N-Acetyl Cysteine
17 benefits mapped to clinical evidence across supplements.
Dose per serving from products
828 products in our catalogue print how much N-Acetyl Cysteine a serving holds.
Most common: 500 mg to 1 g, 31% of 828 products.
| Dose per serving | Products |
|---|---|
| 10 mg or less | 23 |
| 10 mg to 25 mg | 35 |
| 25 mg to 50 mg | 63 |
| 50 mg to 100 mg | 117 |
| 100 mg to 250 mg | 141 |
| 250 mg to 500 mg | 144 |
| 500 mg to 1 g | 260 |
| 1 g to 2.5 g | 45 |
Dose per serving from research
242 study groups in 197 studies say how much N-Acetyl Cysteine participants took a day.
These are the doses the studies gave. They are not a recommendation.
Most common: 1 g to 2.5 g, 70% of 242 study groups.
| Daily dose | Study groups |
|---|---|
| 250 mg or less | 12 |
| 250 mg to 500 mg | 7 |
| 500 mg to 1 g | 38 |
| 1 g to 2.5 g | 170 |
| 2.5 g to 5 g | 12 |
| over 5 g | 3 |
Commonly used together
34 of 250 study groups took N-Acetyl Cysteine with something else. Shown: what 3 or more different studies gave.
What was given together, not what works together.
| Taken with | Study groups |
|---|---|
| Vitamin E | 9 |
| Vitamin C | 8 |
| Selenium | 6 |
| Vitamin B12 | 5 |
Benefit Evidence
Glutathione+oxidative stress
Ongoing pregnancy +24.2pp
Hepatotoxicity -37.5pp
Symptom relief, better breathing
Exacerbations down, lung function +10%
Endothelial function, ICAM/VCAM
-25.4% homocysteine, BP
Nitrate tolerance relief
Symptom relief, better breathing
Exacerbations down, lung function +10%
Endothelial function, ICAM/VCAM
-25.4% homocysteine, BP
Nitrate tolerance relief
Research sources
Cell health (92)
- A non-inferiority randomised controlled trial of a shorter acetylcysteine regimen for paracetamol overdose - the SARPO trial
PubMed ID: 40414507
Effectiveness as antidote in acetaminophen poisoning demonstrates protection of hepatocytes from toxin‑induced necrosis.
- Prospective randomized multicentre comparison on sibling oocytes comparing G-Series media system with antioxidants versus standard G-Series media system
PubMed ID: 32299733
Improved embryo quality and implantation when antioxidants (including NAC) were added to culture media → positive cellular outcomes in reproductive cells.
- Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers
PubMed ID: 25731901
NAC lowered blood lead, reduced protein carbonyls and homocysteine—clear biochemical cellular protection/detox signals.
- N-Acetylcysteine supplementation reduces oxidative stress and DNA damage in children with β-thalassemia
PubMed ID: 25222041
Three months of NAC reduced total oxidant status, increased TAC and decreased DNA damage in transfusion‑dependent β‑thalassemia—direct cellular protection.
- N-acetylcysteine modulates markers of oxidation, inflammation and infection in tuberculosis
PubMed ID: 39756697
Rapid GSH rises and decreased MTB‑stimulated TNF‑α show cellular antioxidant and anti‑inflammatory effects though some clinical outcomes were unfavorable.
- Impact of Treatment with Antioxidants as an Adjuvant to Standard Therapy in Patients with Septic Shock: Analysis of the Correlation between Cytokine Storm and Oxidative Stress and Therapeutic Effects
PubMed ID: 38068931
In septic shock NAC increased glutathione and improved organ dysfunction (SOFA), supporting broader cellular resilience in critical illness (multi‑agent caveat).
- Adjunct N-Acetylcysteine Treatment in Hospitalized Patients With HIV-Associated Tuberculosis Dampens the Oxidative Stress in Peripheral Blood: Results From the RIPENACTB Study Trial
PubMed ID: 33613521
Randomized adjunctive NAC increased plasma GSH, total antioxidant capacity and lowered lipid/DNA oxidation—strong biomarker evidence for cellular protection.
- Protective effect of N-acetylcysteine on oxaliplatin-induced neurotoxicity in patients with colorectal and gastric cancers: A randomized, double blind, placebo-controlled, clinical trial
PubMed ID: 32063109
NAC reduced clinically graded oxaliplatin neuropathy onset/severity, consistent with neuroprotective/cell‑protective effects in peripheral nerves.
- Antenatal N-acetylcysteine to improve outcomes of premature infants with intra-amniotic infection and inflammation (Triple I): randomized clinical trial
PubMed ID: 32818949
Perinatal NAC reduced neonatal morbidity and BPD, indicating organ/cellular protection in a high‑risk inflammatory setting.
- N-Acetyl Cysteine Is Associated With Dopaminergic Improvement in Parkinson's Disease
PubMed ID: 31206613
In Parkinson's patients NAC (IV+oral) increased DAT binding and improved symptoms, consistent with improved neuronal cellular function.
- N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis
PubMed ID: 29462456
In early psychosis NAC increased brain and blood GSH and improved processing speed, demonstrating cellular antioxidant engagement.
- Effect of N-acetylcysteine administration on the expression and activities of antioxidant enzymes and the malondialdehyde level in the blood of lead-exposed workers
PubMed ID: 24577230
Normalization of antioxidant enzymes and reduced MDA in occupationally exposed workers → improved cellular oxidative balance.
- N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial
PubMed ID: 24614837
Halved severe mucositis incidence and increased GPx‑1 — mucosal cell protection in transplant patients.
- The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead
PubMed ID: 23731375
Raised RBC GSH and antioxidant enzyme activity in lead‑exposed workers — improved cell redox status.
- The role of preconditioning and N-acetylcysteine on oxidative stress resulting from tourniquet-induced ischemia-reperfusion in arthroscopic knee surgery
PubMed ID: 21610364
Attenuated lipid peroxidation and preserved antioxidant capacity after ischemia–reperfusion — cell‑protective.
- Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn
PubMed ID: 21978796
In severe burns NAC increased GSH and reduced inflammatory cytokines, supporting cellular resilience during systemic injury.
- N-Acetyl-cysteine against noise-induced temporary threshold shift in male workers
PubMed ID: 20638463
NAC reduced temporary noise‑induced hearing threshold shifts (TTS), protecting auditory cells from oxidative noise injury.
- Effect of N-acetylcysteine in attenuating ischemic reperfusion injury in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass
PubMed ID: 19467834
Lowered MDA and raised antioxidants during cardiac reperfusion indicate reduced cellular lipid peroxidation.
- Gentamicin-induced ototoxicity in hemodialysis patients is ameliorated by N-acetylcysteine
PubMed ID: 17457375
NAC given with gentamicin reduced aminoglycoside-associated hearing loss (cellular protection of cochlear structures).
- Cardioprotective effect of cold-blood cardioplegia enriched with N-acetylcysteine during coronary artery bypass grafting
PubMed ID: 16427861
Lower postoperative troponin and MDA indicate reduced myocardial cellular injury with NAC.
- N-acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients
PubMed ID: 14668186
CABG: NAC preserved myocardial glutathione and reduced inflammatory enzyme—cellular myocardium protection.
- Protective effects of N-acetylcysteine and rutin on the lipid peroxidation of the lung epithelium during the adult respiratory distress syndrome
PubMed ID: 10638663
ARDS study raised lung GSH and lowered lipid peroxidation markers, supporting cellular antioxidant status in lung tissue.
- N-acetylcysteine replenishes glutathione in HIV infection
PubMed ID: 11029607
Randomized trial in HIV patients showed NAC raised whole blood and T‑cell GSH, a core cellular redox and protective metric.
- A trial of antioxidants N-acetylcysteine and procysteine in ARDS. The Antioxidant in ARDS Study Group
PubMed ID: 9228372
Restored RBC glutathione by ~47% in RCT and improved physiologic outcomes in acute lung injury—direct cellular biochemical replenishment.
- Comparison of the effects of N-acetyl-cysteine and ginseng in prevention of noise induced hearing loss in male textile workers
PubMed ID: 25033789
Daily NAC reduced temporary noise-induced hearing shifts in workers (protective effect on auditory cells).
- Dynamic thiol-disulphide homeostasis as a biomarker for predicting the development of contrast medium-associated acute kidney injury in the endovascular treatment of peripheral arterial disease: should intravenous N-acetylcysteine be given before the procedure?
PubMed ID: 36941180
Single IV NAC before endovascular treatment reduced contrast-associated AKI incidence and improved thiol/disulfide ratios (renal cellular protection).
- Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation
PubMed ID: 25559659
Major abdominal surgery RCT: NAC increased plasma cystine and GSH:GSSG and lowered MDA—strong systemic cellular antioxidant effects.
- Effect of low-dose N-acetyl-cysteine infusion on tourniquet-induced ischaemia-reperfusion injury in arthroscopic knee surgery
PubMed ID: 15954970
Attenuation of reperfusion lipid peroxidation suggests protection against acute oxidative cellular damage.
- Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPD
PubMed ID: 15607126
Oral NAC lowered airway H2O2 in COPD, reflecting improved local cellular redox state.
- Long-term administration of N-acetylcysteine decreases hydrogen peroxide exhalation in subjects with chronic obstructive pulmonary disease
PubMed ID: 11421501
Long‑term reduction in airway oxidative stress markers with NAC supports improved cellular redox in the respiratory epithelium.
- Early Use of N-acetylcysteine With Nitrate Therapy in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction Reduces Myocardial Infarct Size (the NACIAM Trial [N-acetylcysteine in Acute Myocardial Infarction])
PubMed ID: 28634219
Peri‑PCI high‑dose IV NAC reduced infarct size (less cell death) and increased salvage—direct cellular protection signal in myocardium.
- Clinical outcomes of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention: a prospective, multicenter, randomized study to analyze the effect of hydration and acetylcysteine
PubMed ID: 17651830
Reduced incidence of contrast‑induced nephropathy with NAC+hydration in high‑risk PCI patients implies tissue/cell protection in kidneys.
- Infarct Size Limitation: acute N-acetylcysteine defense (ISLAND trial): preliminary analysis and report after the first 30 patients
PubMed ID: 8821417
Marked infarct‑size reduction with NAC in acute MI indicates direct protection/salvage of myocardial cells in that small RCT.
- Effects of oral administration of N-acetyl-L-cysteine: a multi-biomarker study in smokers
PubMed ID: 11867504
Multiple biomarkers of DNA damage and micronuclei were reduced in smokers, indicating strong cellular protection at molecular level.
- N-acetylcysteine prevents reactive oxygen species-mediated myocardial stress in patients undergoing cardiac surgery: results of a randomized, double-blind, placebo-controlled clinical trial
PubMed ID: 14666027
Significant reductions in myocardial oxidative/nitrosative injury markers indicate cellular protection during cardiac surgery.
- Myocardial apoptosis prevention by radical scavenging in patients undergoing cardiac surgery
PubMed ID: 15224028
Strong, significant reductions in caspase-3 and -7 activation in myocardial tissue indicate NAC protected cells from apoptosis during CPB.
- Randomised, double blind, placebo controlled trial of intravenous antioxidant (n-acetylcysteine, selenium, vitamin C) therapy in severe acute pancreatitis
PubMed ID: 17356040
Biochemical markers of oxidative damage fell with antioxidant therapy including NAC, supporting cell protection though outcomes were not improved.
- Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure
PubMed ID: 19524577
Improved transplant‑free survival in acute liver failure suggests clinically meaningful cellular/organ protection.
- Effects of N-acetylcysteine on semen parameters and oxidative/antioxidant status
PubMed ID: 19428083
Oral NAC increased systemic antioxidant capacity and reduced markers of oxidative stress in men with infertility — supports cellular redox balance.
- Comparison of the effect of propofol and N-acetyl cysteine in preventing ischaemia-reperfusion injury
PubMed ID: 19401659
Lower MDA, IMA and lactate after reperfusion with NAC — direct cellular protection biomarkers in ischemia–reperfusion.
- Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study
PubMed ID: 20089454
After ovarian drilling, NAC increased ovulation, pregnancy and live birth rates — clinical evidence of improved tissue/cellular function in that reproductive setting.
- Impact of high-dose N-acetylcysteine versus placebo on contrast-induced nephropathy and myocardial reperfusion injury in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The LIPSIA-N-ACC (Prospective, Single-Blind, Placebo-Controlled, Randomized Leipzig Immediate PercutaneouS Coronary Intervention Acute Myocardial Infarction N-ACC) Trial
PubMed ID: 20466200
Significant reductions in oxidative-stress biomarkers suggest direct cellular protection via improved redox status.
- Preventing cisplatin induced ototoxicity by N-acetylcysteine and salicylate
PubMed ID: 20626325
Addition of NAC to cisplatin reduced very-high-frequency hearing damage—evidence of cellular (cochlear hair cell) protection in chemotherapy setting.
- Protective effect of N-acetylcysteine from drug-induced ototoxicity in uraemic patients with CAPD peritonitis
PubMed ID: 21551083
RCT: NAC given with intraperitoneal antibiotics reduced ototoxic hearing loss and improved high‑frequency hearing versus control.
- [Study of protective effects on noise-induced hearing loss using N-acetyl-cysteine]
PubMed ID: 22303701
Large randomized trial: oral NAC before noise exposure reduced noise-induced hearing loss—protects auditory sensory cells.
- Use of N-acetylcysteine during liver procurement: a prospective randomized controlled study
PubMed ID: 22859317
Improved graft survival and fewer complications after liver transplant are consistent with cellular protection in ischemia-reperfusion settings.
- Improvements in hepatic serological biomarkers are associated with clinical benefit of intravenous N-acetylcysteine in early stage non-acetaminophen acute liver failure
PubMed ID: 23325162
In early ALF NAC accelerated improvement in liver enzymes and bilirubin, indicating improved cellular/organ recovery.
- Benefits of high-dose N-acetylcysteine to exacerbation-prone patients with COPD
PubMed ID: 24833327
Fewer COPD exacerbations suggest protection against episodic lung injury/insult.
- Preventing amikacin related ototoxicity with N-acetylcysteine in patients undergoing peritoneal dialysis
PubMed ID: 25073872
Protected cochlear (high-frequency) function from aminoglycoside-associated damage—localized cellular protection.
- High dose of N-acetylcystein prevents acute kidney injury in chronic kidney disease patients undergoing myocardial revascularization
PubMed ID: 24657033
Halved AKI incidence and abolished oxidative-stress markers during CABG—strong cellular/organ protection.
- Effect of treatment with N-acetylcysteine on non-enzymatic antioxidant reserves and lipid peroxidation in workers exposed to lead
PubMed ID: 24959775
Lowered lipid peroxidation and boosted vitamin E—improvements in cellular oxidative balance.
- The adjuvant effect of metformin and N-acetylcysteine to clomiphene citrate in induction of ovulation in patients with Polycystic Ovary Syndrome
PubMed ID: 26291797
Improved ovulation/implantation metrics in PCOS when added to clomiphene—supports cellular reproductive health parameters.
- A double-blinded, placebo-controlled, multicenter clinical trial of N-acetylcysteine for preventing amphotericin B-induced nephrotoxicity
PubMed ID: 26050706
NAC reduced amphotericin B–induced nephrotoxicity (clinically significant cellular protection).
- Comparison of combination therapy of high-dose oral N-acetylcysteine and intravenous sodium bicarbonate hydration with individual therapies in the reduction of Contrast-induced Nephropathy during Cardiac Catheterisation and Percutaneous Coronary Intervention (CONTRAST): A multi-centre, randomised, controlled trial
PubMed ID: 26301645
Reduced CIN incidence in patients with baseline renal impairment—protects renal cells in a clinical setting.
- Evaluation of administration of oral N-acetylcysteine to reduce oxidative stress in chronic hemodialysis patients: A double-blind, randomized, controlled clinical trial
PubMed ID: 26787572
Increase in plasma total antioxidant capacity implies enhanced cellular antioxidant defenses and protection.
- N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin
PubMed ID: 25482371
Oral NAC reduced oxidative stress markers in follicular fluid and improved oocyte/embryo quality — evidence of improved local cellular redox status and function.
- Long-Term Protective Effect of N-Acetylcysteine against Amikacin-Induced Ototoxicity in End-Stage Renal Disease: A Randomized Trial
PubMed ID: 29097487
Adjunctive NAC reduced early aminoglycoside ototoxicity and lowered inflammatory markers — reflects short‑term cellular protection in the cochlea.
- N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia: A randomized controlled trial
PubMed ID: 30407312
Oral NAC reduced MDA and increased TAOC in pneumonia patients, indicating reduced oxidative damage to cells systemically.
- Transtympanic Injections of N-acetylcysteine and Dexamethasone for Prevention of Cisplatin-Induced Ototoxicity: Double Blind Randomized Clinical Trial
PubMed ID: 29993216
Transtympanic NAC prevented cisplatin‑induced cochlear hearing loss in cancer patients, demonstrating local cellular/organ protection against oxidative injury.
