Acetylcysteine is a medication with many uses, ranging from breaking up mucus, to replacing certain sulfate molecules lost in autism, to reversing acetaminophen overdoses. Many factors can influence acetylcysteine dosage, but the main factor is the condition this drug is being used to treat. Other factors, such as the age of the patient, body weight, and the presence of liver or kidney damage could influence how much of this medication is used on a given individual, as well.
When used to reverse an overdose of the over the counter painkiller acetaminophen, the total acetylcysteine dosage is contingent on body weight. An initial loading dose of 150 milligrams (mg) per kilogram (kg) is given in 200 milliliters (mL) of saline over the first hour. Next, 50 mg per kg is given in 500 mL over the following four hours. Finally, 100 mg per kg of this medication is given in 1000 mL of solution over 16 hours, for a total of 300 mg per kg over 21 hours.
Children under 88 pounds (40 kilograms) may use a more concentrated acetylcysteine dosage. The mg per kg used to treat children in overdose is the same as that for adults. The main difference is that in children, the amount of liquid is halved, concentrating the solution even further.
Some forms of cystic fibrosis can lead to dense mucus that is difficult to clear out. This medication is sometimes used to disintegrate the mucus and make it easier to cough up. A high acetylcysteine dosage of 600 mg, given three times a day, can be administered. Research has shown that the use of this medication in this dose promotes higher survival rates, and can help these patients from developing pneumonia.
For more common uses, such as in the treatment of autism or of congestion, this medication is given in much smaller amounts. Acetylcysteine for these purposes comes in 10 mL and 30 mL bottles of 10% and 20% solutions. In this form, 1 to 10 mL of either solution may be injected or inhaled at once. Generally, slightly higher doses are needed of even the stronger 20% solution when this drug is vaporized through a nebulizer, and inhaled.
Some studies believe that kidney or liver damage could have an impact on the ability of this medication to be cleared from the body. Many medical practitioners do not lower the acetylcysteine dosage for individuals with liver damage, however. Doctors may choose to lower the dose in patients with kidney issues if they feel that those issues would impede the drug's clearance.