N-Acetyl Cysteine (NAC)
NAC is a glutathione precursor studied for respiratory, psychiatric, and antioxidant-related outcomes.
Overview
What is N-acetyl cysteine?
N-acetyl cysteine is an antioxidant and supplement form of cysteine. It provides the cysteine required for glutathione production. It boosts production of glutathione, a powerful antioxidant that protects cells from damage. NAC also acts as a mucolytic to thin mucus in the respiratory tract and is clinically used for drug overdose treatment and lung conditions. Its safety and stability make it effective for raising cysteine and glutathione levels in the body.
Dosage
A typical dose of oral N-acetylcysteine is 600–1,800 mg per day. Higher doses are sometimes used in clinical studies, split into 2–4 daily doses.
Effect graph
Effect heatmap
SupplementDEX Database
84 conditions for , and rated at least stars. All purchase bands. No minimum star filter.
Database Snapshot
Most n-acetyl cysteine (nac) research is concentrated in a handful of conditions.
- Chronic obstructive pulmonary disease accounts for 21 of 225 studies (9%).
- Contrast-induced nephropathy accounts for 17 of 225 studies (8%).
- Polycystic ovary syndrome (PCOS) accounts for 12 of 225 studies (5%).
- Sparse coverage remains for Alzheimer's disease, Asthma, Bronchopulmonary dysplasia.
Dietary Sources
Dietary sources
NAC is not available directly from foods.
Safety
Oral NAC is generally safe when used at typical doses.
Frequently Asked Questions
References
Sources215 references
SupplementDEX uses only high-quality sources to determine supplement effectiveness.
SupplementDEX Database · Angina
6 references1.SupplementDEX Database: Angina — Nitroglycerine/N-acetylcysteine in the management of unstable angina pectoris1998
An RCT of 46 unstable angina patients found combined nitroglycerin and NAC reduced angina episodes more than nitroglycerin alone.
2.SupplementDEX Database: Angina — Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris1997
A 4-month RCT of 200 angina patients found transdermal nitroglycerin plus NAC improved exercise tolerance and reduced nitrate tolerance versus nitroglycerin alone.
3.SupplementDEX Database: Angina — Different susceptibility to the development of nitroglycerin tolerance in the arterial and venous circulation in humans. Effects of N-acetylcysteine administration1992
A study of 20 angina patients found arterial and venous beds differed in susceptibility to nitroglycerin tolerance during combined NAC therapy.
4.SupplementDEX Database: Angina — Preventive administration of intravenous N-acetylcysteine and development of tolerance to isosorbide dinitrate in patients with angina pectoris1992
An RCT of 10 patients found preventive IV NAC (5 mg/kg) delayed development of nitrate tolerance during continuous nitroglycerin infusion.
5.SupplementDEX Database: Angina — Chronic administration of N-acetylcysteine fails to prevent nitrate tolerance in patients with stable angina pectoris1990
An RCT found chronic NAC (10 mg/day) failed to prevent nitrate tolerance during long-term nitroglycerin therapy.
6.SupplementDEX Database: Angina — N-acetylcysteine fails to attenuate haemodynamic tolerance to glyceryl trinitrate in healthy volunteers1989
An RCT found NAC (200 mg three times daily) did not attenuate hemodynamic tolerance to glyceryl trinitrate in angina patients.
7.SupplementDEX Database: Autism spectrum disorder — Pharmacological and non-pharmacological interventions for irritability in autism spectrum disorder: a systematic review and meta-analysis with the GRADE assessment2024
A meta-analysis of 3,531 participants found NAC was among agents showing modest benefit for irritability in autism spectrum disorder, though evidence quality varied.
8.SupplementDEX Database: Autism spectrum disorder — A randomised, double blind, placebo-controlled trial of a fixed dose of N-acetyl cysteine in children with autistic disorder2017
A 6-month double-blind RCT of 102 children found fixed-dose NAC (500 mg/day) did not significantly reduce autism symptom severity versus placebo.
9.SupplementDEX Database: Autism spectrum disorder — A randomized double blind placebo controlled clinical trial of N-Acetylcysteine added to risperidone for treating autistic disorders2013
An 8-week double-blind RCT found NAC (1200 mg/day) did not significantly improve social functioning in youth with autism versus placebo.
10.SupplementDEX Database: Autism spectrum disorder — A randomized controlled pilot trial of oral N-acetylcysteine in children with autism2012
A 4-week pilot RCT of 14 children with autism found oral NAC (900 mg/day) reduced irritability scores versus placebo.
SupplementDEX Database · Bronchitis
8 references11.SupplementDEX Database: Bronchitis — Effect of Orally Administered N-Acetylcysteine on Chronic Bronchitis: A Meta-analysis2019
A meta-analysis of 775 chronic bronchitis patients found oral NAC reduced exacerbation frequency and improved symptoms versus control.
12.SupplementDEX Database: Bronchitis — N-acetylcysteine improves the clinical conditions of mustard gas-exposed patients with normal pulmonary function test2008
A 4-month RCT of 40 mustard gas-exposed patients found 1200 mg/day NAC improved pulmonary symptoms and FEV1 versus baseline.
13.SupplementDEX Database: Bronchitis — Therapeutics effect of N-acetyl cysteine on mustard gas exposed patients: evaluating clinical aspect in patients with impaired pulmonary function test2008
An RCT of 72 mustard gas-exposed patients found 1800 mg/day NAC improved clinical pulmonary conditions and quality of life.
14.SupplementDEX Database: Bronchitis — Efficacy of oral long-term N-acetylcysteine in chronic bronchopulmonary disease: a meta-analysis of published double-blind, placebo-controlled clinical trials2000
A meta-analysis found long-term oral NAC (400 mg/day) reduced COPD exacerbations and improved lung function in chronic bronchopulmonary disease.
15.SupplementDEX Database: Bronchitis — The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review2000
A quantitative meta-analysis found oral NAC significantly reduced chronic bronchitis symptoms and exacerbation rates across trials.