- N-acetylcysteine decreases urinary level of neutrophil gelatinase-associated lipocalin in deceased-donor renal transplant recipients: a randomized clinical trial
PubMed ID: 29683755
Perioperative NAC reduced urinary NGAL (an early tubular injury biomarker) after deceased‑donor kidney transplant, indicating reduced cellular injury signal.
- Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU
PubMed ID: 30636490
Sepsis ICU RCT: NAC increased antioxidant defenses and reduced lipid peroxidation, consistent with cellular protection.
- Effect of N-acetylcysteine against Vancomycin-Induced Nephrotoxicity: A Randomized Controlled Clinical Trial
PubMed ID: 32536177
Adjunct NAC with vancomycin improved creatinine/CrCl and trended to fewer AKI events, suggesting renal cellular protection (trend).
- Evaluation of the effect of N-acetylcysteine on the prevention and amelioration of paclitaxel-induced peripheral neuropathy in breast cancer patients: a randomized controlled study
PubMed ID: 32601973
Marked reduction in chemo‑induced neuropathy and lowered MDA indicate cellular (neuronal) protection.
- Utility of N-acetylcysteine in ischemic hepatitis in cirrhotics with acute variceal bleed: a randomized controlled trial
PubMed ID: 32048131
IV NAC lowered ischemic hepatic injury and liver‑failure deaths in cirrhotic patients—organ/cellular protection.
- Renal protective effect of N-acetylcysteine with stepwise ramping voltage against extracorporeal shock wave lithotripsy-induced renal injury: a prospective randomized trial
PubMed ID: 32729099
Peri‑ESWL NAC prevented rises in renal tubular injury biomarkers, indicating tubular cell protection.
- N-Acetylcysteine as Prophylactic Therapy for Transplantation-Associated Thrombotic Microangiopathy: A Randomized, Placebo-Controlled Trial
PubMed ID: 35940529
Reduced TA‑TMA incidence after HSCT shows endothelial/cellular protection in a high‑risk setting.
- Comparative Study to Evaluate the Effect of Low-Protein Diet Supplementation with Taurine and N-Acetylcysteine, N-Acetylcysteine and Pyridoxamine Dihydrochloride in Preventing the Progression of Chronic Renal Failure in Patients with Non-Diabetic Kidney Disease
PubMed ID: 35598122
NAC combined with pyridoxamine increased eGFR versus control in non‑diabetic CKD, suggesting improved renal cellular function (combination therapy).
- Prophylactic NAC promoted hematopoietic reconstitution by improving endothelial cells after haploidentical HSCT: a phase 3, open-label randomized trial
PubMed ID: 35473809
Phase‑3 HSCT RCT: oral NAC prophylaxis reduced poor graft function and improved BM endothelial cell numbers/function and reduced EC ROS—strong cellular‑health evidence.
- Effects of N-acetylcysteine on systemic lupus erythematosus disease activity and its associated complications: a randomized double-blind clinical trial study
PubMed ID: 36810107
SLE RCT: NAC reduced disease activity and improved immune markers, indicating beneficial cellular/immune effects.
- Co-administration of vitamin D and N-acetylcysteine to modulate immunosenescence in older adults with vitamin D deficiency: a randomized clinical trial
PubMed ID: 40421021
Marked reductions in cellular senescence markers and p16 expression in PBMCs—direct cellular‑health evidence in older adults.
- N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial
PubMed ID: 41577060
Large RCT: IV NAC markedly reduced linezolid‑associated thrombocytopenia, transfusions and drug discontinuations (clear cellular/platelet protection).
- Effects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men
PubMed ID: 30771790
Improvements in sperm DNA fragmentation and antioxidant markers indicate protection of germ cells from oxidative damage.
- Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedure
PubMed ID: 12392825
Marked reduction in contrast‑induced AKI incidence reflects organ/cellular protection in high‑risk patients.
- Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine
PubMed ID: 10900277
NAC substantially reduced contrast-induced creatinine rises, consistent with renal cellular protection.
- The efficacy of N-acetylcysteine as a hepatoprotective agent in liver transplantation
PubMed ID: 9665023
Peri‑transplant NAC reduced ischemia–reperfusion injury and enzyme peaks, indicating hepatocellular protection.
- Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial
PubMed ID: 1954453
Strong organ- and cell-protection demonstrated in paracetamol hepatotoxicity with marked survival benefit and reduced cerebral edema.
- Randomized Clinical Trial of Antioxidant Therapy Patients with Septic Shock and Organ Dysfunction in the ICU: SOFA Score Reduction by Improvement of the Enzymatic and Non-Enzymatic Antioxidant System
PubMed ID: 37174730
NAC reduced SOFA and improved antioxidant markers in septic shock—strong signal for cellular/organ protection.
- Usefulness of Antioxidants as Adjuvant Therapy for Septic Shock: A Randomized Clinical Trial
PubMed ID: 33213070
Increased TAC and trends toward higher GSH with reduced lipid peroxidation indicate cellular antioxidant support.
- Effects of N-acetyl cysteine and melatonin on early reperfusion injury in patients undergoing coronary artery bypass grafting: A randomized, open-labeled, placebo-controlled trial
PubMed ID: 30045259
CABG study showed reduced lipid peroxidation (MDA) and lactate—markers of cellular oxidative stress improvement.
- N-acetylcysteine and magnesium improve biochemical abnormalities associated with myocardial ischaemic reperfusion in South Indian patients undergoing coronary artery bypass grafting: a comparative analysis
PubMed ID: 20593142
Perioperative NAC lowered lipid peroxidation and improved antioxidant enzymes and ATPase, consistent with improved cellular resilience.
- Efficacy and safety of mesenchymal stem cell in Chinese patients with chronic renal failure: A pilot study in Shandong province, China
PubMed ID: 34602393
NAC decreased creatinine/cystatin C and ROS in chronic renal failure patients (cell/tissue protection signal vs baseline).
- Repurposing of high-dose N-acetylcysteine as anti-inflammatory, antioxidant and neuroprotective agent in moderate to severe traumatic brain injury patients: a randomized controlled trial
PubMed ID: 40205270
NAC lowered NSE and other injury/oxidative markers in TBI, indicating neuronal cell protection.
- New Approach Combination-Dosed Therapy for Nonalcoholic Steatohepatitis Versus Vitamin E: A Randomized Controlled Trial
PubMed ID: 40480879
NAC+rosuvastatin reduced markers of hepatocyte injury and fibrosis, consistent with cellular protection (combination therapy).
- Effect of cysteine derivatives administration in healthy men exposed to intense resistance exercise by evaluation of pro-antioxidant ratio
PubMed ID: 17999779
Preservation of antioxidant enzymes and lower lipid peroxidation with NAC after exercise supports cellular protection.
- Conditioning therapy with N-acetyl-L-cysteine, decitabine and modified BUCY regimen for myeloid malignancies patients prior to allogeneic hematopoietic stem cell transplantation
PubMed ID: 36880836
Clinical trial in HSCT: NAC improved platelet recovery and event-free survival—strong signal of improved cellular/hematopoietic resilience.
- Oxidative status, inflammation, and postoperative atrial fibrillation with metoprolol vs carvedilol or carvedilol plus N-acetyl cysteine treatment
PubMed ID: 24477817
Marked reductions in oxidative stress biomarkers perioperatively indicate systemic cellular protection.
- Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial
PubMed ID: 35975308
GlyNAC improved glutathione, mitochondrial function and physical measures in older adults—broad cellular benefits (combination product).
- Antioxidant Activity with Increased Endogenous Levels of Vitamin C, E and A Following Dietary Supplementation with a Combination of Glutathione and Resveratrol Precursors
PubMed ID: 33105552
Supplements containing NAC raised intracellular GSH and antioxidant vitamin levels in healthy adults.
- Double-blind placebo-controlled randomized trial of N-acetylcysteine infusion following live donor liver transplantation
PubMed ID: 33278022
Lower postoperative transaminase peaks after liver transplant indicate reduced graft cell injury.
- Role of N-acetylcysteine treatment in non-acetaminophen-induced acute liver failure: A prospective study
PubMed ID: 28611340
Improved survival in acute liver failure implies reduced hepatocellular death with IV NAC.
- Protective effect of N-acetylcysteine on antituberculosis drug-induced hepatotoxicity
PubMed ID: 20461008
Prevention of clinical hepatotoxicity in TB patients indicates protection of hepatocytes from drug‑induced injury.
- Cysteine supplementation improves the erythrocyte glutathione synthesis rate in children with severe edematous malnutrition
PubMed ID: 12198013
Strong, randomized evidence of large increases in erythrocyte GSH concentration and synthesis → direct cellular redox/cytoprotective benefit.
Antioxidant (86)
- N-Acetylcysteine supplementation reduces oxidative stress and DNA damage in children with β-thalassemia
PubMed ID: 25222041
NAC increased total antioxidant capacity while lowering oxidant status in a randomized trial.
- Adjunctive N-Acetylcysteine and Lung Function in Pulmonary Tuberculosis
PubMed ID: 39189858
Adjunctive NAC in pulmonary TB increased whole‑blood glutathione in randomized data—clear systemic antioxidant boost.
- Response to Intravenous N-Acetylcysteine Supplementation in Critically Ill Patients with COVID-19
PubMed ID: 37405379
IV NAC in severe COVID‑19 helped preserve whole‑blood GSH and reduced oxidative/inflammatory markers during ICU stay.
- Effects of N-acetylcysteine on oxidative stress biomarkers, depression, and anxiety symptoms in patients with multiple sclerosis
PubMed ID: 37386885
In relapsing MS, NAC reduced serum MDA (lipid peroxidation marker), supporting antioxidant action.
- The therapeutic effect of N-acetylcysteine as an add-on to methadone maintenance therapy medication in outpatients with substance use disorders: A randomized, double-blind, placebo-controlled clinical trial
PubMed ID: 36448959
In methadone patients NAC raised plasma GSH and total antioxidant capacity (TAC) in a randomized trial—strong systemic antioxidant evidence.
- Asymmetric Dimethylarginine Limits the Efficacy of Simvastatin Activating Endothelial Nitric Oxide Synthase
PubMed ID: 27091343
Preclinical/cellular data: NAC prevented ADMA‑driven ROS and restored NO/eNOS signalling—mechanistic oxidative stress mitigation (no direct human trial here).
- Effects of sulphur-containing compounds on plasma redox status in muscle-damaging exercise
PubMed ID: 20034232
NAC increased total antioxidant status and total thiols after exercise—direct antioxidant boosting evidence.
- Effect of cysteine derivatives administration in healthy men exposed to intense resistance exercise by evaluation of pro-antioxidant ratio
PubMed ID: 17999779
Short course NAC lowered TBARS and preserved antioxidant enzymes after intense exercise.
- Oxidative status, inflammation, and postoperative atrial fibrillation with metoprolol vs carvedilol or carvedilol plus N-acetyl cysteine treatment
PubMed ID: 24477817
Strong perioperative biomarker evidence: NAC added to carvedilol increased TAC and reduced TOS and WBC compared with controls.
- Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study
PubMed ID: 23232844
Clinical benefit in POAF accompanied by reductions in oxidative/inflammatory markers when NAC was used.
- Effect of N-acetylcysteine on cardiac injury and oxidative stress after abdominal aortic aneurysm repair: a randomized controlled trial
PubMed ID: 22092168
Perioperative NAC lowered MDA and increased total antioxidant capacity after AAA repair.
- Erdosteine enhances airway response to salbutamol in patients with mild-to-moderate COPD
PubMed ID: 19124377
Short NAC course lowered systemic reactive oxygen species in COPD smokers.
- Can renal dysfunction after infra-renal aortic aneurysm repair be modified by multi-antioxidant supplementation?
PubMed ID: 12124559
Multi‑antioxidant (including NAC) increased total antioxidant capacity perioperatively.
- Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial
PubMed ID: 35975308
GlyNAC corrected GSH deficiency and lowered oxidative stress markers in older adults (combination product).
- A metabolomic analysis of thiol response for standard and modified N-acetyl cysteine treatment regimens in patients with acetaminophen overdose
PubMed ID: 33742775
IV NAC regimens produced higher plasma cysteine/NAC concentrations—direct thiol/antioxidant augmentation.
- Antioxidant Activity with Increased Endogenous Levels of Vitamin C, E and A Following Dietary Supplementation with a Combination of Glutathione and Resveratrol Precursors
PubMed ID: 33105552
Supplement containing NAC raised erythrocyte reduced glutathione and plasma reduced cysteine significantly.
- Protective effect of N-acetylcysteine on antituberculosis drug-induced hepatotoxicity
PubMed ID: 20461008
Marked reduction/prevention of TB‑therapy hepatotoxicity and lower transaminases consistent with reduced oxidative liver injury.
- Cysteine supplementation improves the erythrocyte glutathione synthesis rate in children with severe edematous malnutrition
PubMed ID: 12198013
Direct RCT evidence of large increases (~150% GSH concentration and ~510% synthesis rate increases vs control) → robust antioxidant boosting.
- Association of alpha-interferon and acetyl cysteine in patients with chronic C hepatitis
PubMed ID: 11218623
Reported improvements in oxidative markers with IFN+NAC in HCV trial → supportive antioxidant biomarker changes.
- Prospective randomized multicentre comparison on sibling oocytes comparing G-Series media system with antioxidants versus standard G-Series media system
PubMed ID: 32299733
Antioxidant addition (including NAC) to embryo culture improved embryo outcomes → plausible antioxidant contribution.
- N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin
PubMed ID: 25482371
NAC reduced follicular fluid MDA in PCOS patients and improved embryo/oocyte quality — strong oxidative‑stress biomarker improvement.
- The impact of N-acetylcysteine and ascorbic acid in contrast-induced nephropathy in critical care patients: an open-label randomized controlled study
PubMed ID: 29089038
IV NAC+vitamin C lowered 8‑isoprostane after contrast exposure, showing antioxidant biomarker reduction.
- Long-Term Protective Effect of N-Acetylcysteine against Amikacin-Induced Ototoxicity in End-Stage Renal Disease: A Randomized Trial
PubMed ID: 29097487
Adjunctive NAC during amikacin therapy lowered inflammatory cytokines and reduced early hearing loss, consistent with antioxidant/anti‑inflammatory protection.
- N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia: A randomized controlled trial
PubMed ID: 30407312
Oral NAC increased total antioxidant capacity (TAOC) and lowered MDA in CAP patients after 7 days — direct biomarker evidence for antioxidant boosting.
- Transtympanic Injections of N-acetylcysteine and Dexamethasone for Prevention of Cisplatin-Induced Ototoxicity: Double Blind Randomized Clinical Trial
PubMed ID: 29993216
Transtympanic NAC prevented cisplatin ototoxicity (oxidative injury mechanism) — supports a cell‑protective/antioxidant effect in the cochlea.
- Effects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men
PubMed ID: 30771790
Infertility RCT: NAC increased seminal TAC and decreased MDA — direct evidence of boosting antioxidant measures.
- Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU
PubMed ID: 30636490
Sepsis patients given IV NAC showed clear biochemical antioxidant effects: increased TAC and substantially lower MDA vs placebo.
- A Pilot Study to Evaluate the Effects of Oral N-Acetyl Cysteine on Inflammatory and Oxidative Stress Biomarkers in Rheumatoid Arthritis
PubMed ID: 30255760
RA RCT: 12 weeks oral NAC improved multiple oxidative stress markers (MDA down, TTG up) vs placebo.
- Evaluation of the effect of N-acetylcysteine on the prevention and amelioration of paclitaxel-induced peripheral neuropathy in breast cancer patients: a randomized controlled study
PubMed ID: 32601973
Observed reductions in MDA after high‑dose NAC indicate enhanced antioxidant effect.
- Prophylactic NAC promoted hematopoietic reconstitution by improving endothelial cells after haploidentical HSCT: a phase 3, open-label randomized trial
PubMed ID: 35473809
HSCT RCT showed decreased BM endothelial cell ROS with NAC prophylaxis—direct evidence of reduced oxidative stress in target tissue.
- Effects of N-acetylcysteine on systemic lupus erythematosus disease activity and its associated complications: a randomized double-blind clinical trial study
PubMed ID: 36810107
SLE trial reductions in disease activity and some complement changes are consistent with lowered oxidative/inflammatory activity.
- Co-administration of vitamin D and N-acetylcysteine to modulate immunosenescence in older adults with vitamin D deficiency: a randomized clinical trial
PubMed ID: 40421021
Downregulation of proinflammatory/oxidative gene expression and reduced cellular senescence in older adults with NAC + vitamin D.
- N-Acetylcysteine effects on glutathione and glutamate in schizophrenia: A preliminary MRS study
PubMed ID: 35839558
MRS demonstrated increased medial prefrontal glutathione after 8 weeks of NAC—central antioxidant biomarker elevation.
- Adjunct N-Acetylcysteine Treatment in Hospitalized Patients With HIV-Associated Tuberculosis Dampens the Oxidative Stress in Peripheral Blood: Results From the RIPENACTB Study Trial
PubMed ID: 33613521
Randomized data showed clear increases in plasma GSH and total antioxidant status with NAC—strongest direct evidence for boosting antioxidant levels.
- N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis
PubMed ID: 29462456
Brain GSH increased ~22.6% and blood GSH ~18.8% with NAC in early psychosis — solid antioxidant biomarker increases.
