin barrier such as epidermal growth factor receptor. A Japanese study based on these findings found that topical 20% n-acetylcysteine for 4 weeks improved the skin hydration and decreased transepidermal water loss in a majority of atopic dermatitis patients as well as healthy individuals.
N-acetylcysteine is known to be protective in irritant contact dermatitis and contact hypersensitivity reactions .
Protection from photodamage
N-acetylcysteine may have a role as a prophylactic agent before sun exposure, and thus, may help in the prevention of malignant melanoma as it reduces oxidative stress and decreases the expression of vascular endothelial growth factor in a dose-dependent fashion. It also decreases the expression of Nodal, a gene, whose expression in dysplastic nevi predicts transformation to aggressive melanoma.
N-acetylcysteine acts in melasma probably by increasing glutathione which stimulates the synthesis of pheomelanin, which is lighter in color than melanin. Sulfur in n-acetylcysteine may also complex with copper to inhibit the enzyme tyrosinase. Mild-to-strong bleaching of the skin was observed in 90% patients. No side-effects due to n-acetylcysteine were noted in any of the patients.
Most cases of pseudoporphyria occur in renal failure patients on hemodialysis. N-acetylcysteine is proposed to decrease oxidative stress and relieve angiopathy and hypoxia leading to this condition.
Collagen vascular diseases
N-acetylcysteine has been used in systemic sclerosis due to its effect on vasculature and inhibition of fibroblast proliferation.
Systemic lupus erythematosus
Proven to be effective in systemic lupus erythematosus-induced nephritis in a case report and neuropsychiatric conditions in a placebo-controlled, randomized trial.
The effects of n-acetylcysteine on wound healing are related to its action as an antioxidant, support of nitric oxide system, stimulation of cell proliferation, migration and collagenous expression of matrix metalloproteinases.Recently, there was a report of healing of non-healing pressure ulcers in two patients with n-acetylcysteine topically applied to the wounds.
Polycystic ovarian syndrome and hyperandrogenism
N-acetylcysteine is proposed to benefit in polycystic ovarian syndrome by lowering insulin secretion and restoring the deranged hormonal profile in affected patients. N-acetylcysteine produced significant reduction in free testosterone and hirsutism scores at 6 months after treatment and the results were comparable to the effect produced by metformin.
While n-acetylcysteine helps improve inflammatory lesions of acne by quenching reactive oxygen species, inhibition of leukotrienes and prostaglandins, stabilization of membranes and inhibiting lipid peroxidation, its effect on comedones is less well defined and could be due to decreased sebum production or inhibition of Pityrosporum ovale, a potential comedogenic organism that has been demonstrated in comedones.
Other potential uses
The role of n-acetylcysteine in androgenetic alopecia is proposed as it has been shown to reduce the free radicals and decrease the senescence of balding human dermal papillae obtained from patients of androgenetic alopecia. While in-vitro studies supported the idea that n-acetylcysteine may be useful in the treatment of methemoglobinemia, a crossover, randomized trial on human volunteers with induced methemoglobinemia demonstrated that intravenous n-acetylcysteine offers no reduction in methemoglobin concentration in blood.
Acetylcysteine administration, by increasing glutathione supplies, allows to face its increased needs, thus preventing liver injuries.
It is recommended not to mix other medicines with HIDONAC solution.
Acetylcysteine may interact with rubber and metals (such as iron, nickel, copper) therefore the use of glass or plastic materials is recommended.
Dosage/Direction for Use
By IV infusion. Acetylcysteine (HIDONAC) should be administered by intravenous infusion preferably using Glucose 5% as the infusion fluid. Sodium Chloride 0.9% solution may be used if Glucose 5% is not suitable.
Adverse Reaction: Urticaria, angioedema, bronchospasm, nausea, vomiting, hypertension, tachycardia, dizziness & fever.