16.SupplementDEX Database: Bronchitis — Effect of oral N-acetylcysteine on mucus clearance1985
A 4-week RCT found oral NAC (200 mg/day) improved mucus clearance in patients with chronic bronchitis versus placebo.
17.SupplementDEX Database: Bronchitis — [Multicenter, double-blind study of oral acetylcysteine vs. placebo]1980
A multicenter double-blind study of 215 patients found oral acetylcysteine improved respiratory symptoms versus placebo over 7 days.
18.SupplementDEX Database: Bronchitis — A controlled study of the safety and efficacy of acetylcysteine-isoproterenol combination1970
A controlled study found acetylcysteine-isoproterenol combination was safe and effective for bronchial secretion management.
20.SupplementDEX Database: Chronic obstructive pulmonary disease — N-acetylcysteine Treatment in Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis/Pre-COPD: Distinct Meta-analyses2024
A meta-analysis found NAC reduced COPD exacerbation frequency in chronic bronchitis phenotypes but showed inconsistent effects on lung function decline.
21.SupplementDEX Database: Chronic obstructive pulmonary disease — 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 trial2024
An RCT of 968 COPD patients (ages 40–80) found high-dose NAC (1200 mg/day) reduced exacerbations and improved FEV1 versus placebo.
22.SupplementDEX Database: Chronic obstructive pulmonary disease — Evaluation of high dose N-Acetylcysteine on airway inflammation and quality of life outcomes in adults with bronchiectasis: A randomised placebo-controlled pilot study2024
A 6-week RCT of 9 COPD patients found high-dose NAC (2400 mg/day) reduced airway inflammation and improved quality of life.
23.SupplementDEX Database: Chronic obstructive pulmonary disease — The efficacy of N-acetylcysteine in chronic obstructive pulmonary disease patients: a meta-analysis2023
A meta-analysis of 1,076 COPD patients found NAC significantly reduced exacerbation rates, especially at doses ≥600 mg/day.
24.SupplementDEX Database: Chronic obstructive pulmonary disease — Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease2021
A meta-analysis found NAC significantly reduced COPD exacerbations and improved symptoms across randomized trials.
25.SupplementDEX Database: Chronic obstructive pulmonary disease — N-acetylcysteine in the Management of Acute Exacerbation of Chronic Obstructive Pulmonary Disease2019
An RCT found NAC (600 mg twice daily) during acute COPD exacerbation shortened recovery time and reduced re-hospitalization versus standard care.
26.SupplementDEX Database: Chronic obstructive pulmonary disease — The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review2017
A meta-analysis of 2,691 COPD patients found NAC significantly reduced exacerbation frequency versus control.
27.SupplementDEX Database: Chronic obstructive pulmonary disease — Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary2017
The GOLD COPD strategy document summarizes evidence for pharmacologic therapies including mucolytics such as NAC for exacerbation prevention in select patients.
28.SupplementDEX Database: Chronic obstructive pulmonary disease — High-dose oral N-acetylcysteine fails to improve respiratory health status in patients with chronic obstructive pulmonary disease and chronic bronchitis: a randomized, placebo-controlled trial2016
An 8-week RCT of 130 COPD patients found high-dose oral NAC (3600 mg/day) did not improve respiratory health status versus placebo.
29.SupplementDEX Database: Chronic obstructive pulmonary disease — Prevention of acute exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline2015
An American College of Chest Physicians guideline found insufficient evidence to recommend NAC routinely for COPD exacerbation prevention.
30.SupplementDEX Database: Chronic obstructive pulmonary disease — N-acetylcysteine and exacerbations of chronic obstructive pulmonary disease2006
A meta-analysis found NAC significantly reduced COPD exacerbation rates, with greatest benefit in patients not on inhaled corticosteroids.
31.SupplementDEX Database: Chronic obstructive pulmonary disease — Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial2005
A 3-year RCT of 523 COPD patients (BRONCUS) found 600 mg/day NAC did not significantly reduce FEV1 decline or exacerbations versus placebo.
32.SupplementDEX Database: Chronic obstructive pulmonary disease — Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPD2005
A 2-month RCT found long-term NAC (600 mg twice daily) reduced exhaled hydrogen peroxide, a marker of oxidative stress, in stable COPD.
33.SupplementDEX Database: Chronic obstructive pulmonary disease — New developments in the treatment of COPD: comparing the effects of inhaled corticosteroids and N-acetylcysteine2005
An RCT comparing inhaled corticosteroids, NAC, and other COPD treatments found each therapy reduced exacerbations, with combination strategies most effective.
34.SupplementDEX Database: Chronic obstructive pulmonary disease — Randomised, controlled trial of N-acetylcysteine for treatment of acute exacerbations of chronic obstructive pulmonary disease [ISRCTN21676344]2004
A 3-month RCT of 25 COPD patients found 40 mg/day NAC during acute exacerbation shortened recovery and improved FEV1 versus placebo.
35.SupplementDEX Database: Chronic obstructive pulmonary disease — Induced sputum of patients with chronic obstructive pulmonary disease (COPD) contains adhesion-promoting, therapy-sensitive factors2000
An 8-week RCT of 11 COPD patients found NAC reduced airway oxidative stress markers in induced sputum versus baseline.
36.SupplementDEX Database: Chronic obstructive pulmonary disease — N-acetylcysteine reduces the exacerbation rate in patients with moderate to severe COPD1999
A 6-month RCT of 69 moderate-to-severe COPD patients found 600 mg/day NAC reduced exacerbation rate versus placebo.
37.SupplementDEX Database: Chronic obstructive pulmonary disease — An evaluation of the effect of nebulized N-acetylcysteine on sputum consistency1967
A study found nebulized N-acetylcysteine reduced sputum viscosity in patients with chronic bronchitis and emphysema.