- A randomized placebo-controlled pilot study of N-acetylcysteine in youth with autism spectrum disorder
PubMed ID: 27103982
Clear increases in whole blood GSH in children with ASD.
- Oral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status
PubMed ID: 26447155
Increased plasma cysteine (GSH precursor) and lowered homocysteine in two trials.
- Effect of N-acetylcysteine administration on the expression and activities of antioxidant enzymes and the malondialdehyde level in the blood of lead-exposed workers
PubMed ID: 24577230
Restoration of SOD, CAT, GPx activities and decreased MDA in lead‑exposed workers → clear antioxidant biomarker improvements.
- N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial
PubMed ID: 24614837
Increased GPx‑1 activity with IV NAC in transplant patients.
- The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead
PubMed ID: 23731375
Dose‑dependent increases in erythrocyte GSH and antioxidant enzyme activity in lead‑exposed workers.
- The role of preconditioning and N-acetylcysteine on oxidative stress resulting from tourniquet-induced ischemia-reperfusion in arthroscopic knee surgery
PubMed ID: 21610364
Prevented post‑reperfusion rises in MDA/TOS and preserved TAC — clear oxidative stress attenuation.
- Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn
PubMed ID: 21978796
In severe burns NAC increased GSH and protein‑SH levels, demonstrating robust antioxidant boosting.
- Effect of N-acetylcysteine in attenuating ischemic reperfusion injury in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass
PubMed ID: 19467834
NAC‑enriched cardioplegia significantly lowered malondialdehyde during reperfusion, indicating reduced lipid peroxidation/oxidative stress.
- Cardioprotective effect of cold-blood cardioplegia enriched with N-acetylcysteine during coronary artery bypass grafting
PubMed ID: 16427861
Lower postoperative MDA (lipid peroxidation) after CABG with NAC indicates reduced oxidative stress.
- Effects of antioxidant supplementation on postprandial oxidative stress and endothelial dysfunction: a single-blind, 15-day clinical trial in patients with untreated type 2 diabetes, subjects with impaired glucose tolerance, and healthy controls
PubMed ID: 16368447
Combined antioxidant including NAC reduced postprandial malondialdehyde and increased NO bioavailability (oxidative marker improvement).
- N-acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients
PubMed ID: 14668186
CABG NAC preserved myocardial glutathione and reduced myeloperoxidase—strong local antioxidant effect.
- Protective effects of N-acetylcysteine and rutin on the lipid peroxidation of the lung epithelium during the adult respiratory distress syndrome
PubMed ID: 10638663
ARDS study reported significant reductions in expired ethane/MDA (lipid peroxidation) and increased lung GSH with NAC±rutin.
- The effect of glutathione and N-acetylcysteine on lipoperoxidative damage in patients with early septic shock
PubMed ID: 10852765
Early septic shock patients given GSH+NAC had marked decreases in peroxidative indexes compared with controls (combination therapy caveat).
- N-acetylcysteine replenishes glutathione in HIV infection
PubMed ID: 11029607
Randomized placebo‑controlled trial showed reproducible increases in whole blood and T‑cell glutathione with oral NAC.
- A trial of antioxidants N-acetylcysteine and procysteine in ARDS. The Antioxidant in ARDS Study Group
PubMed ID: 9228372
IV NAC restored RBC glutathione (~47%) in a multicenter RCT — strong evidence of antioxidant boosting.
- Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation
PubMed ID: 25559659
Perioperative IV NAC produced large increases in plasma cystine and GSH:GSSG and decreased MDA—direct, quantitative oxidative‑stress reduction.
- Effect of low-dose N-acetyl-cysteine infusion on tourniquet-induced ischaemia-reperfusion injury in arthroscopic knee surgery
PubMed ID: 15954970
IV NAC attenuated plasma lipid peroxidation on reperfusion—direct oxidative-stress biomarker effect.
- Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPD
PubMed ID: 15607126
Two‑month oral NAC (600 mg b.i.d.) significantly reduced exhaled hydrogen peroxide (~35% by T60) in stable COPD.
- Long-term administration of N-acetylcysteine decreases hydrogen peroxide exhalation in subjects with chronic obstructive pulmonary disease
PubMed ID: 11421501
Year‑long RCT in COPD: NAC 600 mg/day reduced exhaled H2O2 by ~60% vs placebo, clear airway antioxidant effect.
- The effects of low dose N-acetylcysteine (NAC) as an adjunct to cardioplegia in coronary artery bypass surgery
PubMed ID: 19103540
NAC reduced malondialdehyde (MDA) during reperfusion—evidence for lowering oxidative stress in cardiac surgery setting.
- Efficacy and safety of mesenchymal stem cell in Chinese patients with chronic renal failure: A pilot study in Shandong province, China
PubMed ID: 34602393
In chronic renal failure NAC reduced measured ROS and oxidative markers from baseline (smaller effect than MSCs).
- Randomized clinical trial on acute effects of i.v. iron sucrose during haemodialysis
PubMed ID: 20470276
Haemodialysis crossover: NAC reduced iron‑induced MDA at low iron dose.
- Repurposing of high-dose N-acetylcysteine as anti-inflammatory, antioxidant and neuroprotective agent in moderate to severe traumatic brain injury patients: a randomized controlled trial
PubMed ID: 40205270
TBI RCT reduced MDA and other oxidative/inflammatory markers with NAC and improved short‑term outcomes.
- New Approach Combination-Dosed Therapy for Nonalcoholic Steatohepatitis Versus Vitamin E: A Randomized Controlled Trial
PubMed ID: 40480879
NAC+rosuvastatin arm showed marked reductions in malondialdehyde and other oxidative biomarkers (combination therapy).
- N-acetylcysteine and magnesium improve biochemical abnormalities associated with myocardial ischaemic reperfusion in South Indian patients undergoing coronary artery bypass grafting: a comparative analysis
PubMed ID: 20593142
NAC administration around CABG increased antioxidant enzyme levels and reduced lipid peroxidation—strong evidence of antioxidant boosting.
- Effects of N-acetyl cysteine and melatonin on early reperfusion injury in patients undergoing coronary artery bypass grafting: A randomized, open-labeled, placebo-controlled trial
PubMed ID: 30045259
CABG patients showed reduced MDA (lipid peroxidation) with NAC, a direct oxidative stress marker.
- Usefulness of Antioxidants as Adjuvant Therapy for Septic Shock: A Randomized Clinical Trial
PubMed ID: 33213070
Reported improvements in TAC and reduced LPO with NAC in septic patients.
- Randomized Clinical Trial of Antioxidant Therapy Patients with Septic Shock and Organ Dysfunction in the ICU: SOFA Score Reduction by Improvement of the Enzymatic and Non-Enzymatic Antioxidant System
PubMed ID: 37174730
TAC increased and lipid peroxidation decreased in ICU septic shock patients treated with NAC.
- Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial
PubMed ID: 1954453
Mechanistic basis (glutathione repletion) and clear clinical benefit in paracetamol toxicity imply oxidative‑stress mitigation.
- Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers
PubMed ID: 25731901
NAC decreased protein carbonyl groups (oxidative protein damage) in lead-exposed workers.
- Effects of oral administration of N-acetyl-L-cysteine: a multi-biomarker study in smokers
PubMed ID: 11867504
Significant reductions in 8‑oxo‑dG and other DNA adducts indicate lowered oxidative/nitrosative damage in smokers.
- The effect of N-acetylcysteine on renal function, nitric oxide, and oxidative stress after angiography
PubMed ID: 14633141
NAC preserved urinary nitric oxide/creatinine ratio and creatinine clearance after angiography, indicating reduced oxidative endothelial dysfunction.
- N-acetylcysteine prevents reactive oxygen species-mediated myocardial stress in patients undergoing cardiac surgery: results of a randomized, double-blind, placebo-controlled clinical trial
PubMed ID: 14666027
Significant reductions in myocardial 8‑iso‑PGF2α and nitrotyrosine (markers of lipid peroxidation and nitrosative stress) in cardiac surgery patients.
- N-acetylcysteine for preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass
PubMed ID: 14999536
Peri-CPB reductions in malondialdehyde and other oxidative markers indicate antioxidant effects during surgical oxidative stress.
- High-dose acetylcysteine in idiopathic pulmonary fibrosis
PubMed ID: 16306520
IPF trial's lung-function preservation is consistent with NAC antioxidant mechanisms; oxidative markers not primary endpoint but mechanism plausible.
- A pilot study of aerosolized N-acetylcysteine for idiopathic pulmonary fibrosis
PubMed ID: 16135167
Inhaled NAC reduced serum KL‑6 and improved CT ground-glass (markers linked to lung oxidative/inflammatory processes).
- Randomised, double blind, placebo controlled trial of intravenous antioxidant (n-acetylcysteine, selenium, vitamin C) therapy in severe acute pancreatitis
PubMed ID: 17356040
Antioxidant cocktail including NAC increased antioxidant markers and reduced oxidative stress measures.
- Effects of N-acetylcysteine on semen parameters and oxidative/antioxidant status
PubMed ID: 19428083
Direct demonstration of increased total antioxidant capacity and decreased oxidative stress index with oral NAC.
- Comparison of the effect of propofol and N-acetyl cysteine in preventing ischaemia-reperfusion injury
PubMed ID: 19401659
NAC infusion reduced malondialdehyde and other oxidative‑injury markers after reperfusion in a randomized surgical study.
- Effect of antioxidant therapy on hospital stay and complications in patients with early acute pancreatitis: a randomised controlled trial
PubMed ID: 20426279
Antioxidant cocktail including NAC increased FRAP and vitamin C and reduced TBARS and altered SOD.
- Hyperbaric oxygen, oxidative stress, NO bioavailability and ulcer oxygenation in diabetic patients
PubMed ID: 19341122
NAC attenuated MDA and preserved TAOS/NO in a subgroup during hyperbaric oxygen—clear antioxidant effect.
- Impact of high-dose N-acetylcysteine versus placebo on contrast-induced nephropathy and myocardial reperfusion injury in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The LIPSIA-N-ACC (Prospective, Single-Blind, Placebo-Controlled, Randomized Leipzig Immediate PercutaneouS Coronary Intervention Acute Myocardial Infarction N-ACC) Trial
PubMed ID: 20466200
High-dose NAC significantly lowered oxidative-stress markers (~20%) in a randomized trial.
- Use of N-acetylcysteine during liver procurement: a prospective randomized controlled study
PubMed ID: 22859317
Perioperative benefits in liver transplant likely relate to antioxidant/cytoprotective properties of NAC.
- [Clinical efficacy of tetrandrine combined with acetylcysteine effervescent tablets in treatment of silicosis]
PubMed ID: 24370303
Silicosis study reported increased serum SOD after NAC addition, showing antioxidant enzyme increase.
- High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study
PubMed ID: 23348146
Year‑long high‑dose NAC in COPD improved small‑airway measures and reduced exacerbations; antioxidant mechanism was proposed.
- Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial
PubMed ID: 24621680
COPD exacerbation reduction may reflect antioxidant/antixidative-pathway effects of long-term NAC.
- N-acetylcysteine administration prevents nonthyroidal illness syndrome in patients with acute myocardial infarction: a randomized clinical trial
PubMed ID: 25148231
Short NAC infusion in acute MI improved oxidative-balance measures (and thyroid-hormone profile), consistent with antioxidant action.
- Preventing amikacin related ototoxicity with N-acetylcysteine in patients undergoing peritoneal dialysis
PubMed ID: 25073872
Improved antioxidant markers in PD-related peritonitis and preserved cochlear function—supports antioxidant boosting.
- High dose of N-acetylcystein prevents acute kidney injury in chronic kidney disease patients undergoing myocardial revascularization
PubMed ID: 24657033
Abolished oxidative-stress markers in CKD patients undergoing CABG—strong evidence of oxidative-stress reduction.
- Effect of treatment with N-acetylcysteine on non-enzymatic antioxidant reserves and lipid peroxidation in workers exposed to lead
PubMed ID: 24959775
Dose-dependent decreases in lipid hydroperoxides and increases in alpha‑tocopherol in lead‑exposed workers—clear antioxidant effect.
- Evaluation of administration of oral N-acetylcysteine to reduce oxidative stress in chronic hemodialysis patients: A double-blind, randomized, controlled clinical trial
PubMed ID: 26787572
Randomized trial showed a statistically significant increase in total antioxidant capacity with NAC in hemodialysis patients.
Inflammation (53)
- Efficacy Of N-Acetyl-Cysteine as Adjuvant Therapy for Diabetic Foot Osteomyelitis: An Open-Label Randomized Controlled Trial
PubMed ID: 40751519
Adjunctive oral NAC accelerated reductions in CRP, ESR and WBC in diabetic foot osteomyelitis (robust inflammatory‑marker improvement).
- Role of Prophylactic N-Acetylcysteine Supplementation on Postoperative Outcomes in Patients Undergoing Elective Double-Valve Replacement (Aortic and Mitral Valve)
PubMed ID: 39365130
Perioperative IV NAC reduced postoperative liver enzyme elevations and shortened ICU/ventilation time, with lower CRP reported.
- Effects of N-Acetylcysteine combined with Ambroxol Hydrochloride on clinical symptoms, CRP, and PCT in children with pneumonia
PubMed ID: 39208656
Pediatric pneumonia trial: inhaled NAC added to ambroxol lowered CRP/PCT (inflammatory markers) versus ambroxol alone.
- Effects of N-acetylcysteine on systemic lupus erythematosus disease activity and its associated complications: a randomized double-blind clinical trial study
PubMed ID: 36810107
3‑month RCT in SLE: oral NAC (1.8 g/day) produced significant decreases in validated disease‑activity scores and immune markers consistent with anti‑inflammatory effect.
- N-Acetyl Cysteine as an Add-on Therapy is Useful in Treating Acute Lumbar Radiculopathy Caused by Disc Herniation: Results of a Randomized, Controlled Clinical Trial
PubMed ID: 37779397
RCT in lumbar radiculopathy: NAC adjunct reduced pain and disability by 8 weeks consistent with an anti‑inflammatory/analgesic effect.
- Use of N-acetylcysteine as treatment adjuvant regulates immune response in visceral leishmaniasis: Pilot clinical trial and in vitro experiments
PubMed ID: 36506010
Pilot RCT in visceral leishmaniasis showed decreased IL‑10 and other immunologic changes consistent with modulatory/anti‑inflammatory effects (no clinical cure difference).
- Study of the Effects of N-acetylcysteine on Inflammatory Biomarkers and Disease Activity Score in Patients with Rheumatoid Arthritis
PubMed ID: 34664816
RA add‑on trial produced larger drops in clinical disease activity scores consistent with anti‑inflammatory benefit.
- N-Acetylcysteine Improves Inflammatory Response in COPD Patients by Regulating Th17/Treg Balance through Hypoxia Inducible Factor-1α Pathway
PubMed ID: 34258270
Large COPD RCT showed marked decreases in Th17/Treg ratio and IL‑17 with rise in IL‑10 (anti‑inflammatory shift).
- Effect of N-acetylcysteine on remission maintenance in patients with ulcerative colitis: A randomized, double-blind controlled clinical trial
PubMed ID: 33067169
Randomized UC trial: NAC reduced relapse and inflammatory biomarkers (fecal calprotectin, hs‑CRP).
- N-acetylcysteine as an adjunctive treatment for smoking cessation: a randomized clinical trial
PubMed ID: 32725102
Adjunct smoking‑cessation RCT: NAC lowered sTNF‑R2 (an inflammatory marker).
- Effect of Oral N-Acetylcysteine Supplementation on the Immunity System in Patients with Acute Myocardial Infarction
PubMed ID: 32041914
Post‑MI trial: short NAC course significantly lowered inflammatory biomarkers (hsCRP, MPO, Gal‑3) vs control.
- Impact of smoking status and concomitant medications on the effect of high-dose N-acetylcysteine on chronic obstructive pulmonary disease exacerbations: A post-hoc analysis of the PANTHEON study
PubMed ID: 30704697
COPD exacerbation reduction suggests downstream anti‑inflammatory/clinical benefit with long‑term NAC use (large trial/post‑hoc data).
- A Pilot Study to Evaluate the Effects of Oral N-Acetyl Cysteine on Inflammatory and Oxidative Stress Biomarkers in Rheumatoid Arthritis
PubMed ID: 30255760
12‑week RCT in rheumatoid arthritis showed NAC improved oxidative stress markers and reduced some inflammatory mediators versus placebo.
- Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU
PubMed ID: 30636490
Sepsis ICU study: IV NAC increased TAC and reduced MDA, indicating reduced oxidative/inflammatory burden (biochemical evidence).
- N-Acetylcysteine inhalation improves pulmonary function in patients received liver transplantation
PubMed ID: 30217943
Perioperative inhaled NAC around liver transplant decreased inflammatory biomarkers and reduced pulmonary complications, supporting anti‑inflammatory action.
- N-acetylcysteine improves oxidative stress and inflammatory response in patients with community acquired pneumonia: A randomized controlled trial
PubMed ID: 30407312
Oral NAC in community‑acquired pneumonia reduced TNF‑α and improved oxidative stress markers over 7 days, showing anti‑inflammatory biomarker effects.
