Hidonac Dosage/Direction for Use

Acetylcysteine 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.
Adults: The full course of treatment with acetylcysteine comprises 3 consecutive intravenous infusions: First infusion: Initial loading dose of 150 mg/kg body weight infused in 200 mL over 1 hour.
Second infusion: 50 mg/kg in 500 mL over the next 4 hours.
Third infusion: 100 mg/kg in 1 litre over the next 16 hours.
The patient should therefore receive a total of 300 mg/kg over a 21-hour period.
Continued treatment with N-acetylcysteine (given at the dose and rate as used in the third infusion) may be necessary depending on the clinical evaluation of the individual patient.
A ceiling weight of 110 kg should be used when calculating the dosage for obese patients. Dosage should be calculated using the patient's actual weight. (See Table 1.)

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Children: Children should be treated with the same doses and regimen as adults; however, the quantity of intravenous fluid used must be modified to take into account age and weight, as fluid overload is a potential danger.
N-acetylcysteine 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.
Doses should be administered using an appropriate infusion pump.
The full course of treatment with N-acetylcysteine comprises 3 consecutive intravenous infusions: First infusion: Initial loading dose of 150 mg/kg infused over 1 hour (150 mg/kg/h). Given as a 50 mg/mL solution at a rate of 3 mL/kg/h.
Second infusion: Dose: 50 mg/kg infused over 4 hours (12.5 mg/kg/h). Given as a 6.25 mg/mL solution at a rate of 2 mL/kg/h.
Third infusion: Dose: 100 mg/kg infused over 16 hours (6.25 mg/kg/h). Given as a 6.25 mg/mL solution at a rate of 1 mL/kg/h.
Preparation of the solution: Dose 1: Prepare a 50 mg/mL solution. Dilute 10mL of N-acetylcysteine (200 mg/mL) with 30 mL glucose 5% or sodium chloride 0.9% to give a total volume of 40 mL.
Dose 2: Prepare a 6.25 mg/mL solution. Dilute 10 mL of N-acetylcysteine (200 mg/mL) with 310 mL glucose 5% or sodium chloride 0.9% to give a total volume of 320 mL.
Dose 3: Prepare a 6.25 mg/mL solution. Dilute 10 mL of N-acetylcysteine (200 mg/mL) with 310 mL glucose 5% or sodium chloride 0.9% to give a total volume of 320 mL.
Administration: Weigh the child.
Determine the total volume of solution to be infused (infusion fluid + N-acetylcysteine prepared as previously mentioned) into the child from Table 2. A separate volume will be required for each of the three infusion periods.
For example for a child weighing 12 kg, 38mL of solution is required for Dose 1, 100mL for Dose 2 and 200mL for Dose 3.
Infuse intravenously according to the weight of the child (see Table 2).
For example for a child weighing 12 kg, Dose 1 is infused at 38mL/h over 60 minutes, Dose 2 would be infused at 25mL/h and Dose 3 at 13mL/h.
Doses should be administered sequentially with no break between the doses. (See Table 2.)

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