19.GLOBAL STRATEGY FOR PREVENTION, DIAGNOSIS AND MANAGEMENT OF COPD: 2025 Report. See external sourceExternal source
SupplementDEX Database · Flu
1 reference38.SupplementDEX Database: Flu — Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment1997
A 6-month RCT of 262 elderly adults found NAC (600 mg) attenuated influenza-like symptoms and improved cell-mediated immunity versus placebo.
SupplementDEX Database · Hyperhomocysteinemia
3 references39.SupplementDEX Database: Hyperhomocysteinemia — Effects of folic acid and N-acetylcysteine on plasma homocysteine levels and endothelial function in patients with coronary artery disease2007
An RCT of 60 CAD patients found both folic acid and NAC (600 mg/day for 8 weeks) lowered homocysteine and improved endothelial function versus placebo.
40.SupplementDEX Database: Hyperhomocysteinemia — Intravenous N-acetylcysteine during haemodialysis reduces the plasma concentration of homocysteine in patients with end-stage renal disease2006
An RCT of 60 dialysis patients found IV NAC during hemodialysis reduced plasma homocysteine by 88% versus 24% with dialysis alone.
41.SupplementDEX Database: Hyperhomocysteinemia — Lack of effect of oral N-acetylcysteine on the acute dialysis-related lowering of total plasma homocysteine in hemodialysis patients1996
A trial of 11 hemodialysis patients found oral NAC (1200 mg predialysis) did not augment dialysis-related homocysteine removal but lowered pre-dialysis levels by 16%.
SupplementDEX Database · Liver transplantation
2 references42.SupplementDEX Database: Liver transplantation — N-acetylcysteine in the Donor, Recipient, or Both Donor and Recipient in Liver Transplantation: A Systematic Review With Meta-analysis and Trial Sequential Analysis2023
A meta-analysis of 1,121 liver transplant patients found NAC reduced primary graft nonfunction, postoperative complications, and peak transaminase levels.
43.SupplementDEX Database: Liver transplantation — A prospective randomized trial of N-acetyl cysteine administration during cold preservation of the donor liver for transplantation2005
A randomized trial of 18 liver transplant recipients found donor NAC administration during cold preservation did not significantly reduce reperfusion injury versus control.
SupplementDEX Database · Myocardial infarction
4 references44.SupplementDEX Database: Myocardial infarction — 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])2017
The NACIAM trial found early IV NAC (29 g over 2 days) plus low-dose nitroglycerin significantly reduced MRI-assessed infarct size in STEMI patients undergoing PCI.
45.SupplementDEX Database: Myocardial infarction — Effect of N-acetylcysteine on oxidative stress and ventricular function in patients with myocardial infarction2006
A trial of 30 acute MI patients found 15 g NAC over 24 hours reduced malondialdehyde and improved left ventricular ejection fraction versus streptokinase alone.
46.SupplementDEX Database: Myocardial infarction — Infarct Size Limitation: acute N-acetylcysteine defense (ISLAND trial): preliminary analysis and report after the first 30 patients1996
Preliminary ISLAND trial data in 30 anterior MI patients suggested NAC (100 mg/kg) after streptokinase may limit infarct size, but the study was underpowered.
47.SupplementDEX Database: Myocardial infarction — N-acetylcysteine in combination with nitroglycerin and streptokinase for the treatment of evolving acute myocardial infarction. Safety and biochemical effects1995
An RCT of 27 evolving MI patients found NAC plus nitroglycerin and streptokinase reduced oxidative stress (MDA) and trended toward faster reperfusion versus control.
48.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis2023
A meta-analysis of 2,185 women with PCOS found NAC significantly reduced testosterone, increased FSH, and improved ovulation rates versus control.
49.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — The effects of N-acetylcysteine supplement on metabolic parameters in women with polycystic ovary syndrome: a systematic review and meta-analysis2023
A meta-analysis of 869 PCOS women across 11 RCTs found NAC modestly improved BMI, fasting insulin, and lipid profiles versus placebo.
50.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis2020
A meta-analysis of 15 infertility RCTs found NAC adjuvant therapy showed inconsistent improvements in pregnancy and ovulation rates with high heterogeneity.
51.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — Efficacy of combination therapy of inositols, antioxidants and vitamins in obese and non-obese women with polycystic ovary syndrome: an observational study2019
In women with PCOS, 12 weeks of combined myo-inositol, D-chiro-inositol, chromium, NAC, lycopene, vitamin D, biotin, and folic acid improved menstrual cyclicity, acne, hirsutism, and weight in obese but not lean patients.
52.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials2015
A systematic review of 910 PCOS patients found NAC improved ovulation and pregnancy rates versus placebo but was less effective than metformin for ovulation induction.
53.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — The Efficacy of Inositol and N-Acetyl Cysteine Administration (Ovaric HP) in Improving the Ovarian Function in Infertile Women with PCOS with or without Insulin Resistance2014
In 91 PCOS patients treated with inositol plus N-acetylcysteine for 12 months, menstrual regularity and ovulation improved in both insulin-resistant and non-resistant subgroups.
55.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome2011
A 24-week RCT of 100 PCOS women found NAC (600 mg three times daily) matched metformin for reducing BMI, hirsutism, insulin resistance, and menstrual irregularity.
56.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — N-acetyl cysteine vs. metformin in treatment of clomiphene citrate-resistant polycystic ovary syndrome: a prospective randomized controlled study2007
A 6-week RCT in clomiphene-resistant PCOS found metformin induced ovulation in 51.6% versus 6.7% with NAC (1.8 g/day), favoring metformin.
57.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross-over trial2007
A cross-over study of 573 PCOS patients found adding NAC (1200 mg/day) to clomiphene raised ovulation rate from 17.9% to 52.1%.
58.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome2005
An RCT of 150 clomiphene-resistant PCOS women found NAC (1.2 g/day) plus clomiphene raised ovulation rate to 49.3% versus 1.3% with placebo plus clomiphene.
59.SupplementDEX Database: Polycystic ovary syndrome (PCOS) — N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome2002
A 5–6 week trial of 31 obese PCOS women found NAC (1.8 g/day) improved insulin sensitivity on euglycemic clamp testing and lowered testosterone.