- The effect of intravenous N-acetylcysteine on prevention of atrial fibrillation after coronary artery bypass graft surgery: a double-blind, randomised, placebo-controlled trial
PubMed ID: 28980294
Perioperative IV NAC reduced POAF incidence with concordant reductions in hsCRP, supporting an anti‑inflammatory effect in surgical inflammation.
- Long-Term Protective Effect of N-Acetylcysteine against Amikacin-Induced Ototoxicity in End-Stage Renal Disease: A Randomized Trial
PubMed ID: 29097487
Adjunctive NAC reduced early amikacin‑associated hearing loss and lowered TNF‑α and IL‑6 at 1 month, indicating anti‑inflammatory effects.
- [Effect of N-acetylcysteine inhalation on ventilator-associated pneumonia caused by biofilm in endotracheal tubes]
PubMed ID: 27055427
Inhaled NAC reduced endotracheal biofilm and VAP incidence in ICU patients — likely reflects reduced pathogen‑driven inflammatory complications.
- High dose of N-acetylcystein prevents acute kidney injury in chronic kidney disease patients undergoing myocardial revascularization
PubMed ID: 24657033
Abolished oxidative-stress markers in CKD patients undergoing CABG—oxidative-stress reduction often parallels reductions in inflammatory signaling.
- Effect of oral N-acetylcysteine treatment on immune system in continuous ambulatory peritoneal dialysis patients
PubMed ID: 22745145
Randomized study in dialysis patients showed consistent, statistically significant reductions in IL‑6, hsCRP and TNF‑α with NAC.
- Impact of high-dose N-acetylcysteine versus placebo on contrast-induced nephropathy and myocardial reperfusion injury in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The LIPSIA-N-ACC (Prospective, Single-Blind, Placebo-Controlled, Randomized Leipzig Immediate PercutaneouS Coronary Intervention Acute Myocardial Infarction N-ACC) Trial
PubMed ID: 20466200
NAC lowered oxidative-stress biomarkers (~20%); antioxidant effects often accompany reduced inflammatory signaling.
- Effect of N-acetylcysteine administration on intraoperative plasma levels of interleukin-4 and interleukin-10 in liver transplant recipients
PubMed ID: 19010165
Perioperative NAC increased anti‑inflammatory cytokines (IL‑4, IL‑10) in liver transplant patients — direct anti‑inflammatory biomarker changes.
- N-acetylcysteine improves the clinical conditions of mustard gas-exposed patients with normal pulmonary function test
PubMed ID: 18801028
Mustard gas bronchiolitis trial: symptomatic and spirometric improvements likely reflect reduction in airway inflammation.
- [Nitric oxide metabolism in the inclusion of N-acetylcysteine into the complex therapy of patients with community-acquired pneumonia]
PubMed ID: 18038601
Small pneumonia study: NAC normalized multiple nitric‑oxide–related markers, consistent with modulation of inflammatory pathways.
- A pilot study of aerosolized N-acetylcysteine for idiopathic pulmonary fibrosis
PubMed ID: 16135167
Inhaled NAC in IPF reduced serum KL‑6 (fibrosis/inflammation marker) and improved imaging, suggesting anti‑inflammatory/fibrosis modulation.
- N-acetylcysteine for preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass
PubMed ID: 14999536
Peri-CPB reductions in IL-6, CRP and other inflammatory markers indicate anti-inflammatory effects (small study).
- [Effect of prophylactic N-acetylcysteine on postoperative organ dysfunction and inflammatory markers after major abdominal surgery for cancer. Prospective, randomized, double-blind, placebo-controlled clinical trial]
PubMed ID: 12616822
Postoperative CRP was significantly lower with NAC despite no change in organ dysfunction.
- Randomized Clinical Trial of Antioxidant Therapy Patients with Septic Shock and Organ Dysfunction in the ICU: SOFA Score Reduction by Improvement of the Enzymatic and Non-Enzymatic Antioxidant System
PubMed ID: 37174730
ICU septic shock RCT produced reductions in organ-failure and improvements in oxidative/inflammatory markers.
- N-acetylcysteine modulates markers of oxidation, inflammation and infection in tuberculosis
PubMed ID: 39756697
Adjunctive NAC decreased MTB‑stimulated TNF‑α, showing a clear anti‑inflammatory biomarker effect despite mixed microbiologic outcomes.
- Response to Intravenous N-Acetylcysteine Supplementation in Critically Ill Patients with COVID-19
PubMed ID: 37405379
IV NAC in critically ill COVID‑19 reduced several inflammatory markers (CRP/LDH) supporting anti‑inflammatory action.
- Impact of Treatment with Antioxidants as an Adjuvant to Standard Therapy in Patients with Septic Shock: Analysis of the Correlation between Cytokine Storm and Oxidative Stress and Therapeutic Effects
PubMed ID: 38068931
In septic patients the antioxidant arm including NAC lowered TNF‑α and improved SOFA, supporting anti‑inflammatory activity (multi‑agent trial limitation).
- The therapeutic effect of N-acetylcysteine as an add-on to methadone maintenance therapy medication in outpatients with substance use disorders: A randomized, double-blind, placebo-controlled clinical trial
PubMed ID: 36448959
NAC lowered hs‑CRP and inflammatory/metabolic markers in methadone patients, indicating anti‑inflammatory effects.
- Antenatal N-acetylcysteine to improve outcomes of premature infants with intra-amniotic infection and inflammation (Triple I): randomized clinical trial
PubMed ID: 32818949
Perinatal NAC reduced bronchopulmonary morbidity in newborns exposed to intra‑amniotic inflammation, implying attenuation of inflammatory neonatal lung injury.
- Effect of N-acetylcysteine administration on the expression and activities of antioxidant enzymes and the malondialdehyde level in the blood of lead-exposed workers
PubMed ID: 24577230
Lowered MDA and normalized antioxidant enzymes in lead‑exposed workers → reduced oxidative stress often parallels lower inflammatory burden.
- N-acetylcysteine reduces disease activity by blocking mammalian target of rapamycin in T cells from systemic lupus erythematosus patients: a randomized, double-blind, placebo-controlled trial
PubMed ID: 22549432
In SLE lowered disease activity, inhibited mTOR and increased regulatory T cells — anti‑inflammatory/immunomodulatory.
- Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn
PubMed ID: 21978796
In severe burn patients NAC lowered IL‑6/IL‑8/IL‑10 and raised GSH, showing clear anti‑inflammatory effects.
- Effect of oral N-acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: a placebo-controlled study
PubMed ID: 20190028
Eight weeks of oral NAC in peritoneal dialysis patients significantly reduced IL‑6, showing an anti‑inflammatory effect.
- N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis: randomized, placebo-controlled pilot study
PubMed ID: 18473409
Oral NAC added to mesalamine in UC reduced inflammatory chemokines (IL‑8, MCP‑1) and improved symptom scores.
- Effects of antioxidant supplementation on postprandial oxidative stress and endothelial dysfunction: a single-blind, 15-day clinical trial in patients with untreated type 2 diabetes, subjects with impaired glucose tolerance, and healthy controls
PubMed ID: 16368447
Combined antioxidant regimen including NAC reduced postprandial VCAM-1 and other oxidative/inflammatory markers.
- N-acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients
PubMed ID: 14668186
CABG: NAC reduced myeloperoxidase activity—marker of neutrophil‑mediated inflammation.
- Protective effects of N-acetylcysteine and rutin on the lipid peroxidation of the lung epithelium during the adult respiratory distress syndrome
PubMed ID: 10638663
ARDS study showed decreased lipid peroxidation markers (ethane/MDA) and raised lung GSH, consistent with reduced oxidative‑driven inflammation in lung tissue.
- Efficacy and safety of combined nebulization of unfractionated heparin, acetylcysteine, budesonide and ipratropium bromide in hospitalised patients with COVID-19 pneumonia: a randomized controlled clinical trial
PubMed ID: 40696325
Nebulized combination therapy including NAC reduced CRP and radiologic lung inflammation in COVID pneumonia (open‑label, multi‑agent so attribution limited).
- Co-administration of vitamin D and N-acetylcysteine to modulate immunosenescence in older adults with vitamin D deficiency: a randomized clinical trial
PubMed ID: 40421021
Downregulation of IL‑6 and TNF‑α gene expression in PBMCs when NAC given with vitamin D in older adults.
- Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation
PubMed ID: 25559659
Major abdominal surgery: NAC lowered MDA and improved GSH:GSSG—reduction in oxidative‑driven inflammation.
- Repurposing of high-dose N-acetylcysteine as anti-inflammatory, antioxidant and neuroprotective agent in moderate to severe traumatic brain injury patients: a randomized controlled trial
PubMed ID: 40205270
TBI trial: NAC reduced IL‑6 and other inflammatory/oxidative markers and improved short‑term outcomes.
- New Approach Combination-Dosed Therapy for Nonalcoholic Steatohepatitis Versus Vitamin E: A Randomized Controlled Trial
PubMed ID: 40480879
NAC+rosuvastatin arm produced reductions in multiple inflammatory markers (NASH trial; combination therapy).
- Evaluation the efficacy and safety of N-acetylcysteine inhalation spray in controlling the symptoms of patients with COVID-19: An open-label randomized controlled clinical trial
PubMed ID: 36495185
Large RCT in COVID: inhaled NAC markedly lowered CRP and WBC, consistent with anti‑inflammatory effect.
- Oxidative status, inflammation, and postoperative atrial fibrillation with metoprolol vs carvedilol or carvedilol plus N-acetyl cysteine treatment
PubMed ID: 24477817
Perioperative biomarkers showed NAC reduced total oxidative stress and WBC counts consistent with lowered inflammation.
- Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study
PubMed ID: 23232844
Clinical reduction in POAF accompanied by lower inflammatory markers when NAC was added to therapy.
- Effect of N-acetylcysteine on cardiac injury and oxidative stress after abdominal aortic aneurysm repair: a randomized controlled trial
PubMed ID: 22092168
Perioperative NAC reduced pro‑inflammatory cytokines (TNF‑α, IL‑1β) after major vascular surgery.
- Potential benefits of combined N-acetylcysteine and ciprofloxacin therapy in partial biliary obstruction
PubMed ID: 20388917
IV NAC (with ciprofloxacin) reduced CRP and WBC in partial biliary obstruction → direct anti‑inflammatory biomarker changes.
- The effect of glutathione and N-acetylcysteine on lipoperoxidative damage in patients with early septic shock
PubMed ID: 10852765
In early septic shock GSH+NAC reduced peroxidative indexes and improved clinical scores, consistent with less oxidative inflammation (combination therapy caveat).
Respiratory comfort (43)
- Lung function in idiopathic pulmonary fibrosis--extended analyses of the IFIGENIA trial
PubMed ID: 19860915
In IPF, NAC modestly slowed lung-function decline when added to standard therapy—supportive for maintaining lung function.
- Efficacy and safety of combined nebulization of unfractionated heparin, acetylcysteine, budesonide and ipratropium bromide in hospitalised patients with COVID-19 pneumonia: a randomized controlled clinical trial
PubMed ID: 40696325
Nebulized regimen including NAC improved radiologic lung lesion absorption and oxygenation in COVID pneumonia (consistent with improved lung comfort/function; attribution partly confounded).
- Evaluation of the efficacy of N-acetylcysteine and bromhexine compared with standard care in preventing hospitalization of outpatients with COVID-19: a double blind randomized clinical trial
PubMed ID: 38215974
Outpatient COVID trial reported fewer hospitalizations and modest oxygenation improvements with NAC, suggesting respiratory benefit (methodological caveats).
- Effects of N-Acetylcysteine combined with Ambroxol Hydrochloride on clinical symptoms, CRP, and PCT in children with pneumonia
PubMed ID: 39208656
Pediatric pneumonia RCT: adding inhaled NAC shortened symptoms and improved lung function vs ambroxol alone.
- Effect of high-dose N-acetylcysteine on exacerbations and lung function in patients with mild-to-moderate COPD: a double-blind, parallel group, multicentre randomised clinical trial
PubMed ID: 39349461
Large COPD RCT: high‑dose NAC reduced moderate/severe exacerbations, supporting longer‑term maintenance of lung comfort/clinical stability.
- Intravenous N-acetylcysteine in respiratory disease with abnormal mucus secretion
PubMed ID: 37318485
IV NAC improved sputum properties and expectoration in hospitalized respiratory patients—consistent with maintained airway comfort/clearance.
- A randomized, double-blind, placebo-controlled study evaluating the efficacy of propolis and N-acetylcysteine in exacerbations of chronic obstructive pulmonary disease
PubMed ID: 35856373
NAC+propolis trial after COPD exacerbation produced large reductions in 1‑year exacerbation rates, consistent with sustained respiratory benefit though combination limits attribution.
- Factorial analysis of N-acetylcysteine and propolis treatment effects on symptoms, life quality and exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD): a randomized, double-blind, placebo-controlled trial
PubMed ID: 35587070
6‑month NAC+propolis trial reported improved cough/symptom scores and fewer COPD exacerbations (confounded by propolis).
- N-Acetylcysteine Improves Inflammatory Response in COPD Patients by Regulating Th17/Treg Balance through Hypoxia Inducible Factor-1α Pathway
PubMed ID: 34258270
Immunologic shifts in stable COPD patients could translate to respiratory benefit/comfort.
- Impact of smoking status and concomitant medications on the effect of high-dose N-acetylcysteine on chronic obstructive pulmonary disease exacerbations: A post-hoc analysis of the PANTHEON study
PubMed ID: 30704697
COPD large trial: long‑term NAC lowered exacerbation rates (clinically meaningful for lung comfort/maintenance).
- Effect of N-acetylcysteine on exacerbations of bronchiectasis (BENE): a randomized controlled trial
PubMed ID: 30975143
Large randomized bronchiectasis trial: 1 year oral NAC markedly reduced exacerbation rate, sputum volume and improved QoL — strong respiratory benefit.
- N-Acetylcysteine inhalation improves pulmonary function in patients received liver transplantation
PubMed ID: 30217943
Perioperative inhaled NAC significantly lowered postoperative pulmonary complications and ALI after liver transplant, supporting maintenance of lung integrity/comfort.
- [Effect of N-acetylcysteine inhalation on ventilator-associated pneumonia caused by biofilm in endotracheal tubes]
PubMed ID: 27055427
Inhaled NAC reduced endotracheal biofilm and VAP rates in intubated ICU patients — tangible maintenance of airway/pulmonary comfort and reduced infection burden.
- Benefits of high-dose N-acetylcysteine to exacerbation-prone patients with COPD
PubMed ID: 24833327
High‑dose NAC reduced and delayed COPD exacerbations in exacerbation-prone patients—clear respiratory clinical benefit.
- Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial
PubMed ID: 24621680
Large RCT in COPD showing a ~22% reduction in exacerbation rate with long-term NAC supports maintenance of lung comfort.
- High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study
PubMed ID: 23348146
One‑year high‑dose NAC in stable COPD improved small‑airway measures and significantly reduced exacerbations — strong lung comfort signal.
- [Clinical efficacy of tetrandrine combined with acetylcysteine effervescent tablets in treatment of silicosis]
PubMed ID: 24370303
Silicosis patients receiving NAC had better symptoms, increased SOD and modest lung‑function gains (combination therapy).
- N-acetylcysteine improves the clinical conditions of mustard gas-exposed patients with normal pulmonary function test
PubMed ID: 18801028
Marked symptomatic and spirometric improvements in mustard gas–related bronchiolitis after 4 months of NAC — strong evidence for maintaining lung comfort.
- [Nitric oxide metabolism in the inclusion of N-acetylcysteine into the complex therapy of patients with community-acquired pneumonia]
PubMed ID: 18038601
Normalization of nitric‑oxide markers in pneumonia indicates physiologic lung benefits that may translate to comfort.
- Therapeutics effect of N-acetyl cysteine on mustard gas exposed patients: evaluating clinical aspect in patients with impaired pulmonary function test
PubMed ID: 18036807
Large RCT in mustard‑gas bronchiolitis showed clinically meaningful improvements in lung function and symptoms with NAC.
- A pilot study of aerosolized N-acetylcysteine for idiopathic pulmonary fibrosis
PubMed ID: 16135167
Inhaled NAC improved exercise desaturation and fibrosis biomarkers in IPF—evidence of maintained/Improved lung comfort in disease context.
- [Efficacy of Derinox assessed with one PNIF (Peak Nasal Inspiratory Flow) in patients suffering from common cold]
PubMed ID: 16439935
Dérinox improved nasal airflow and some cold symptoms, supporting short-term upper-airway comfort.
- High-dose acetylcysteine in idiopathic pulmonary fibrosis
PubMed ID: 16306520
IPF trial showed NAC slowed decline in VC and DLCO over 1 year—meaningful preservation of lung function and comfort.
- Effect of N-acetylcysteine on the incidence of recurrence of otitis media with effusion and re-insertion of ventilation tubes
PubMed ID: 10908985
Middle-ear instillation reduced ENT recurrences; relevant to upper-airway/ear comfort.
