Exflem/Exflem 200 Drug Interactions

Exflem 200: Interaction studies have only been performed in adults.
Combined administration of Acetylcysteine with antitussives (cough-relieving agents) may cause a dangerous secretory congestion due to the reduced cough reflex, so that an especially careful diagnosis is required for this combination treatment.
The use of activated charcoal may reduce the effect of acetylcysteine.
Reports on an inactivation of antibiotics (tetracyclines, aminoglycosides, penicillins) due to acetylcysteine exclusively refer to in vitro experiments in which the relevant substances were mixed directly). Nevertheless for safety reasons, oral antibiotics should be administered separately and at an interval of at least 2 hours. This does not apply to cefixime and loracarbef.
Enhanced vasolidative and anti-platelet effects of glyceryl trinitrate have been reported with concomitant administration of acetylcysteine. The clinical relevance of these finding is not yet known.
If concomitant treatment with nitroglycerin and acetylcysteine is deemed necessary, the patient should be monitored for potential hypotension which may be severe; headache may be a sign for it.
Altered determination of laboratory parameters: Acetylcysteine can affect colorimetric assays of salicylates.
In urine tests, acetylcysteine can affect the results of trials to determine ketone bodies.
It is not recommended to dissolve acetylcysteine preparations together with other medicines.