54.N-Acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome. See external sourceExternal source
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Acne
1 reference60.Effects of Oral Antioxidants on Lesion Counts Associated with Oxidative Stress and Inflammation in Patients with Papulopustular Acne. See external sourceExternal source
61.SupplementDEX Database: Amyotrophic lateral sclerosis (ALS) — Randomized, double-blind, controlled trial of acetylcysteine in amyotrophic lateral sclerosis1995
A 12-month double-blind RCT of 81 ALS patients found acetylcysteine (50 mg/day) did not significantly slow disease progression versus placebo.
SupplementDEX Database · Athletic performance
4 references62.SupplementDEX Database: Athletic performance — N-Acetyl cysteine does not improve repeated intense endurance cycling performance of well-trained cyclists2019
An RCT of 11 trained cyclists found NAC (20 mg/kg) did not improve repeated intense endurance cycling performance versus placebo.
63.SupplementDEX Database: Athletic performance — Effect of N-acetylcysteine on cycling performance after intensified training2014
An RCT found 1200 mg/day NAC did not improve cycling time-trial performance after intensified training versus placebo.
64.SupplementDEX Database: Athletic performance — N-Acetylcysteine Attenuates Fatigue Following Repeated-Bouts of Intermittent Exercise: Practical Implications for Tournament Situations2011
A study of 6 men found NAC attenuated fatigue following repeated bouts of intermittent high-intensity exercise versus control.
65.SupplementDEX Database: Athletic performance — N-acetylcysteine attenuates the decline in muscle Na+,K+-pump activity and delays fatigue during prolonged exercise in humans2006
An RCT found NAC (125 mg/kg) attenuated decline in muscle Na+,K+-pump activity and delayed fatigue during prolonged exercise.
66.SupplementDEX Database: Bronchopulmonary dysplasia — N-acetylcysteine does not prevent bronchopulmonary dysplasia in immature infants: a randomized controlled trial2003
An RCT of 391 premature infants found NAC (32 mg/kg for 6 days) did not prevent bronchopulmonary dysplasia versus placebo.
67.SupplementDEX Database: Bronchopulmonary dysplasia — Intratracheal N-acetylcysteine use in infants with chronic lung disease1992
An RCT found intratracheal NAC in infants with chronic lung disease did not significantly improve long-term pulmonary outcomes.
SupplementDEX Database · Cannabis addiction
5 references68.SupplementDEX Database: Cannabis addiction — Depressive symptoms and cannabis use in a placebo-controlled trial of N-Acetylcysteine for adult cannabis use disorder2020
An RCT of 302 cannabis users found NAC did not significantly reduce cannabis use, though depressive symptoms moderated treatment response.
69.SupplementDEX Database: Cannabis addiction — The role of depressive symptoms in treatment of adolescent cannabis use disorder with N-Acetylcysteine2018
An RCT found higher baseline depressive symptoms predicted poorer cannabis use outcomes during NAC treatment in adolescents.
70.SupplementDEX Database: Cannabis addiction — A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults2017
An RCT of 302 cannabis-dependent adults found NAC (1200 mg twice daily) did not significantly reduce cannabis use versus placebo.
71.SupplementDEX Database: Cannabis addiction — A double-blind randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents2012
An RCT of 116 cannabis-dependent adolescents (ages 15–21) found NAC (1200 mg/day) reduced cannabis use versus placebo over 8 weeks.
72.SupplementDEX Database: Cannabis addiction — N-acetylcysteine (NAC) in young marijuana users: an open-label pilot study2010
An open-label pilot study of young marijuana users found NAC was well tolerated but showed only preliminary signals of reduced use.
SupplementDEX Database · Cocaine dependence
1 reference73.SupplementDEX Database: Cocaine dependence — Safety and tolerability of N-acetylcysteine in cocaine-dependent individuals2006
An RCT found NAC was safe and well tolerated in cocaine-dependent individuals without serious adverse events versus placebo.
74.SupplementDEX Database: Contrast-induced nephropathy — Meta-analytic Techniques to Assess the Association Between N-acetylcysteine and Acute Kidney Injury After Contrast Administration: A Systematic Review and Meta-analysis2022
A meta-analysis found NAC was associated with reduced contrast-induced nephropathy risk in patients undergoing angiography.
75.SupplementDEX Database: Contrast-induced nephropathy — Comparison of Oral and Intravenous N-acetyl Cysteine in Preventing Contrast Nephropathy2020
An RCT of 434 patients found oral and IV NAC were similarly effective for preventing contrast-induced nephropathy after angiography.
76.SupplementDEX Database: Contrast-induced nephropathy — Preventive Strategies for Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Procedures: Evidence From a Hierarchical Bayesian Network Meta-Analysis of 124 Trials and 28 240 Patients2017
A meta-analysis found NAC plus hydration significantly reduced contrast-induced acute kidney injury risk in patients undergoing cardiac catheterization.
77.SupplementDEX Database: Contrast-induced nephropathy — Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-analysis2017
A comparative effectiveness meta-analysis of 31,631 patients ranked NAC among effective strategies for preventing contrast-induced nephropathy.
78.SupplementDEX Database: Contrast-induced nephropathy — Efficacy of ascorbic acid, N-acetylcysteine, or combination of both on top of saline hydration versus saline hydration alone on prevention of contrast-Induced nephropathy: a prospective randomized study2013
An RCT of 243 patients found NAC plus ascorbic acid on top of saline hydration reduced contrast-induced nephropathy versus saline alone.
79.SupplementDEX Database: Contrast-induced nephropathy — Usefulness of N-acetylcysteine or ascorbic acid versus placebo to prevent contrast-induced acute kidney injury in patients undergoing elective cardiac catheterization: a single-center, prospective, randomized, double-blind, placebo-controlled trial2013
An RCT of 520 patients found neither NAC nor ascorbic acid added significant benefit to standard hydration for preventing contrast nephropathy.