- N-acetylcysteine reduces the exacerbation rate in patients with moderate to severe COPD
PubMed ID: 10575333
Six months of oral NAC reduced COPD exacerbations and modestly improved spirometry—strong support for maintaining lung comfort.
- Nitrate therapy is an alternative to furosemide/morphine therapy in the management of acute cardiogenic pulmonary edema
PubMed ID: 9924848
In acute pulmonary edema NAC with nitroglycerin improved oxygenation faster than standard therapy.
- Orally administered N-acetylcysteine may improve general well-being in patients with mild chronic bronchitis
PubMed ID: 7972979
Improvements in patient-reported well‑being in chronic bronchitis suggest perceived lung comfort benefits despite no objective FEV1 change.
- N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study
PubMed ID: 8275731
IV NAC in mild–moderate acute lung injury improved oxygenation and reduced need for mechanical ventilation (clinically meaningful respiratory benefit).
- Adjunctive N-Acetylcysteine and Lung Function in Pulmonary Tuberculosis
PubMed ID: 39189858
Adjunctive NAC increased whole‑blood glutathione and was associated with improved recovery of FVC/FEV1 after TB treatment—evidence of maintained/improved lung function.
- Response to Intravenous N-Acetylcysteine Supplementation in Critically Ill Patients with COVID-19
PubMed ID: 37405379
IV NAC in critically ill COVID‑19 preserved GSH and improved oxygenation (PaO2/FiO2), consistent with maintaining lung function/comfort in severe disease.
- Antenatal N-acetylcysteine to improve outcomes of premature infants with intra-amniotic infection and inflammation (Triple I): randomized clinical trial
PubMed ID: 32818949
Maternal NAC significantly reduced neonatal bronchopulmonary dysplasia and composite respiratory morbidity — strong evidence for protecting/maintaining lung comfort in newborns.
- N-acetylcysteine for therapy-resistant tobacco use disorder: a pilot study
PubMed ID: 25729878
Smokers reduced cigarette consumption and CO and had higher quit rates — likely long‑term respiratory benefit.
- Long-term treatment with oral N-acetylcysteine: affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial
PubMed ID: 25228446
In cystic fibrosis NAC preserved FEV1 over 24 weeks — meaningful physiologic respiratory benefit.
- Protective effects of N-acetylcysteine and rutin on the lipid peroxidation of the lung epithelium during the adult respiratory distress syndrome
PubMed ID: 10638663
ARDS patients treated with NAC (±rutin) had reduced lung oxidative stress markers and increased epithelial lining fluid GSH — supports lung comfort/biology.
- A trial of antioxidants N-acetylcysteine and procysteine in ARDS. The Antioxidant in ARDS Study Group
PubMed ID: 9228372
In acute lung injury, IV NAC (and procysteine) restored RBC GSH and was associated with shorter duration of acute lung injury — clinically relevant respiratory benefit.
- Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPD
PubMed ID: 15607126
Two‑month oral NAC decreased airway H2O2 in stable COPD, consistent with improved lung comfort biomarkers.
- Long-term administration of N-acetylcysteine decreases hydrogen peroxide exhalation in subjects with chronic obstructive pulmonary disease
PubMed ID: 11421501
Long‑term oral NAC reduced exhaled H2O2 (~60% relative reduction) in COPD, supporting maintained airway redox/homeostasis and comfort.
- Evaluation the efficacy and safety of N-acetylcysteine inhalation spray in controlling the symptoms of patients with COVID-19: An open-label randomized controlled clinical trial
PubMed ID: 36495185
Inhaled NAC in COVID showed dramatic mortality reduction and improved inflammatory/respiratory markers—strong respiratory benefit.
- Effect of On-Demand vs Routine Nebulization of Acetylcysteine With Salbutamol on Ventilator-Free Days in Intensive Care Unit Patients Receiving Invasive Ventilation: A Randomized Clinical Trial
PubMed ID: 29486489
Large ICU RCT: on-demand nebulized acetylcysteine noninferior for ventilator-free days and markedly fewer adverse events — supports respiratory management.
- Effectiveness of nebulized N-acetylcysteine solution in children with acute bronchiolitis
PubMed ID: 24953914
Nebulized NAC in infants with bronchiolitis produced modest clinical-score improvements and slightly shorter hospitalization.
- Aerosol antibiotic therapy in children with chronic upper airway infections: a potential alternative to surgery
PubMed ID: 19505384
6‑month aerosol preparation including acetylcysteinate markedly reduced ENT symptoms and surgery need in children.
- Erdosteine enhances airway response to salbutamol in patients with mild-to-moderate COPD
PubMed ID: 19124377
Short NAC course reduced systemic ROS and gave a transient bronchodilator‑response benefit in COPD smokers.
- Inhaled thiamphenicol and acetylcysteine in children with acute bacterial rhinopharyngitis
PubMed ID: 18831930
Inhaled thiamphenicol + acetylcysteine improved symptoms and cultures in pediatric rhinopharyngitis (combination product).
Detoxification (38)
- Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers
PubMed ID: 25731901
NAC lowered blood lead levels in exposed workers and reduced oxidative protein damage—strong evidence of detoxification activity in this occupational setting.
- A study to evaluate the hepatoprotective effect of N- acetylcysteine on anti tuberculosis drug induced hepatotoxicity and quality of life
PubMed ID: 37562904
NAC improved liver enzymes during anti‑TB therapy suggesting enhanced protection/detoxification during drug exposure.
- Adjunct N-Acetylcysteine Treatment in Hospitalized Patients With HIV-Associated Tuberculosis Dampens the Oxidative Stress in Peripheral Blood: Results From the RIPENACTB Study Trial
PubMed ID: 33613521
NAC increased GSH and TAC and reduced oxidative DNA/lipid markers, supporting glutathione‑mediated detoxification processes.
- N-acetylcysteine in Acute Organophosphorus Pesticide Poisoning: A Randomized, Clinical Trial
PubMed ID: 26786042
Improved antioxidant markers and reduced atropine requirements in organophosphate poisoning — enhanced detox/clinical recovery.
- Effect of N-acetylcysteine administration on the expression and activities of antioxidant enzymes and the malondialdehyde level in the blood of lead-exposed workers
PubMed ID: 24577230
Lowered oxidative stress markers in lead‑exposed workers → supports enhanced detox/antioxidant defenses in toxic exposure.
- The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead
PubMed ID: 23731375
Lowered blood lead and increased erythrocyte antioxidant capacity in exposed workers — direct detox/reduction in body burden markers.
- New Approach Combination-Dosed Therapy for Nonalcoholic Steatohepatitis Versus Vitamin E: A Randomized Controlled Trial
PubMed ID: 40480879
NAC+rosuvastatin markedly reduced liver fat/fibrosis and oxidative biomarkers—consistent with enhanced hepatic recovery/detox (combination therapy).
- Early Cessation of Acetylcysteine Treatment After Paracetamol Overdose (NACSTOP 2): A Non-Inferiority Randomised Controlled Trial
PubMed ID: 41549406
Non‑inferiority of a shortened NAC regimen in paracetamol overdose supports its established detoxifying role.
- A metabolomic analysis of thiol response for standard and modified N-acetyl cysteine treatment regimens in patients with acetaminophen overdose
PubMed ID: 33742775
Metabolomics in APAP overdose showed NAC rapidly increases cysteine/NAC and affects APAP‑cysteine metabolites—direct detox pharmacology.
- Assessment of Renal and Hepatic Tissue-Protective Effects of N-Acetylcysteine via Ammonia Metabolism: A Prospective Randomized Study
PubMed ID: 29540661
Perioperative reductions in ammonia/BUN suggest NAC influences nitrogenous waste handling.
- Role of N-acetylcysteine treatment in non-acetaminophen-induced acute liver failure: A prospective study
PubMed ID: 28611340
IV NAC benefits in acute liver failure indicate enhanced detox/clinical recovery pathways.
- Cysteine supplementation improves the erythrocyte glutathione synthesis rate in children with severe edematous malnutrition
PubMed ID: 12198013
Increased cysteine/GSH synthesis supports conjugation/detox pathways.
- A non-inferiority randomised controlled trial of a shorter acetylcysteine regimen for paracetamol overdose - the SARPO trial
PubMed ID: 40414507
Clinical RCT demonstrating effective antidote use in paracetamol overdose → direct detoxification/antidotal role for NAC.
- Population pharmacokinetic-pharmacodynamic modelling to describe the effects of paracetamol and N-acetylcysteine on the international normalized ratio
PubMed ID: 25316328
PK/PD modeling supports NAC's pharmacodynamic contribution to INR changes in paracetamol overdose context—strong mechanistic link to detoxification.
- N-acetylcysteine and/or ascorbic acid versus placebo to prevent contrast-induced nephropathy in patients undergoing elective cardiac catheterization: The NAPCIN trial; A single-center, prospective, randomized trial
PubMed ID: 26787567
Single-center randomized trial reported high‑dose peri-procedural NAC was associated with lower contrast‑induced nephropathy rates versus other regimens (supports renal protection/detox).
- Utility of N-acetylcysteine in ischemic hepatitis in cirrhotics with acute variceal bleed: a randomized controlled trial
PubMed ID: 32048131
IV NAC reduced ischemic hepatitis and liver‑failure deaths in cirrhotics—consistent with hepatic protective/detoxification support.
- N-Acetylcysteine and Liver Transplant. Advantages of its Administration in Multi-Organ Donors Especially During World-Economical-Crisis. Long-Term Sub-Group Analysis in a Randomized Study
PubMed ID: 39809659
NAC perfusion of donor organs associated with higher 5‑year recipient survival (particularly HCC subgroup), suggesting organ/tissue protection relevant to detox functions (likely liver).
- A double-blinded, placebo-controlled, multicenter clinical trial of N-acetylcysteine for preventing amphotericin B-induced nephrotoxicity
PubMed ID: 26050706
NAC lowered amphotericin B nephrotoxicity—demonstrates detox/protective properties against drug toxicity.
- Role of Prophylactic N-Acetylcysteine Supplementation on Postoperative Outcomes in Patients Undergoing Elective Double-Valve Replacement (Aortic and Mitral Valve)
PubMed ID: 39365130
Perioperative NAC reduced postoperative liver enzyme elevations after cardiac surgery, indicating support of hepatic resilience/detox capacity.
- High dose of N-acetylcystein prevents acute kidney injury in chronic kidney disease patients undergoing myocardial revascularization
PubMed ID: 24657033
Perioperative reduction in oxidative stress and AKI implies enhanced capacity to handle peri-procedural oxidative/toxic stress.
- Use of N-acetylcysteine during liver procurement: a prospective randomized controlled study
PubMed ID: 22859317
Strong liver transplant outcomes are consistent with improved hepatic resilience and detox-related organ protection.
- Glucocorticoids plus N-acetylcysteine in severe alcoholic hepatitis
PubMed ID: 22070475
Beneficial outcomes in severe alcoholic hepatitis imply enhanced hepatic resilience/detoxification when NAC added to steroids.
- Does oral N-acetylcysteine reduce contrast-induced renal injury in patients with peripheral arterial disease undergoing peripheral angiography? A randomized-controlled study
PubMed ID: 20682612
Oral NAC plus hydration reduced serum creatinine by day 3 post-angiography—suggestive renal protection.
- N-acetylcysteine: short-term clinical benefits after coronary angiography in high-risk renal patients
PubMed ID: 20089221
IV NAC around coronary angiography reduced short-term contrast kidney injury in high-risk patients.
- Intravenous N-acetylcysteine plus high-dose hydration versus high-dose hydration and standard hydration for the prevention of contrast-induced nephropathy: CASIS--a multicenter prospective controlled trial
PubMed ID: 21106264
IV NAC plus high-dose hydration significantly reduced creatinine rise and CIN incidence—strong renoprotective/detox signal.
- [Radionuclide renoscintigraphy for the evaluation of nephroprotective action of acetylcysteine]
PubMed ID: 20017349
Small renoscintigraphy study showed preserved radionuclide GFR and tracer clearance with NAC after coronarography.
- Efficacy of N-acetylcysteine and aminophylline in preventing contrast-induced nephropathy
PubMed ID: 20206069
Small study: NAC before coronary procedures improved creatinine and creatinine clearance vs hydration alone — supports renal protective/detox processes.
- Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure
PubMed ID: 19524577
In acute liver failure (non‑acetaminophen), NAC improved transplant‑free survival — strong evidence of enhanced hepatic recovery/detox capacity in this severe setting.
- Improved estimation of glomerular filtration rate by serum cystatin C in preventing contrast induced nephropathy by N-acetylcysteine or zinc--preliminary results
PubMed ID: 18174269
NAC prevented short‑term cystatin C rises after contrast exposure — suggests protection against early kidney injury (detoxification function).
- Effect of N-acetylcysteine on cystatin C-based renal function after elective coronary angiography (ENABLE Study): a prospective, randomized trial
PubMed ID: 18793808
Oral NAC reduced early cystatin C‑defined kidney injury after elective angiography — supports renal/clearance protection.
- The reno-protective effect of hydration with sodium bicarbonate plus N-acetylcysteine in patients undergoing emergency percutaneous coronary intervention: the RENO Study
PubMed ID: 17394959
Rapid bicarbonate hydration plus NAC markedly lowered contrast‑induced nephropathy vs standard hydration; NAC contributed but was combined with bicarbonate so attribution is moderate.
- N-acetylcysteine and contrast-induced nephropathy in primary angioplasty
PubMed ID: 16807414
IV+oral NAC reduced contrast-induced renal injury dose-dependently after angioplasty—supports protection against a toxin/insult (contrast).
- Renoprotective effect of high periprocedural doses of oral N-acetylcysteine in patients scheduled to undergo a same-day angiography
PubMed ID: 16211988
High-dose short-course NAC produced a favorable 48-hour creatinine change vs placebo (small trial), consistent with transient renal-protective/detox effect.
- Standard vs double dose of N-acetylcysteine to prevent contrast agent associated nephrotoxicity
PubMed ID: 14972420
Higher (double) NAC dosing appeared more effective than standard dosing at preventing contrast nephropathy, particularly with larger contrast volumes.
- N-Acetylcysteine versus fenoldopam mesylate to prevent contrast agent-associated nephrotoxicity
PubMed ID: 15312855
Randomized trial: oral NAC reduced incidence of contrast-associated nephrotoxicity vs fenoldopam in chronic renal insufficiency—supports renal protective/detox role.
- N-acetylcysteine reduces contrast-associated nephropathy but not clinical events during long-term follow-up
PubMed ID: 15459602
High-dose oral NAC reduced short-term contrast-related kidney injury after PCI/angiography (did not alter long-term clinical outcomes).
- Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedure
PubMed ID: 12392825
Oral NAC markedly reduced contrast‑induced AKI in chronic renal insufficiency, a clinically relevant detox/protective effect.
- Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial
PubMed ID: 1954453
NAC is standard antidote for paracetamol toxicity; RCT shows marked survival benefit—definitive evidence for promoting detoxification (glutathione repletion).
Immune support (35)
- N-Acetylcysteine as Prophylactic Therapy for Transplantation-Associated Thrombotic Microangiopathy: A Randomized, Placebo-Controlled Trial
PubMed ID: 35940529
Peri‑transplant NAC lowered TA‑TMA and improved EFS, suggesting protective effects on immune/endothelial stress in HSCT.
- Evaluation the efficacy and safety of N-acetylcysteine inhalation spray in controlling the symptoms of patients with COVID-19: An open-label randomized controlled clinical trial
PubMed ID: 36495185
COVID trial: large mortality and inflammatory marker improvements with inhaled NAC suggest enhanced clinical immune/host resilience.
- Improvement of immune functions in HIV infection by sulfur supplementation: two randomized trials
PubMed ID: 10759030
Randomized trials in HIV+ patients: NAC improved NK/T-cell function and raised plasma albumin (clinically relevant immune effects).
- Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment
PubMed ID: 9230243
Large randomized double‑blind trial in older adults showed substantially fewer symptomatic influenza‑like episodes and improved cell‑mediated immunity with long‑term NAC.
- Conditioning therapy with N-acetyl-L-cysteine, decitabine and modified BUCY regimen for myeloid malignancies patients prior to allogeneic hematopoietic stem cell transplantation
PubMed ID: 36880836
Addition of decitabine + NAC to conditioning improved platelet recovery and EFS after HSCT, implying improved marrow/immune recovery.
- N-acetylcysteine replenishes glutathione in HIV infection
PubMed ID: 11029607
In HIV patients NAC safely raised whole blood and T‑cell glutathione, a plausible mechanism for improved immune cell function.
- Effect of oral N-acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: a placebo-controlled study
PubMed ID: 20190028
Reduction in IL‑6 with NAC in dialysis patients suggests modulation of systemic immune/inflammatory state.
- Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn
PubMed ID: 21978796
NAC increased GSH and lowered pro‑inflammatory cytokines in severe burns, consistent with strengthened immune homeostasis.
- N-acetylcysteine reduces disease activity by blocking mammalian target of rapamycin in T cells from systemic lupus erythematosus patients: a randomized, double-blind, placebo-controlled trial
PubMed ID: 22549432
SLE trial showed increased FoxP3+ regulatory T cells, reduced mTOR activity and clinical disease improvement.
