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N-Acetyl Cysteine

What does n-acetyl cysteine do?

N-acetyl cysteine (NAC) is an altered form of the amino acid cysteine, which is commonly found in food and synthesized by the body.

NAC helps break down mucus. Double-blind research has found that NAC supplements improved symptoms and prevented recurrences in people with chronic bronchitis.1 2 3 NAC may also protect lung tissue through its antioxidant activity.4

NAC helps the body synthesize glutathione, an important antioxidant. In animals, the antioxidant activity of NAC protects the liver from the adverse effects of exposure to several toxic chemicals. NAC also protects the body from acetaminophen toxicity and is used at very high levels in hospitals for patients with acetaminophen poisoning. It has also been shown to be effective at treating liver failure from causes other than acetaminophen poisoning (e.g., hepatitis, and other drug toxicity)5 and at preventing kidney damage caused by injections of iopromide, a contrast medium used in people scheduled to undergo computerized tomography (CT) imaging.6

Supplementation with NAC has been shown to reduce the proliferation of certain cells lining the colon and may reduce the risk of colon cancer in people with recurrent polyps in the colon.7

There have been several case reports of oral NAC producing dramatic improvements in Unverricht-Lundborg disease, an inherited degenerative disorder involving seizures and progressive disability.8 9 One study used 3 grams of NAC per day.

Oral supplementation with NAC has been used successfully in two cases to treat a rare syndrome that complicates kidney dialysis.10 This condition, known as pseudoporphyria, has no other known treatment. Controlled clinical trials are needed to confirm these preliminary observations.

People undergoing a certain cardiac procedure (coronary angiography) are at risk of developing kidney damage from the injected dye that is used to visualize the coronary arteries. In a double-blind study, oral administration of NAC reduced by 86% the incidence of kidney damage in people undergoing this procedure.11 The amount of NAC used in that study was 400 mg twice a day, on the day before and the day of the procedure.12 Other studies have shown that NAC is protective only when a low dose of dye is used.

Where is n-acetyl cysteine found?

Cysteine, the amino acid from which NAC is derived, is found in most high-protein foods. NAC is not found in the diet.

N-acetyl cysteine has been used in connection with the following conditions (refer to the individual health concern for complete information):


Rating Health Concerns
Acetaminophen poisoning
Bronchitis (chronic)
Chronic obstructive pulmonary disease (COPD)
Angina pectoris
Heart Attack (IV immediately following a myocardial infarction)
HIV support
Prevention of kidney damage during coronary angiography
Unverricht-Lundborg Disease


Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.


Who is likely to be deficient of n-acetyl cysteine?

Deficiencies of NAC have not been defined and may not exist. Deficiencies of the related amino acidcysteine have been reported in HIV-infected patients.13

How much n-acetyl cysteine is usually taken?

Healthy people do not need to supplement NAC. Optimal levels of supplementation remain unknown, though much of the research uses 250–1,500 mg per day.

Are there any side effects or interactions with n-acetyl cysteine?

One study reported that 19% of people taking NAC orally experienced nausea, vomiting, headache, dry mouth, dizziness, or abdominal pain.14 These symptoms have not been consistently reported by other researchers, however.

Although a great deal of research has shown that NAC has antioxidant activity, one small study found that daily amounts of 1.2 grams or more could lead to increased oxidative stress.15 Extremely large amounts of cysteine, the amino acid from which NAC is derived, may be toxic to nerve cells in rats.

NAC may increase urinary zinc excretion.16 Therefore, supplemental zinc and copper should be added when supplementing with NAC for extended periods.

Are there any drug interactions?

Certain medicines may interact with N-Acetyl Cysteine. Refer to drug interactions for a list of those medicines.