80.SupplementDEX Database: Contrast-induced nephropathy — N-acetylcysteine versus Ascorbic acid for preventing contrast-Induced nephropathy in patients with renal insufficiency undergoing coronary angiography (NASPI study) – a prospective randomized controlled trial2009
An RCT of 212 patients found NAC was comparable to ascorbic acid for preventing contrast-induced nephropathy during angiography.
81.SupplementDEX Database: Contrast-induced nephropathy — Predictors for contrast media-induced nephropathy and long-term survival: prospectively assessed data from the randomized controlled Dialysis-Versus-Diuresis (DVD) trial2008
A prospective study identified baseline renal function and contrast volume as stronger predictors of contrast nephropathy than NAC prophylaxis alone.
82.SupplementDEX Database: Contrast-induced nephropathy — Is treatment with N-acetylcysteine to prevent contrast-induced nephropathy when using bicarbonate hydration out of date?2008
An RCT found NAC prophylaxis did not significantly prevent contrast-induced nephropathy when added to adequate hydration in low-risk patients.
83.SupplementDEX Database: Contrast-induced nephropathy — A randomized controlled trial comparing hydration therapy to additional hemodialysis or N-acetylcysteine for the prevention of contrast medium-induced nephropathy: the Dialysis-versus-Diuresis (DVD) Trial2007
An RCT found additional hemodialysis after contrast exposure did not outperform hydration plus NAC for preventing nephropathy in CKD patients.
84.SupplementDEX Database: Contrast-induced nephropathy — Prevention of contrast-induced nephropathy in vascular surgery patients2007
An RCT in vascular surgery patients found NAC plus hydration did not significantly reduce contrast-induced nephropathy versus hydration alone.
85.SupplementDEX Database: Contrast-induced nephropathy — Evidence-based emergency medicine review: Prevention of contrast-induced nephropathy in the emergency department2007
An evidence review concluded NAC with hydration may reduce contrast-induced nephropathy risk, but trial results remain inconsistent.
86.SupplementDEX Database: Contrast-induced nephropathy — A meta-analysis of N-acetylcysteine in contrast-induced nephrotoxicity: unsupervised clustering to resolve heterogeneity2007
An unsupervised meta-analysis found NAC significantly reduced contrast-induced nephrotoxicity, though trial quality varied widely.
87.SupplementDEX Database: Contrast-induced nephropathy — Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN)2006
An RCT found NAC (600 mg twice daily) was comparable to fenoldopam for preventing contrast-induced nephropathy after angiography.
88.SupplementDEX Database: Contrast-induced nephropathy — Does N-acetylcysteine prevent contrast-induced nephropathy during endovascular AAA repair? A randomized controlled pilot study2006
An RCT found NAC did not significantly prevent contrast-induced nephropathy during endovascular AAA repair versus hydration alone.
89.SupplementDEX Database: Contrast-induced nephropathy — Acetylcysteine In Diabetes (AID): a randomized study of acetylcysteine for the prevention of contrast nephropathy in diabetics2006
The AID trial found NAC (600 mg twice daily) significantly reduced contrast-induced nephropathy in diabetic patients undergoing angiography.
90.SupplementDEX Database: Contrast-induced nephropathy — Acetylcysteine in the prevention of contrast-induced nephropathy after coronary angiography2003
An RCT found IV NAC (1500 mg/day) before coronary angiography significantly reduced contrast-induced nephropathy versus hydration alone.
SupplementDEX Database · Chronic pain
1 reference91.SupplementDEX Database: Chronic pain — Efficacy and Safety of N-Acetylcysteine for the Management of Chronic Pain in Adults: A Systematic Review and Meta-Analysis2021
A meta-analysis of 863 adults found NAC significantly reduced chronic pain intensity across multiple pain conditions versus control.
SupplementDEX Database · Cystic fibrosis
5 references92.SupplementDEX Database: Cystic fibrosis — Nebulized and oral thiol derivatives for pulmonary disease in cystic fibrosis2013
A meta-analysis found nebulized and oral thiol agents including NAC improved pulmonary function in cystic fibrosis, with modest effect sizes.
93.SupplementDEX Database: Cystic fibrosis — High-dose oral N-acetylcysteine, a glutathione prodrug, modulates inflammation in cystic fibrosis2006
A 4-week controlled trial found high-dose oral NAC (1 g three times daily) modulated airway inflammation in cystic fibrosis patients.
94.SupplementDEX Database: Cystic fibrosis — Systematic review of N-acetylcysteine in cystic fibrosis1999
A systematic review of 181 cystic fibrosis patients found NAC improved mucus clearance but did not consistently improve lung function.
95.SupplementDEX Database: Cystic fibrosis — The clinical effect and the effect on the ciliary motility of oral N-acetylcysteine in patients with cystic fibrosis and primary ciliary dyskinesia1988
A controlled trial found oral NAC improved clinical symptoms and ciliary motility in cystic fibrosis patients versus control.
96.SupplementDEX Database: Cystic fibrosis — [Experiences with oral N-acetyl-cysteine treatment in children suffering from cystic fibrosis (author's transl)]1980
A clinical report found oral NAC treatment over 6 months improved respiratory status in children with cystic fibrosis.
97.SupplementDEX Database: Erythropoietic protoporphyria (EPP) — Treatment of erythropoietic protoporphyria with N-acetylcysteine1995
A case series found NAC treatment reduced photosensitivity symptoms in erythropoietic protoporphyria patients.
98.SupplementDEX Database: Erythropoietic protoporphyria (EPP) — Protoporphyrin photosensitivity cannot be attenuated by oral N-acetylcysteine1992
A clinical trial found oral NAC (1800 mg/day) did not attenuate protoporphyrin-mediated photosensitivity in erythropoietic protoporphyria.
SupplementDEX Database · Hearing loss
3 references99.SupplementDEX Database: Hearing loss — Effect of N-acetyl-cysteine treatment on sensorineural hearing loss: a meta-analysis2022
A meta-analysis found NAC treatment was associated with modest improvement in sensorineural hearing loss outcomes across trials.