- N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial
PubMed ID: 24614837
Reduced severe oral mucositis incidence and increased GPx‑1 after stem‑cell transplant — mucosal protection/host resilience.
- Antenatal N-acetylcysteine to improve outcomes of premature infants with intra-amniotic infection and inflammation (Triple I): randomized clinical trial
PubMed ID: 32818949
Maternal NAC reduced neonatal morbidity (including BPD) in infection/inflammation context, consistent with improved perinatal immune/organ resilience.
- Impact of Treatment with Antioxidants as an Adjuvant to Standard Therapy in Patients with Septic Shock: Analysis of the Correlation between Cytokine Storm and Oxidative Stress and Therapeutic Effects
PubMed ID: 38068931
Septic shock patients receiving antioxidant regimen including NAC had higher glutathione, lower TNF‑α and improved SOFA—evidence for immune/organ resilience (multicomponent intervention).
- Adjunctive N-Acetylcysteine and Lung Function in Pulmonary Tuberculosis
PubMed ID: 39189858
Adjunctive NAC in pulmonary TB raised whole‑blood GSH and was associated with improved lung‑function recovery, consistent with supportive immune/repair effects.
- Randomized Clinical Trial of Antioxidant Therapy Patients with Septic Shock and Organ Dysfunction in the ICU: SOFA Score Reduction by Improvement of the Enzymatic and Non-Enzymatic Antioxidant System
PubMed ID: 37174730
Improved SOFA and antioxidant markers in septic shock imply improved host resilience to organ dysfunction/infection.
- N-acetylcysteine reduces respiratory burst but augments neutrophil phagocytosis in intensive care unit patients
PubMed ID: 11246305
Dose-dependent reduction in neutrophil oxidative burst and increased phagocytosis indicate altered innate immune function.
- [Nitric oxide metabolism in the inclusion of N-acetylcysteine into the complex therapy of patients with community-acquired pneumonia]
PubMed ID: 18038601
Normalization of nitric‑oxide metabolism in pneumonia patients suggests immunomodulatory effects relevant to resilience against infection.
- Effect of oral N-acetyl cysteine on recurrent preterm labor following treatment for bacterial vaginosis
PubMed ID: 18851855
In women with prior preterm birth and treated bacterial vaginosis, oral NAC increased pregnancy length and reduced recurrence — may reflect enhanced host response in an infection‑associated setting.
- Effect of N-acetylcysteine administration on intraoperative plasma levels of interleukin-4 and interleukin-10 in liver transplant recipients
PubMed ID: 19010165
NAC raised anti‑inflammatory cytokines during liver transplant, indicating an immune‑modulating effect (enhanced anti‑inflammatory response).
- Biofilm demolition and antibiotic treatment to eradicate resistant Helicobacter pylori: a clinical trial
PubMed ID: 20478402
Pretreatment with NAC markedly improved H. pylori eradication rates in refractory patients—supports antimicrobial/immune facilitation.
- Glucocorticoids plus N-acetylcysteine in severe alcoholic hepatitis
PubMed ID: 22070475
Large RCT in severe alcoholic hepatitis: NAC added to prednisolone significantly lowered short-term infections and hepatorenal deaths.
- Effects of N-acetylcysteine on cytokines in non-acetaminophen acute liver failure: potential mechanism of improvement in transplant-free survival
PubMed ID: 23782487
Mechanistic substudy showed NAC-associated reductions in IL‑17, linking NAC to favorable immune modulation in ALF.
- [Effect of N-acetylcysteine inhalation on ventilator-associated pneumonia caused by biofilm in endotracheal tubes]
PubMed ID: 27055427
Inhaled NAC decreased endotracheal biofilm positivity and ventilator‑associated pneumonia rates, an infection/immune resilience outcome in intubated patients.
- N-Acetylcysteine inhalation improves pulmonary function in patients received liver transplantation
PubMed ID: 30217943
Perioperative inhaled NAC in liver transplant patients reduced postoperative pulmonary complications and inflammatory biomarkers, suggesting improved host resilience to pulmonary insults.
- Effect of N-acetylcysteine on exacerbations of bronchiectasis (BENE): a randomized controlled trial
PubMed ID: 30975143
Bronchiectasis trial: 12 months NAC reduced exacerbations and sputum volume, implying improved host resilience to respiratory infections/exacerbations.
- Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU
PubMed ID: 30636490
Sepsis ICU study produced robust antioxidant effects (TAC up, MDA down), consistent with bolstering systemic defense mechanisms (biochemical).
- A Pilot Study to Evaluate the Effects of Oral N-Acetyl Cysteine on Inflammatory and Oxidative Stress Biomarkers in Rheumatoid Arthritis
PubMed ID: 30255760
RA adjunctive trial improved oxidative/inflammatory biomarkers, which can support immune homeostasis (biomarker evidence).
- Impact of smoking status and concomitant medications on the effect of high-dose N-acetylcysteine on chronic obstructive pulmonary disease exacerbations: A post-hoc analysis of the PANTHEON study
PubMed ID: 30704697
COPD exacerbation rate reduction in a large trial suggests improved clinical resilience in the airways (clinical outcome evidence).
- N-Acetylcysteine Improves Inflammatory Response in COPD Patients by Regulating Th17/Treg Balance through Hypoxia Inducible Factor-1α Pathway
PubMed ID: 34258270
Robust immunological modulation in elderly COPD patients (Th17/Treg and cytokine changes) indicates improved immune regulation.
- N-acetylcysteine reduces incidence and duration of linezolid-associated thrombocytopenia in critically ill patients: A randomized controlled trial
PubMed ID: 41577060
IV NAC markedly reduced linezolid‑associated thrombocytopenia and related events in critically ill patients (protective effect on blood/immune‑related cells).
- Co-administration of vitamin D and N-acetylcysteine to modulate immunosenescence in older adults with vitamin D deficiency: a randomized clinical trial
PubMed ID: 40421021
Reduced immune‑cell senescence (SA‑β‑gal, p16) and inflammatory gene expression in older adults, implying improved immune resilience.
- Evaluation of the efficacy of N-acetylcysteine and bromhexine compared with standard care in preventing hospitalization of outpatients with COVID-19: a double blind randomized clinical trial
PubMed ID: 38215974
Symptomatic COVID‑19 outpatient trial reported fewer hospitalizations and deaths with oral/inhaled NAC arms, suggesting possible clinical immune/resilience benefit (single‑center, limited detail).
- Effects of N-acetylcysteine on systemic lupus erythematosus disease activity and its associated complications: a randomized double-blind clinical trial study
PubMed ID: 36810107
SLE RCT showed decreased disease activity and improved complement (CH50), indicating beneficial immune modulation.
- Effect of co-trimoxazole and N-acetylcysteine alone and in combination on bacterial adherence on ureteral stent surface
PubMed ID: 38079000
Large RCT in ureteral stents: oral NAC reduced stent and urine bacterial colonization, implying an effect on infection risk/host defense.
- Prophylactic NAC promoted hematopoietic reconstitution by improving endothelial cells after haploidentical HSCT: a phase 3, open-label randomized trial
PubMed ID: 35473809
Prophylactic oral NAC reduced poor graft function after HSCT and improved BM endothelial health—outcomes relevant to hematopoietic/immune recovery.
- Use of N-acetylcysteine as treatment adjuvant regulates immune response in visceral leishmaniasis: Pilot clinical trial and in vitro experiments
PubMed ID: 36506010
Adjuvant NAC in visceral leishmaniasis shifted immune markers (↑sCD40L, ↓IL‑10), showing immunomodulatory activity though no clinical cure benefit.
Liver support (32)
- Role of N-acetylcysteine treatment in non-acetaminophen-induced acute liver failure: A prospective study
PubMed ID: 28611340
Randomized trial in non‑acetaminophen acute liver failure: IV NAC improved survival and shortened hospital stay.
- A non-inferiority randomised controlled trial of a shorter acetylcysteine regimen for paracetamol overdose - the SARPO trial
PubMed ID: 40414507
High‑quality randomized non‑inferiority trial showing 12‑hr IV NAC regimen is effective and safe in paracetamol overdose → strong liver clinical evidence.
- Protective effect of N-acetylcysteine on antituberculosis drug-induced hepatotoxicity
PubMed ID: 20461008
Randomized trial in older TB patients: NAC prevented clinical hepatotoxicity (0% vs 37.5%) and lowered transaminases → strong protective liver effect.
- Potential benefits of combined N-acetylcysteine and ciprofloxacin therapy in partial biliary obstruction
PubMed ID: 20388917
IV NAC before ERCP lowered cholestatic enzymes (ALP/GGT) and inflammatory markers in partial biliary obstruction → direct liver marker improvements.
- Reduction of adverse effects from intravenous acetylcysteine treatment for paracetamol poisoning: a randomised controlled trial
PubMed ID: 24290406
Large RCT showed markedly fewer anaphylactoid reactions with modified IV NAC and similar early ALT outcomes → clinically relevant liver treatment optimization.
- Pharmacological Modulation of Ischemic-Reperfusion Injury during Pringle Maneuver in Hepatic Surgery. A Prospective Randomized Pilot Study
PubMed ID: 27094558
Pilot RCT: perioperative NAC associated with better liver enzyme recovery after prolonged inflow occlusion → improved postoperative liver function.
- Double-blind placebo-controlled randomized trial of N-acetylcysteine infusion following live donor liver transplantation
PubMed ID: 33278022
Perioperative NAC after living‑donor liver transplant reduced peak transaminases and hastened normalization.
- A Randomized Controlled Trial of Intravenous N-Acetylcysteine in the Management of Anti-tuberculosis Drug-Induced Liver Injury
PubMed ID: 32845997
IV NAC in anti‑TB drug liver injury shortened hospital stay though ALT recovery unchanged.
- A metabolomic analysis of thiol response for standard and modified N-acetyl cysteine treatment regimens in patients with acetaminophen overdose
PubMed ID: 33742775
IV NAC regimens raised cysteine/NAC levels and identified metabolites predicting liver injury—direct hepatic detox/pharmacology data.
- Early Cessation of Acetylcysteine Treatment After Paracetamol Overdose (NACSTOP 2): A Non-Inferiority Randomised Controlled Trial
PubMed ID: 41549406
Non‑inferiority trial supports shortened IV NAC regimens in low‑risk paracetamol overdose—reinforces NAC's hepatoprotective role.
- New Approach Combination-Dosed Therapy for Nonalcoholic Steatohepatitis Versus Vitamin E: A Randomized Controlled Trial
PubMed ID: 40480879
NAC+rosuvastatin produced substantially larger reductions in steatosis, fibrosis indices and liver biomarkers (combination therapy).
- [A clinical study of N-acetylcysteine treatment in chronic hepatitis B patients]
PubMed ID: 18647523
Short trial in chronic hepatitis B reported decreased bilirubin and improved prothrombin activity with NAC versus glutathione.
- N-acetylcysteine in Acute Organophosphorus Pesticide Poisoning: A Randomized, Clinical Trial
PubMed ID: 26786042
In organophosphate poisoning NAC improved antioxidant markers and reduced atropine needs — hepatic detox/antioxidant support in poisoning context.
- A study to evaluate the hepatoprotective effect of N- acetylcysteine on anti tuberculosis drug induced hepatotoxicity and quality of life
PubMed ID: 37562904
In new TB patients NAC (600 mg bid) modestly improved ALT/AST at 4 weeks, suggesting hepatoprotective potential during hepatotoxic therapy.
- Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial
PubMed ID: 1954453
High-quality RCT in paracetamol-induced fulminant hepatic failure: IV NAC markedly improved survival and reduced complications—definitive liver benefit.
- The efficacy of N-acetylcysteine as a hepatoprotective agent in liver transplantation
PubMed ID: 9665023
Peri‑transplant pilot showed reduced ischemia–reperfusion injury, lower transaminase peaks and better early graft function—strong hepatoprotective signal.
- N-acetylcysteine increases liver blood flow and improves liver function in septic shock patients: results of a prospective, randomized, double-blind study
PubMed ID: 11153617
In septic shock NAC increased liver blood flow index and improved MEGX, a liver function marker.
- [A multi-center clinical study of N-acetylcysteine on chronic hepatitis B]
PubMed ID: 15670485
Randomized trial in chronic hepatitis B showed NAC addition reduced bilirubin and improved prothrombin activity—clinically meaningful liver function improvements.
- Effect of N-acetylcysteine administration on intraoperative plasma levels of interleukin-4 and interleukin-10 in liver transplant recipients
PubMed ID: 19010165
During liver transplant, NAC increased anti‑inflammatory cytokines (IL‑4, IL‑10) — biomarker evidence of beneficial perioperative hepatic immune modulation.
- Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure
PubMed ID: 19524577
Randomized trial in non‑acetaminophen acute liver failure: IV NAC increased transplant‑free survival, especially when given early — strong clinical liver benefit.
- Glucocorticoids plus N-acetylcysteine in severe alcoholic hepatitis
PubMed ID: 22070475
Large randomized trial in severe alcoholic hepatitis: adding IV NAC to prednisolone improved 1-month survival and reduced hepatorenal deaths and infections.
- Use of N-acetylcysteine during liver procurement: a prospective randomized controlled study
PubMed ID: 22859317
Robust RCT in liver transplant showing improved graft survival and fewer postoperative complications after perioperative NAC — strong direct evidence for liver benefit.
- Improvements in hepatic serological biomarkers are associated with clinical benefit of intravenous N-acetylcysteine in early stage non-acetaminophen acute liver failure
PubMed ID: 23325162
In early non-APAP acute liver failure, NAC recipients had faster improvement in ALT/bilirubin linked to better transplant-free survival.
- Effects of N-acetylcysteine on cytokines in non-acetaminophen acute liver failure: potential mechanism of improvement in transplant-free survival
PubMed ID: 23782487
NAC-associated IL‑17 reductions correlated with better transplant-free survival in early ALF — mechanistic liver-relevant signal.
- Population pharmacokinetic-pharmacodynamic modelling to describe the effects of paracetamol and N-acetylcysteine on the international normalized ratio
PubMed ID: 25316328
PK/PD modeling shows NAC contributes to INR changes in paracetamol overdose context—mechanistic link to hepatic effects/detoxification.
- N-ACETYLCYSTEINE AND/OR URSODEOXYCHOLIC ACID ASSOCIATED WITH METFORMIN IN NON-ALCOHOLIC STEATOHEPATITIS: AN OPEN-LABEL MULTICENTER RANDOMIZED CONTROLLED TRIAL
PubMed ID: 31460584
In biopsy‑proven NASH, NAC+metformin yielded within‑group histologic and ALT improvements, suggesting potential hepatic benefit (limited between‑group evidence).
- Effect of N-acetylcysteine on liver and kidney function tests after surgical bypass in obstructive jaundice: A randomized controlled trial
PubMed ID: 31280997
Perioperative IV NAC in patients with obstructive jaundice showed greater postoperative improvement in liver enzymes and bilirubin vs controls (clinical hepatic benefit).
- N-Acetylcysteine Prevents Post-embolization Syndrome in Patients with Hepatocellular Carcinoma Following Transarterial Chemoembolization
PubMed ID: 31073737
Peri‑TACE IV NAC halved post‑embolization syndrome incidence (clinical benefit after liver procedure) though liver decompensation unchanged.
- Utility of N-acetylcysteine in ischemic hepatitis in cirrhotics with acute variceal bleed: a randomized controlled trial
PubMed ID: 32048131
Large RCT in cirrhotic patients: IV NAC reduced ischemic hepatitis, AKI and decreased liver‑failure deaths—strong liver‑protective evidence.
- Role of Prophylactic N-Acetylcysteine Supplementation on Postoperative Outcomes in Patients Undergoing Elective Double-Valve Replacement (Aortic and Mitral Valve)
PubMed ID: 39365130
Prophylactic IV NAC around double‑valve replacement significantly reduced postoperative hyperbilirubinemia and transaminase elevations (strong perioperative hepatic protection).
- Efficacy of N-acetylcysteine vs dexamethasone in preventing postembolization syndrome post-transarterial chemoembolization in hepatocellular carcinoma: A randomized controlled trial
PubMed ID: 40901687
Peri‑TACE IV NAC halved postembolization syndrome incidence versus dexamethasone; ALBI scores similar but PES reduction suggests less postprocedural hepatic injury.
- N-Acetylcysteine and Liver Transplant. Advantages of its Administration in Multi-Organ Donors Especially During World-Economical-Crisis. Long-Term Sub-Group Analysis in a Randomized Study
PubMed ID: 39809659
Use of NAC perfusion in donor organs associated with markedly higher 5‑year recipient survival, with a pronounced effect in the HCC (liver) subgroup (suggests liver graft benefit).
Heart health (27)
- Comparing the efficacy of N-acetylcysteine plus carvedilol versus carvedilol in the prevention of atrial fibrillation following coronary artery bypass graft surgery
PubMed ID: 36285551
CABG trial adding NAC to carvedilol showed a numerical (non-significant) reduction in POAF, suggesting possible cardiac benefit.
