Mechanisms and Therapeutics of N-acetylcysteine: A Recent Update

N-acetylcysteine (NAC), a precursor and a source of glutathione, which has been used for past four decades, with well-established safety, widely used for the treatment of acetaminophen poisoning and as a mucolytic. NAC also would be administered in combination with certain drugs, imparting beneficial effects and having a medical rationale. NAC is a molecule having a wider therapeutic index with a broad spectrum of prophylactic and therapeutic applications and has become an important social need. Research is ongoing to understand the various pharmacological and biochemical pathways by which NAC exhibits various therapeutic effects. Clinical uses of NAC is attributed, to the presence of thiol group, which acts as a direct antioxidant and also replenishes glutathione levels, which is decreased in various disease conditions. This review aims to understand the role of NAC in various clinical conditions. The article concludes that NAC may be beneficial in some conditions, especially in patients with depleted glutathione, or with oxidative stress, for which patients can be screened before prescribing NAC.