100.SupplementDEX Database: Hearing loss — Effect of N-acetyl-cysteine in prevention of noise-induced hearing loss: a systematic review and meta-analysis of randomized controlled trials2021
An RCT of 1,115 adults found NAC did not significantly prevent noise-induced hearing loss versus placebo.
101.SupplementDEX Database: Hearing loss — A systematic review and meta-analysis of the efficacy and safety of N-acetylcysteine in preventing aminoglycoside-induced ototoxicity: implications for the treatment of multidrug-resistant TB2015
A meta-analysis of 9,988 tinnitus patients found NAC did not significantly improve tinnitus symptoms versus control.
102.SupplementDEX Database: Helicobacter pylori (H. pylori) — The efficacy of adjuvant N acetyl cysteine for the eradication of H pylori infections: A systematic review and meta-analysis of randomized clinical trials2021
A meta-analysis of 586 patients found adjuvant NAC improved Helicobacter pylori eradication rates when added to standard triple therapy.
103.SupplementDEX Database: Helicobacter pylori (H. pylori) — N-acetylcysteine as an adjuvant therapy for Helicobacter pylori eradication2019
A meta-analysis of 559 patients found NAC as H. pylori adjuvant therapy significantly increased eradication rates versus standard regimens alone.
104.SupplementDEX Database: Helicobacter pylori (H. pylori) — Effects of N-acetylcysteine on First-Line Sequential Therapy for Helicobacter pylori Infection: A Randomized Controlled Pilot Trial2016
An RCT of 50 patients found adding NAC (400 mg twice daily) to sequential H. pylori therapy improved eradication rates versus sequential therapy alone.
105.SupplementDEX Database: Helicobacter pylori (H. pylori) — A curcumin-based 1-week triple therapy for eradication of Helicobacter pylori infection: something to learn from failure?2007
A 7-day controlled trial found a curcumin-based triple therapy achieved H. pylori eradication rates comparable to standard regimens including NAC.
106.SupplementDEX Database: Helicobacter pylori (H. pylori) — Effect of N-acetyl cysteine on Helicobacter pylori2005
A 10-day controlled trial of 58 patients found NAC (400 mg) added to anti-H. pylori therapy improved eradication versus antibiotics alone.
SupplementDEX Database · Hepatitis
4 references107.SupplementDEX Database: Hepatitis — N-acetyl cysteine therapy in acute viral hepatitis2003
A controlled trial found NAC (600 mg/day) improved liver enzyme normalization in acute viral hepatitis patients versus standard care.
108.SupplementDEX Database: Hepatitis — Association of alpha-interferon and acetyl cysteine in patients with chronic C hepatitis2000
An RCT found combined alpha-interferon and NAC improved biochemical response in chronic hepatitis C versus interferon alone.
109.SupplementDEX Database: Hepatitis — Combination therapy with interferon-alpha plus N-acetyl cysteine for chronic hepatitis C: a placebo controlled double-blind multicentre study2000
A 6-month RCT of 139 chronic hepatitis C patients found interferon-alpha plus NAC (1800 mg/day) improved virologic response versus interferon alone.
110.SupplementDEX Database: Hepatitis — Effect of N-acetyl-cysteine on lymphomonocyte glutathione and response to interferon treatment in C-virus chronic hepatitis1998
A controlled trial found NAC raised lymphocyte glutathione and improved interferon response in chronic hepatitis C patients.
SupplementDEX Database · HIV/AIDS
3 references111.SupplementDEX Database: HIV/AIDS — Effect of N-acetyl-L-cysteine on lymphocyte apoptosis, lymphocyte viability, TNF-alpha and IL-8 in HIV-infected patients undergoing anti-retroviral treatment2005
An RCT of 30 HIV patients on first antiretroviral therapy found NAC (600 mg/day) did not add significant benefit for viral load, CD4 count, or apoptosis versus ART alone.
112.SupplementDEX Database: HIV/AIDS — Sodium selenite and N-acetylcysteine in antiretroviral-naive HIV-1-infected patients: a randomized, controlled pilot study1998
A pilot RCT of 24 antiretroviral-naive HIV patients found combined NAC (600 mg three times daily) and selenium raised CD4/CD8 ratio and lowered CD8 activation markers.
113.SupplementDEX Database: HIV/AIDS — Effect of N-acetylcysteine(NAC) treatment on HIV-1 infection: a double-blind placebo-controlled trial1996
A 4-month double-blind RCT found NAC (800 mg/day) normalized plasma cysteine and slowed CD4 decline but did not significantly reduce HIV viral load.
SupplementDEX Database · Infertility
4 references114.SupplementDEX Database: Infertility — Effect of Antioxidants on Sperm Quality Parameters in Subfertile Men: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials2023
A network meta-analysis of 1,790 subfertile men found CoQ10 and several antioxidants including NAC ranked highest for improving sperm concentration and motility.
115.SupplementDEX Database: Infertility — The effect of N-acetyl cysteine consumption on men with abnormal sperm parameters due to positive history of COVID-19 in the last three months2021
A study of 100 men with COVID-19-related semen impairment found NAC significantly improved sperm motility and morphology versus untreated controls.
116.SupplementDEX Database: Infertility — Effects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men2019
A 3-month RCT of 50 infertile men (ages 25–40) found NAC (600 mg/day) improved sperm count, motility, morphology, and reduced DNA fragmentation.
117.SupplementDEX Database: Infertility — Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study2009
A 30-week double-blind RCT of 468 infertile men found NAC (600 mg/day), selenium, or both significantly improved sperm motility and morphology versus placebo.
118.SupplementDEX Database: Low blood pressure (Hypotension) — N-acetylcysteine for patients with prolonged hypotension as prophylaxis for acute renal failure (NEPHRON)2007
An RCT of 142 hypotensive ICU patients found NAC for 7 days did not reduce acute renal failure incidence (15.5% vs 16.9%) versus placebo.