- Effect of N-acetylcysteine on cardiac injury and oxidative stress after abdominal aortic aneurysm repair: a randomized controlled trial
PubMed ID: 22092168
Perioperative NAC reduced cardiac injury biomarkers after AAA repair, suggesting cardiac protection.
- Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study
PubMed ID: 23232844
Randomized trial: NAC + carvedilol significantly reduced postoperative atrial fibrillation and shortened hospital stay—direct cardiac clinical benefit.
- Oxidative status, inflammation, and postoperative atrial fibrillation with metoprolol vs carvedilol or carvedilol plus N-acetyl cysteine treatment
PubMed ID: 24477817
Same large perioperative study showed NAC reduced oxidative stress/inflammation and was linked to less atrial fibrillation.
- Infarct Size Limitation: acute N-acetylcysteine defense (ISLAND trial): preliminary analysis and report after the first 30 patients
PubMed ID: 8821417
Small RCT in acute MI showed marked LVEF improvement and infarct‑size reduction with NAC added to reperfusion.
- Early Use of N-acetylcysteine With Nitrate Therapy in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction Reduces Myocardial Infarct Size (the NACIAM Trial [N-acetylcysteine in Acute Myocardial Infarction])
PubMed ID: 28634219
High‑dose IV NAC around PCI reduced infarct size and increased salvage—strong direct heart benefit.
- Protection from Reperfusion Injury with Intracoronary N-Acetylcysteine in Patients with STEMI Undergoing Primary Percutaneous Coronary Intervention in a Cardiac Tertiary Center
PubMed ID: 29322434
Randomized STEMI trial: NAC improved troponin kinetics and TIMI flow—direct cardioprotective signal.
- Effects of folic acid and N-acetylcysteine on plasma homocysteine levels and endothelial function in patients with coronary artery disease
PubMed ID: 18214123
Oral NAC lowered homocysteine and improved endothelium-dependent dilation in coronary disease patients.
- A trial of antioxidants N-acetylcysteine and procysteine in ARDS. The Antioxidant in ARDS Study Group
PubMed ID: 9228372
Multicenter RCT showed NAC restored RBC GSH and increased cardiac index (~14%) and shortened acute lung injury duration — direct hemodynamic benefit.
- N-acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients
PubMed ID: 14668186
CABG trial: NAC preserved myocardial glutathione and halved myeloperoxidase—evidence of myocardial protection.
- Cardioprotective effect of cold-blood cardioplegia enriched with N-acetylcysteine during coronary artery bypass grafting
PubMed ID: 16427861
Perioperative NAC lowered troponin I and MDA after CABG, indicating reduced myocardial ischemia–reperfusion injury.
- Effect of N-acetylcysteine in attenuating ischemic reperfusion injury in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass
PubMed ID: 19467834
NAC-enriched cardioplegia reduced oxidative stress and improved early postoperative ejection fraction after CABG, indicating cardioprotective effect.
- Oral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status
PubMed ID: 26447155
Lowered homocysteine and modest BP reduction in two trials — vascular risk factors improved.
- Correlation of plasma lipidomic profiles with cardiometabolic disease in transfusion-dependent thalassemia patients with six-month N-acetylcysteine intervention: A prospective cohort study
PubMed ID: 41135647
6‑month NAC altered plasma lipids and correlated with improved HRV, suggesting possible cardiac autonomic/heart benefit.
- N-acetylcysteine Restored Heart Rate Variability and Prevented Serious Adverse Events in Transfusion-dependent Thalassemia Patients: a Double-blind Single Center Randomized Controlled Trial
PubMed ID: 32547310
In transfusion-dependent thalassemia NAC reduced serious adverse events and preserved heart-rate variability, indicating cardioprotective effects.
- N-acetylcysteine and magnesium improve biochemical abnormalities associated with myocardial ischaemic reperfusion in South Indian patients undergoing coronary artery bypass grafting: a comparative analysis
PubMed ID: 20593142
Perioperative NAC reduced oxidative stress and improved cardiac biochemical markers after CABG.
- N-acetylcysteine prevents reactive oxygen species-mediated myocardial stress in patients undergoing cardiac surgery: results of a randomized, double-blind, placebo-controlled clinical trial
PubMed ID: 14666027
Reduced myocardial oxidative‑stress biomarkers during cardiac surgery (biomarker evidence of cardiac protection, no short‑term hemodynamic benefit).
- The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial
PubMed ID: 12600912
RCT in hemodialysis patients showed a significant reduction in composite cardiovascular events with oral NAC.
- Myocardial apoptosis prevention by radical scavenging in patients undergoing cardiac surgery
PubMed ID: 15224028
Perioperative NAC markedly reduced myocardial apoptosis markers (caspases), a cellular cardiac-protective signal despite no short-term clinical outcome change.
- N-acetylcysteine and contrast-induced nephropathy in primary angioplasty
PubMed ID: 16807414
NAC (IV+oral) dose-dependently reduced in-hospital mortality and composite adverse cardiac outcomes after primary angioplasty.
- Intravenous N-acetylcysteine during haemodialysis reduces the plasma concentration of homocysteine in patients with end-stage renal disease
PubMed ID: 17163251
Acute IV NAC during dialysis markedly lowered homocysteine and correlated with reduced pulse pressure (improved vascular load).
- N-acetylcysteine for the prevention of postoperative atrial fibrillation: a prospective, randomized, placebo-controlled pilot study
PubMed ID: 18263874
Randomized trial showing perioperative NAC markedly reduced postoperative atrial fibrillation — clear cardiac benefit.
- Ischemia-modified albumin reduction after coronary bypass surgery is associated with the cardioprotective efficacy of cold-blood cardioplegia enriched with N-acetylcysteine: a preliminary study
PubMed ID: 19955769
Cardioplegia enriched with NAC markedly reduced ischemia-modified albumin, a biochemical marker of myocardial ischemia.
- Effects of N-acetylcysteine on the cardiac remodeling biomarkers and major adverse events following acute myocardial infarction: a randomized clinical trial
PubMed ID: 24105017
Randomized trial after acute MI showed fewer MACE and lower remodeling enzymes with NAC.
- N-acetylcysteine administration prevents nonthyroidal illness syndrome in patients with acute myocardial infarction: a randomized clinical trial
PubMed ID: 25148231
Short NAC infusion in acute MI ameliorated thyroid-hormone derangement and oxidative markers that can affect cardiac recovery.
- The effect of intravenous N-acetylcysteine on prevention of atrial fibrillation after coronary artery bypass graft surgery: a double-blind, randomised, placebo-controlled trial
PubMed ID: 28980294
Perioperative IV NAC significantly reduced postoperative atrial fibrillation and lowered perioperative hsCRP, a clinically relevant cardiac endpoint.
- Effect of Oral N-Acetylcysteine Supplementation on the Immunity System in Patients with Acute Myocardial Infarction
PubMed ID: 32041914
Small RCT in STEMI patients showed short‑course oral NAC lowered inflammatory biomarkers (CRP, MPO, Gal‑3), which are relevant to post‑MI cardiac inflammation.
Mucus clearance (20)
- Use of N-acetylcysteine plus simethicone to improve mucosal visibility during upper GI endoscopy: a double-blind, randomized controlled trial
PubMed ID: 29037773
Premedication with simethicone+NAC before endoscopy improved gastric mucosal visibility by reducing mucus/foam.
- Efficacy and safety of combined nebulization of unfractionated heparin, acetylcysteine, budesonide and ipratropium bromide in hospitalised patients with COVID-19 pneumonia: a randomized controlled clinical trial
PubMed ID: 40696325
Nebulized therapy including NAC is commonly used for mucolysis; trial showed faster radiologic clearance and improved oxygenation in COVID pneumonia (multi‑agent limitation).
- Intravenous N-acetylcysteine in respiratory disease with abnormal mucus secretion
PubMed ID: 37318485
Large RCT in hospitalized respiratory disease: IV NAC improved sputum viscosity and ease of expectoration vs placebo (strong mucolytic evidence).
- A prospective randomized controlled trial comparing simethicone, N-acetylcysteine, sodium bicarbonate and peppermint for visualization in upper gastrointestinal endoscopy
PubMed ID: 32016519
Pre‑endoscopy simethicone + NAC improved gastric mucosal visualization by reducing mucus/foam — practical mucolytic effect for GI prep.
- Impact of smoking status and concomitant medications on the effect of high-dose N-acetylcysteine on chronic obstructive pulmonary disease exacerbations: A post-hoc analysis of the PANTHEON study
PubMed ID: 30704697
COPD trial: high‑dose NAC reduced exacerbation rates (likely via mucolytic and antioxidant actions) with subgroup mucus‑related benefits reported.
- Effectiveness of nebulized N-acetylcysteine solution in children with acute bronchiolitis
PubMed ID: 24953914
Nebulized NAC in bronchiolitis produced clinical improvements that may reflect mucolytic effects in infants.
- Mucolytic-antifoam solution for reduction of artifacts during endoscopic ultrasonography: a randomized controlled trial
PubMed ID: 1657680
Mucolytic‑antifoam mix containing acetylcysteine markedly improved endoscopic visualization—practical mucolytic effect in GI procedure setting.
- N-Acetylcysteine Rinse for Thick Secretion and Mucositis of Head and Neck Chemoradiotherapy (Alliance MC13C2): A Double-Blind Randomized Clinical Trial
PubMed ID: 31405750
Topical 10% NAC rinse during head‑and‑neck chemoradiotherapy reduced sticky saliva and xerostomia symptoms — improved mucosal/mucus properties.
- Effect of N-acetylcysteine on exacerbations of bronchiectasis (BENE): a randomized controlled trial
PubMed ID: 30975143
Bronchiectasis RCT: 12 months oral NAC reduced 24‑hour sputum volume and exacerbations — strong mucolytic/clinical mucus‑clearing effect.
- N-Acetylcysteine inhalation improves pulmonary function in patients received liver transplantation
PubMed ID: 30217943
Perioperative inhaled NAC reduced postoperative pulmonary complications and ALI rates after liver transplant, consistent with improved airway clearance/comfort from inhaled NAC.
- [Effect of N-acetylcysteine inhalation on ventilator-associated pneumonia caused by biofilm in endotracheal tubes]
PubMed ID: 27055427
Inhaled NAC reduced endotracheal tube biofilm and VAP incidence; inhaled NAC's mucolytic properties plausibly contributed to improved airway hygiene in intubated patients.
- Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy: a randomized, controlled, endoscopist-blinded study
PubMed ID: 23739279
Duplicate entry avoided — same mucolytic gastroscopy evidence as above.
- The add-on N-acetylcysteine is more effective than dimethicone alone to eliminate mucus during narrow-band imaging endoscopy: a double-blind, randomized controlled trial
PubMed ID: 23268593
Large randomized endoscopy study: oral NAC premedication reduced flush volume needed to clear mucus (~10 mL median reduction) and improved visibility.
- N-acetylcysteine improves the clinical conditions of mustard gas-exposed patients with normal pulmonary function test
PubMed ID: 18801028
Mustard gas exposure trial: NAC for 4 months reduced sputum frequency from 76.9% to 9.6% and improved cough/dyspnea — strong mucolytic/expectoration effect.
- Premedication with pronase or N-acetylcysteine improves visibility during gastroendoscopy: an endoscopist-blinded, prospective, randomized study
PubMed ID: 17230616
Premedication with NAC improved mucosal visibility for endoscopy by reducing mucus/foam.
- Therapeutics effect of N-acetyl cysteine on mustard gas exposed patients: evaluating clinical aspect in patients with impaired pulmonary function test
PubMed ID: 18036807
Improved symptoms in bronchiolitis may include less cough/sputum, consistent with mucolytic benefit.
- [Efficacy of Derinox assessed with one PNIF (Peak Nasal Inspiratory Flow) in patients suffering from common cold]
PubMed ID: 16439935
Dérinox (contains NAC) improved nasal airflow and reduced rhinorrhea in the common cold—consistent with mucolytic/mucus-clearing effects.
- N-acetylcysteine reduces the exacerbation rate in patients with moderate to severe COPD
PubMed ID: 10575333
Long‑term oral NAC reduced COPD exacerbations and modestly improved airflow—consistent with mucolytic/airway‑secretion effects.
- Long-term treatment with oral N-acetylcysteine: affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial
PubMed ID: 25228446
Oral NAC preserved FEV1 in cystic fibrosis over 24 weeks — consistent with mucolytic/airway benefits.
- Administration of maximum dose of mucolytic solution before upper endoscopy - a double-blind, randomized trial
PubMed ID: 37115977
High-dose mucolytic containing NAC modestly improved gastric mucosal visibility in gastroscopy.
Brain health (25)
- N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial
PubMed ID: 18436195
Large RCT in chronic schizophrenia showed moderate improvements in total and negative symptoms with adjunctive NAC—clinical CNS benefit.
- N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study
PubMed ID: 19581567
Double-blind RCT showed NAC substantially reduced compulsive hair-pulling and improved clinical psychiatric outcomes.
- Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure
PubMed ID: 19524577
Benefit on transplant‑free survival was concentrated in patients with early hepatic encephalopathy — indicates improved brain/encephalopathy outcomes in that context.
- A double-blind randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents
PubMed ID: 22706327
In adolescents with CUD, NAC doubled odds of cannabis-negative urine tests when added to behavioral therapy—evidence of CNS/behavioral effect.
- N-Acetyl Cysteine Is Associated With Dopaminergic Improvement in Parkinson's Disease
PubMed ID: 31206613
In Parkinson's patients NAC (IV+oral) increased striatal DAT binding on imaging and produced significant clinical symptom improvements — strong brain/neuroprotective signal.
- N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis
PubMed ID: 29462456
NAC raised brain and blood GSH and improved processing speed in early psychosis, demonstrating neural antioxidant and cognitive effects.
- Cognitive effects of adjunctive N-acetyl cysteine in psychosis
PubMed ID: 27894373
Improved working memory in psychosis after 24 weeks — domain‑specific cognitive benefit.
- Towards stage specific treatments: effects of duration of illness on therapeutic response to adjunctive treatment with N-acetyl cysteine in schizophrenia
PubMed ID: 25315856
Adjunctive NAC improved positive symptoms and functioning in long‑duration schizophrenia — clinical CNS benefit in a subgroup.
- N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial
PubMed ID: 18534556
Adjunctive NAC significantly improved depressive symptoms in bipolar disorder over 24 weeks—supports CNS mood/brain benefit.
- Repurposing of high-dose N-acetylcysteine as anti-inflammatory, antioxidant and neuroprotective agent in moderate to severe traumatic brain injury patients: a randomized controlled trial
PubMed ID: 40205270
In moderate–severe TBI NAC reduced NSE (neuronal injury marker) and inflammatory/oxidative markers with clinical improvement.
- Fluoxetine versus N-acetylcysteine in reducing craving in Indian men with alcohol dependence syndrome: a randomised controlled trial
PubMed ID: 41486713
In men with alcohol dependence NAC reduced craving and relapse versus fluoxetine, implying CNS/mood‑related benefit.
- Metabolite profiles in the anterior cingulate cortex of depressed patients differentiate those taking N-acetyl-cysteine versus placebo
PubMed ID: 23341476
MRS study showed NAC-associated changes in anterior cingulate metabolites (Glx, NAA, mI), indicating target engagement in brain.
- A Phase II Randomized Clinical Trial of a Nutritional Formulation for Cognition and Mood in Alzheimer's Disease
PubMed ID: 25589719
Phase II RCT in Alzheimer's with multi‑nutrient formula (includes NAC) improved some cognitive scores at 3 months → relevant to brain health though NAC attribution uncertain.
- A randomized controlled pilot trial of oral N-acetylcysteine in children with autism
PubMed ID: 22342106
12-week RCT in children with autism produced significant behavioral improvements, consistent with CNS/brain effects.
- N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial
PubMed ID: 23131885
12-week RCT in refractory OCD showed significant symptom improvement — strong clinical evidence of CNS benefit in this context.
- Amelioration of acute sequelae of blast induced mild traumatic brain injury by N-acetyl cysteine: a double-blind, placebo controlled study
PubMed ID: 23372680
Double‑blind RCT in blast mTBI showed large, rapid symptom resolution and cognitive normalization with early NAC treatment.
- N-acetylcysteine as an adjunct to risperidone for treatment of negative symptoms in patients with chronic schizophrenia: a randomized, double-blind, placebo-controlled study
PubMed ID: 24201233
Add-on NAC improved negative symptoms in chronic schizophrenia in an RCT — clinically relevant central nervous system effect.
- N-acetylcysteine as an adjunctive therapy to risperidone for treatment of irritability in autism: a randomized, double-blind, placebo-controlled clinical trial of efficacy and safety
PubMed ID: 25580916
Adjunctive NAC reduced irritability and hyperactivity in children with autism—clinically relevant neuropsychiatric benefit.
- N-acetylcysteine augmentation therapy for moderate-to-severe obsessive-compulsive disorder: randomized, double-blind, placebo-controlled trial
PubMed ID: 26931055
Double‑blind augmentation RCT in OCD showed significant symptom improvement with NAC adjunct to fluvoxamine.