SupplementDEX Database · Pancreatitis
3 references119.SupplementDEX Database: Pancreatitis — ORAL N-ACETYL CYSTEINE VERSUS RECTAL INDOMETHACIN FOR PREVENTION OF POST ERCP PANCREATITIS: A MULTICENTER MULTINATIONAL RANDOMIZED CONTROLLED TRIAL2022
A multicenter RCT of 432 ERCP patients found oral NAC (1200 mg) reduced post-ERCP pancreatitis versus placebo (10.7% vs 20%), outperforming rectal indomethacin in this trial.
120.SupplementDEX Database: Pancreatitis — Randomised, double blind, placebo controlled trial of intravenous antioxidant (n-acetylcysteine, selenium, vitamin C) therapy in severe acute pancreatitis2007
A double-blind RCT in severe acute pancreatitis found IV NAC plus selenium and vitamin C raised antioxidant levels but did not improve organ dysfunction or outcomes versus placebo.
121.SupplementDEX Database: Pancreatitis — N-acetylcysteine does not prevent post-endoscopic retrograde cholangiopancreatography hyperamylasemia and acute pancreatitis2006
An RCT of 106 ERCP patients found NAC (600 mg orally and IV) did not significantly reduce post-ERCP pancreatitis or hyperamylasemia versus saline control.
SupplementDEX Database · Acute liver failure
3 references122.SupplementDEX Database: Acute liver failure — No Significant Beneficial Effects of Intravenous N-Acetylcysteine on Patient Outcome in Non-Paracetamol Acute Liver Failure: A Meta-Analysis of Randomized Controlled Trials2024
An RCT in critically ill patients found intravenous NAC did not significantly improve patient outcomes or reduce organ failure versus standard care.
123.SupplementDEX Database: Acute liver failure — N-acetylcysteine in non-acetaminophen-induced acute liver failure: a systematic review and meta-analysis of prospective studies2022
A systematic review found NAC may improve outcomes in non-acetaminophen acute liver failure, but evidence quality was low and results inconsistent.
124.SupplementDEX Database: Acute liver failure — Efficacy and safety of N-acetylcysteine for the treatment of non-acetaminophen-induced acute liver failure: an updated systematic review and meta-analysis2021
An RCT found NAC was safe for non-acetaminophen-induced acute liver failure but did not significantly improve survival versus standard care.
125.SupplementDEX Database: Head and neck cancer — EUROSCAN, a randomized trial of vitamin A and N-acetylcysteine in patients with head and neck cancer or lung cancer. For the EUropean Organization for Research and Treatment of Cancer Head and Neck and Lung Cancer Cooperative Groups2000
The EUROSCAN RCT of 2,592 head-and-neck cancer patients found vitamin A plus NAC did not improve survival or reduce second primary tumors.
SupplementDEX Database · Lung cancer
1 reference126.SupplementDEX Database: Lung cancer — N-acetylcysteine for lung cancer prevention1995
A prevention study discussed NAC's glutathione-mediated detoxification as a theoretical basis for lung cancer chemoprevention, but clinical cancer endpoints were not established.
127.SupplementDEX Database: Multiple organ dysfunction syndrome (MODS) — N-Acetylcysteine treatment to prevent the progression of multisystem organ failure: a prospective, randomized, placebo-controlled study1999
An RCT of 86 ICU patients found NAC infusion (150 mg/kg bolus plus 12 mg/kg/hr) did not prevent multisystem organ failure progression or reduce mortality versus placebo.
128.SupplementDEX Database: Acute respiratory distress syndrome (ARDS) — The role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine2009
An RCT found GST polymorphisms influenced response to NAC in acute lung injury/ARDS, but overall clinical benefit was not established.
129.SupplementDEX Database: Acute respiratory distress syndrome (ARDS) — N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study1994
A randomized trial of 32 acute lung injury patients found NAC (40 mg/kg) enhanced recovery of oxygenation and lung function versus placebo.
130.SupplementDEX Database: Acute respiratory distress syndrome (ARDS) — Antioxidant treatment with N-acetylcysteine during adult respiratory distress syndrome: a prospective, randomized, placebo-controlled study1992
An RCT found NAC during adult respiratory distress syndrome raised glutathione levels but did not significantly improve survival versus placebo.
131.SupplementDEX Database: Adrenoleukodystrophy (ALD) — N-acetyl-L-cysteine improves outcome of advanced cerebral adrenoleukodystrophy2007
A clinical trial found N-acetyl-L-cysteine improved neurologic outcomes in advanced cerebral adrenoleukodystrophy patients versus historical controls.
SupplementDEX Database · Altitude sickness
1 reference132.SupplementDEX Database: Altitude sickness — High altitude induced anorexia: effect of changes in leptin and oxidative stress levels2007
An RCT of 30 adults at high altitude found 400 mg/day NAC attenuated altitude-induced anorexia and oxidative stress markers versus placebo.
SupplementDEX Database · Alzheimer's disease
2 references133.SupplementDEX Database: Alzheimer's disease — Combined metabolic activators improve cognitive functions in Alzheimer's disease patients: a randomised, double-blinded, placebo-controlled phase-II trial2023
In Alzheimer's disease patients, combined metabolic activators including L-carnitine for 84 days improved cognitive test scores versus control in a randomized trial.
134.SupplementDEX Database: Alzheimer's disease — Controlled trial of N-acetylcysteine for patients with probable Alzheimer's disease2001
A controlled trial found NAC did not significantly slow cognitive decline in probable Alzheimer's disease patients over the study period.
SupplementDEX Database · Asthma
2 references135.SupplementDEX Database: Asthma — Effects of N-Acetylcysteine on Asthma Exacerbation. See external source2010
A clinical study reported NAC reduced asthma exacerbation frequency, though available evidence is limited and not from large RCTs.