- Therapeutic effect of adjunctive N-acetyl cysteine (NAC) on symptoms of chronic schizophrenia: A double-blind, randomized clinical trial
PubMed ID: 29126981
12‑week adjunctive NAC modestly improved some schizophrenia symptoms and cognitive tasks — positive CNS symptom/cognition signal.
- Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders
PubMed ID: 29588126
One‑year adjunctive NAC (3600 mg/day) improved overall and negative symptoms in early‑phase schizophrenia — clinically meaningful CNS symptom benefit.
- Safety and efficacy of N-acetylcysteine (NAC) as an adjunct to standard treatment in patients with acute ischemic stroke: a randomized controlled pilot trial (NACTLYS)
PubMed ID: 38212360
In acute ischemic stroke, IV NAC added to alteplase improved early NIHSS at 24 h (early neurologic improvement but no 90‑day functional benefit demonstrated).
- Changes in Resting-State Functional Connectivity and Cognitive-Affective Symptoms in Patients With Post-Concussion Syndrome Treated With N-Acetyl Cysteine
PubMed ID: 39531327
In chronic post‑concussion syndrome, NAC (oral+IV) produced symptom improvements and changes in resting‑state functional connectivity that correlated with clinical gains.
- Frontal white matter hyperintensity burden predicts cognitive response to N-acetylcysteine and exercise in vascular mild cognitive impairment
PubMed ID: 41579736
In vascular MCI patients exercising, NAC treatment yielded modest executive-function improvements in a subgroup with lower frontal WMH.
- A vitamin/nutriceutical formulation improves memory and cognitive performance in community-dwelling adults without dementia
PubMed ID: 20191258
Randomized placebo‑controlled multi‑nutrient trial (includes NAC) showed improved memory/executive function → supports cognitive/brain outcomes as part of combination.
Vascular health (18)
- Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers
PubMed ID: 25731901
Homocysteine reduction and decreased protein oxidative damage in workers are favorable for vascular function.
- Effects of folic acid and N-acetylcysteine on plasma homocysteine levels and endothelial function in patients with coronary artery disease
PubMed ID: 18214123
Oral NAC lowered homocysteine and significantly improved endothelium-dependent dilation in coronary disease patients.
- Acetylcysteine has No Mechanistic Effect in Patients at Risk of Contrast-Induced Nephropathy: A Failure of Academic Clinical Science
PubMed ID: 35098531
IV NAC increased renal blood flow in healthy volunteers, indicating vascular/hemodynamic effects in some settings.
- The effect of N-acetylcysteine on renal function, nitric oxide, and oxidative stress after angiography
PubMed ID: 14633141
NAC preserved creatinine clearance and urinary NO after contrast exposure in patients with mild renal failure—supports endothelial/vascular protection.
- Acetylcysteine for prevention of acute deterioration of renal function following elective coronary angiography and intervention: a randomized controlled trial
PubMed ID: 12578487
Large randomized trial: oral NAC around coronary angiography reduced incidence of contrast‑induced renal impairment (supports vascular/renal perfusion protection).
- The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial
PubMed ID: 12600912
Hemodialysis RCT: NAC reduced composite cardiovascular events—supports vascular/cardiac benefits in a high-risk population.
- N-acetylcysteine and contrast-induced nephropathy in primary angioplasty
PubMed ID: 16807414
Reduced contrast-induced renal injury and improved outcomes after angioplasty imply vascular and end-organ protective effects after ischemic/contrast injury.
- Intravenous N-acetylcysteine during haemodialysis reduces the plasma concentration of homocysteine in patients with end-stage renal disease
PubMed ID: 17163251
Significant homocysteine lowering with NAC correlated with pulse-pressure reduction—direct relevance to vascular health.
- Effects of N-acetylcysteine on the cardiac remodeling biomarkers and major adverse events following acute myocardial infarction: a randomized clinical trial
PubMed ID: 24105017
Post-MI reductions in MMPs with NAC suggest beneficial remodeling effects on vessels and myocardium.
- N-Acetylcysteine as Prophylactic Therapy for Transplantation-Associated Thrombotic Microangiopathy: A Randomized, Placebo-Controlled Trial
PubMed ID: 35940529
Significant reduction in transplantation‑associated thrombotic microangiopathy (endothelial/vascular protection) after peri‑transplant NAC.
- Prophylactic NAC promoted hematopoietic reconstitution by improving endothelial cells after haploidentical HSCT: a phase 3, open-label randomized trial
PubMed ID: 35473809
NAC prophylaxis improved bone‑marrow endothelial cell percentage/function and reduced EC ROS, and reduced poor graft function—direct endothelial/vascular benefit.
- Impact of N-Acetyl-Cysteine on Ischemic Stumps Following Major Lower Extremity Amputation: A Pilot Randomized Clinical Trial
PubMed ID: 35129469
Improved stump perfusion and higher healing rates in high‑risk ischemic amputations indicate better local blood flow/microvascular function.
- Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn
PubMed ID: 21978796
Reduced vasopressor requirements in severe burns may reflect improved hemodynamic stability related to antioxidant/anti‑inflammatory effects.
- Effect of N-acetylcysteine in attenuating ischemic reperfusion injury in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass
PubMed ID: 19467834
Reduced reperfusion oxidative stress and improved early EF after CABG suggest NAC protects myocardium/vasculature during ischemia–reperfusion.
- Asymmetric Dimethylarginine Limits the Efficacy of Simvastatin Activating Endothelial Nitric Oxide Synthase
PubMed ID: 27091343
Preclinical data show NAC reverses ADMA‑induced NO dysfunction—mechanistic support for vascular protection.
- Effects of antioxidant supplementation on postprandial oxidative stress and endothelial dysfunction: a single-blind, 15-day clinical trial in patients with untreated type 2 diabetes, subjects with impaired glucose tolerance, and healthy controls
PubMed ID: 16368447
Combined antioxidant treatment including NAC improved postprandial endothelial markers (NO, VCAM-1).
- Intravenous N-acetylcysteine during hemodialysis reduces asymmetric dimethylarginine level in end-stage renal disease patients
PubMed ID: 18226399
In dialysis patients NAC produced a greater reduction in ADMA, a vasculature‑relevant biomarker—supports vascular benefit.
- Oral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status
PubMed ID: 26447155
Lowered homocysteine and modestly reduced blood pressure — direct vascular risk factor improvements.
Mood balance (12)
- Amelioration of acute sequelae of blast induced mild traumatic brain injury by N-acetyl cysteine: a double-blind, placebo controlled study
PubMed ID: 23372680
In acute blast mTBI NAC led to rapid symptom resolution including affective symptoms — suggests mood/affect benefit post‑injury.
- N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study
PubMed ID: 19581567
RCT demonstrated robust benefit of NAC for compulsive hair-pulling, supporting modulation of compulsive/affective symptoms.
- N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial
PubMed ID: 18534556
Large double‑blind RCT showed significant, clinically meaningful reductions in depressive symptoms in bipolar disorder with adjunctive NAC.
- Fluoxetine versus N-acetylcysteine in reducing craving in Indian men with alcohol dependence syndrome: a randomised controlled trial
PubMed ID: 41486713
Randomized trial in men with alcohol dependence: NAC reduced craving scores and relapse rate vs fluoxetine, indicating clinically meaningful CNS/mood effects.
- The therapeutic effect of N-acetylcysteine as an add-on to methadone maintenance therapy medication in outpatients with substance use disorders: A randomized, double-blind, placebo-controlled clinical trial
PubMed ID: 36448959
In methadone maintenance patients NAC improved depression and anxiety scores along with GSH increases—randomized evidence of mood benefit.
- The efficacy of adjunctive N-acetylcysteine in major depressive disorder: a double-blind, randomized, placebo-controlled trial
PubMed ID: 25004186
Adjunctive trial in MDD failed primary endpoint but showed functioning and subgroup symptomatic benefit over longer follow‑up.
- The efficacy of N-acetylcysteine as an adjunctive treatment in bipolar depression: an open label trial
PubMed ID: 21719110
Open‑label adjunctive NAC over 8 weeks was associated with large decreases in depressive scores (uncontrolled but suggestive).
- Changes in Resting-State Functional Connectivity and Cognitive-Affective Symptoms in Patients With Post-Concussion Syndrome Treated With N-Acetyl Cysteine
PubMed ID: 39531327
Post‑concussion RCT reported improvements in symptom scales including anxiety/mood correlated with brain connectivity changes after NAC.
- A Double-Blind, Randomized, Controlled Pilot Trial of N-Acetylcysteine in Veterans With Posttraumatic Stress Disorder and Substance Use Disorders
PubMed ID: 27736051
RCT in Veterans with PTSD+SUD showed large reductions in PTSD symptoms and depression with NAC adjunct—strong mood/mood-related symptom signal.
- N-acetylcysteine augmentation therapy for moderate-to-severe obsessive-compulsive disorder: randomized, double-blind, placebo-controlled trial
PubMed ID: 26931055
Double‑blind RCT showed NAC augmentation of fluvoxamine produced greater reductions in OCD symptoms (affect/mood-related improvements via symptom relief).
- N-acetylcysteine as an adjunctive therapy to risperidone for treatment of irritability in autism: a randomized, double-blind, placebo-controlled clinical trial of efficacy and safety
PubMed ID: 25580916
Adjunctive NAC improved irritability and hyperactivity in autism—clinically meaningful behavioral/affective effects.
- A randomized controlled pilot trial of oral N-acetylcysteine in children with autism
PubMed ID: 22342106
RCT in children with autism showed reduced irritability and behavioral symptoms, supportive of mood/behavior modulation.
Healthy aging (9)
- Improvement of health status of sepsis patients undergoing blood purification therapy by using combination of acetylcysteine and frail management
PubMed ID: 40761047
NAC combined with a FRAIL management program improved frailty scores and lowered inflammatory/oxidative indices (multi‑component intervention confounds attribution).
- Co-administration of vitamin D and N-acetylcysteine to modulate immunosenescence in older adults with vitamin D deficiency: a randomized clinical trial
PubMed ID: 40421021
Well‑powered RCT in older adults: NAC + vitamin D produced marked reductions in PBMC senescence markers and senescence/germline inflammatory gene expression.
- Effect of treatment with N-acetylcysteine on non-enzymatic antioxidant reserves and lipid peroxidation in workers exposed to lead
PubMed ID: 24959775
Reduced lipid peroxidation and increased vitamin E in lead‑exposed workers—biomarkers consistent with oxidative-stress mitigation relevant to aging.
- Effect of N-acetylcysteine administration on homocysteine level, oxidative damage to proteins, and levels of iron (Fe) and Fe-related proteins in lead-exposed workers
PubMed ID: 25731901
Reduced oxidative protein damage and homocysteine in workers—biomarkers linked to aging processes.
- Effects of oral administration of N-acetyl-L-cysteine: a multi-biomarker study in smokers
PubMed ID: 11867504
Smokers had reductions in DNA damage markers and micronuclei, which relate to molecular aging processes.
- N-Acetylcysteine supplementation reduces oxidative stress and DNA damage in children with β-thalassemia
PubMed ID: 25222041
Three months of NAC lowered oxidative stress and DNA damage in children with β‑thalassemia; reduced DNA damage is mechanistically relevant to aging.
- Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment
PubMed ID: 9230243
Large RCT in older adults showed markedly fewer symptomatic influenza‑like episodes and improved cell‑mediated immunity, relevant to resilience in aging.
- Oxidative status, inflammation, and postoperative atrial fibrillation with metoprolol vs carvedilol or carvedilol plus N-acetyl cysteine treatment
PubMed ID: 24477817
Reduced oxidative stress and inflammation perioperatively—mechanisms tied to aging.
- Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial
PubMed ID: 35975308
GlyNAC in older adults corrected GSH deficiency and improved mitochondrial function and physical performance.
Skin health (8)
- Improvements in pincer nail deformity occur earlier and last longer when acetylcysteine gel is added to an overcurvature-correcting device: Results of a phase 3, multicenter, randomized, vehicle-controlled, investigator-blinded study
PubMed ID: 38009825
Phase‑3 multicenter RCT: 10% topical NAC gel plus device corrected pincer nails faster and maintained shape longer vs device alone (robust dermatologic evidence).
- Efficacy, safety, tolerability, and satisfaction of N-acetylcysteine and pentoxifylline in lichen planopilaris patients under treatment with topical clobetasol: A triple arm blinded randomized controlled trial
PubMed ID: 35703373
Add‑on oral NAC improved disease activity index in lichen planopilaris vs topical alone (small RCT).
- Efficacy and safety of topical acetylcysteine combined with the use of an overcurvature-correcting device in patients with pincer nail deformity: a randomized, vehicle-controlled, investigator-blinded study
PubMed ID: 37599384
Investigator‑blinded RCT: single topical acetylcysteine application plus corrective device accelerated pincer‑nail flattening vs device alone (dermatologic/integrument benefit).
- Hyperbaric oxygen, oxidative stress, NO bioavailability and ulcer oxygenation in diabetic patients
PubMed ID: 19341122
IV NAC during hyperbaric oxygen improved wound TcPO2 and antioxidant markers and helped healing in affected diabetic ulcer patients.
- Topical acne treatment with acetylcysteine: clinical and experimental effects
PubMed ID: 23346662
Topical 5% acetylcysteine gel modestly reduced comedones in mild acne vs placebo (double‑blind clinical study).
- N-Acetylcysteine in the Treatment of Excoriation Disorder: A Randomized Clinical Trial
PubMed ID: 27007062
Randomized trial showed NAC reduced skin‑picking severity and produced greater global improvement vs placebo—direct clinical skin‑health benefit (behavioral/clinical).
- N-acetylcysteine versus chlorhexidine in treatment of aphthous ulcers: a preliminary clinical trial
PubMed ID: 31679408
Single‑application NAC mouthwash produced faster pain relief in recurrent aphthous ulcers vs chlorhexidine (mucosal/skin‑surface symptomatic benefit).
- Impact of N-Acetyl-Cysteine on Ischemic Stumps Following Major Lower Extremity Amputation: A Pilot Randomized Clinical Trial
PubMed ID: 35129469
Perioperative IV NAC improved perfusion and 30‑day healing of ischemic amputation stumps in high‑risk subgroup (wound/skin healing relevance).
Energy & Fatigue (5)
- A pilot study of N-acetylcysteine as adjunctive therapy for severe malaria
PubMed ID: 11978899
Adjunctive NAC in severe malaria halved median time to lactate normalization and accelerated metabolic recovery (direct metabolic/energy production improvement).
- Effect of N-acetyl-cysteine and hyperoxia on erythropoietin production
PubMed ID: 21394639
Single NAC dose before hyperoxia produced a sustained EPO increase up to 48 h in healthy volunteers.
- Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial
PubMed ID: 35975308
GlyNAC improved mitochondrial function in older adults, implying enhanced cellular energy production (combination product).
- [The effect of prophylactically administered n-acetylcysteine on clinical indicators for tissue oxygenation during hyperoxic ventilation in cardiac risk patients]
PubMed ID: 8702052
Preserved VO2 and myocardial performance during short hyperoxia in cardiac-risk patients—physiologic support for energy production preservation.
- N-acetylcysteine preserves oxygen consumption and gastric mucosal pH during hyperoxic ventilation
PubMed ID: 7881669
NAC helped maintain whole-body oxygen consumption (VO2) and gastric pH during hyperoxic ventilation in septic patients—supports cellular energy/oxidative metabolism.
Exercise recovery (3)
- Effects of sulphur-containing compounds on plasma redox status in muscle-damaging exercise
PubMed ID: 20034232
Short NAC course in trained men boosted antioxidant capacity and reduced oxidative damage after intense resistance exercise—supports recovery.
- Effect of low-dose N-acetyl-cysteine infusion on tourniquet-induced ischaemia-reperfusion injury in arthroscopic knee surgery
PubMed ID: 15954970
IV NAC reduced plasma lipid peroxidation after tourniquet release (reperfusion) in knee arthroscopy—relevant to recovery from ischemia/reperfusion-type stress.
- Effect of cysteine derivatives administration in healthy men exposed to intense resistance exercise by evaluation of pro-antioxidant ratio
PubMed ID: 17999779
Short‑term NAC reduced exercise‑induced lipid peroxidation and preserved antioxidant enzymes in resistance exercisers.
Eye health (3)
- [Clinical application of irradiated drug-containing porcine-cornea to patients with ocular burns]
PubMed ID: 11876893
Randomized clinical trial: drug‑loaded porcine cornea (including NAC) rescued more burned eyes—clinical ocular benefit though NAC was in a multiagent graft.
- N-acetylcysteine in chronic blepharitis
PubMed ID: 11862087
Randomized study in chronic blepharitis: oral NAC improved tear break‑up time and mucous fern pattern.
- A Controlled, Randomized Double-Blind Study to Evaluate the Safety and Efficacy of Chitosan-N-Acetylcysteine for the Treatment of Dry Eye Syndrome
PubMed ID: 28441068
Chitosan‑NAC eye drops rapidly increased tear film thickness (~+23%) and improved dry‑eye signs/symptoms in a randomized within‑subject trial.
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Products with N-Acetyl Cysteine
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Being studied right now
Recruiting clinical trials registered on ClinicalTrials.gov. A trial in progress has no result yet — this is what the field is asking, not what it found.