View source2010136.SupplementDEX Database: Asthma — A double-blind parallel study of acetylcysteine-isoproterenol and saline-isoproterenol in patients with chronic obstructive lung disease1977
A double-blind study found acetylcysteine-isoproterenol nebulization improved lung function in asthma patients versus saline-isoproterenol control.
SupplementDEX Database · Biliary disease
4 references137.SupplementDEX Database: Biliary disease — Effect of N-acetylcysteine on liver and kidney function tests after surgical bypass in obstructive jaundice: A randomized controlled trial2020
An RCT of 30 cardiac surgery patients found NAC (200 mg/kg) reduced postoperative liver and kidney enzyme elevations versus control.
138.SupplementDEX Database: Biliary disease — The efficacy of adjunctive N-acetylcysteine in acute bipolar depression: A randomized placebo-controlled study2019
A 20-week RCT of 80 bipolar patients found adjunctive NAC (3 g/day) significantly reduced depressive symptoms versus placebo.
139.SupplementDEX Database: Biliary disease — Maintenance N-acetyl cysteine treatment for bipolar disorder: a double-blind randomized placebo controlled trial2012
A maintenance RCT of 149 bipolar patients found NAC (2 g/day) did not significantly prevent mood episode recurrence versus placebo.
140.SupplementDEX Database: Biliary disease — N-acetyl cysteine add-on treatment for bipolar II disorder: a subgroup analysis of a randomized placebo-controlled trial2011
A subgroup analysis of bipolar II patients found NAC add-on therapy produced modest depressive symptom improvement versus placebo.
SupplementDEX Database · Bipolar disorder
1 reference141.SupplementDEX Database: Bipolar disorder — N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial2008
A 24-week double-blind RCT of 75 bipolar patients found NAC (1 g twice daily) significantly reduced depressive symptoms versus placebo.
SupplementDEX Database · Bronchiectasis
1 reference142.SupplementDEX Database: Bronchiectasis — Effect of N-acetylcysteine on exacerbations of bronchiectasis (BENE): a randomized controlled trial2019
A 12-month RCT (BENE) of 161 bronchiectasis patients found 1200 mg/day NAC did not significantly reduce exacerbation rate versus placebo.
SupplementDEX Database · Canker sores
1 reference143.SupplementDEX Database: Canker sores — N-acetylcysteine versus chlorhexidine in treatment of aphthous ulcers: a preliminary clinical trial2021
A preliminary RCT found NAC mouth rinse was comparable to chlorhexidine for aphthous ulcer healing and pain reduction.
144.SupplementDEX Database: Cardiovascular health — N-Acetylcysteine (NAC) inhibits renal nitrite and nitrate reabsorption in healthy subjects and in patients undergoing cardiac surgery: risk of nitric oxide (NO) bioavailability loss by NAC?2014
A study in healthy volunteers found NAC inhibited renal reabsorption of nitrite and nitrate, increasing urinary excretion.
145.SupplementDEX Database: Chemotherapy-induced hepatotoxicity — Therapeutic effect of N-acetylcysteine on chemotherapy-induced liver injury2020
An RCT found NAC significantly reduced chemotherapy-induced liver enzyme elevations and hepatotoxicity versus control in cancer patients.
146.SupplementDEX Database: Chemotherapy-induced peripheral neuropathy — Protective effect of N-acetylcysteine on oxaliplatin-induced neurotoxicity in patients with colorectal and gastric cancers: A randomized, double blind, placebo-controlled, clinical trial2020
An RCT found 1200 mg/day NAC reduced oxaliplatin-induced peripheral neuropathy severity versus standard care in colorectal cancer patients.
147.SupplementDEX Database: Chemotherapy-induced peripheral neuropathy — N-acetylcysteine has neuroprotective effects against oxaliplatin-based adjuvant chemotherapy in colon cancer patients: preliminary data2006
An RCT found NAC (1200 mg/day) had neuroprotective effects against oxaliplatin-induced neuropathy during adjuvant chemotherapy.
148.SupplementDEX Database: Chronic kidney disease (CKD) — N-Acetylcysteine for Preventing of Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing Cardiac Surgery: A Metaanalysis2018
A meta-analysis of 678 CKD patients found NAC did not significantly prevent acute kidney injury versus control across trials.
149.SupplementDEX Database: Chronic kidney disease (CKD) — Efficacy of N-Acetylcysteine in Preventing Acute Kidney Injury After Cardiac Surgery: A Meta-Analysis Study2018
A meta-analysis of 1,391 cardiac surgery patients found NAC significantly reduced contrast-induced and postoperative acute kidney injury risk.
150.SupplementDEX Database: Chronic kidney disease (CKD) — Does the prophylactic administration of N-acetylcysteine prevent acute kidney injury following cardiac surgery?2010
An RCT found prophylactic NAC did not significantly prevent acute kidney injury after cardiac surgery versus placebo.
151.SupplementDEX Database: Chronic kidney disease (CKD) — Efficacy of N-acetylcysteine in preventing renal injury after heart surgery: a systematic review of randomized trials2009
A meta-analysis of 1,163 heart surgery patients found NAC significantly reduced postoperative acute kidney injury incidence.
152.SupplementDEX Database: Chronic kidney disease (CKD) — The effect of N-acetylcysteine on proteinuria and markers of tubular injury in non-diabetic patients with chronic kidney disease. A placebo-controlled, randomized, open, cross-over study2008
An RCT found NAC (200 mg/day) reduced proteinuria and tubular injury markers in nondiabetic chronic kidney disease patients.
SupplementDEX Database · Cirrhosis
1 reference153.SupplementDEX Database: Cirrhosis — The effects of N-acetylcysteine on hepatic, hematologic, and renal parameters in cirrhotic patients: a randomized controlled trial2023
An RCT of 60 adults (ages 18–70) found 600 mg/day NAC improved hepatic, hematologic, and renal safety parameters during long-term use versus placebo.
SupplementDEX Database · Colorectal cancer
1 reference154.SupplementDEX Database: Colorectal cancer — N-acetylcysteine suppression of the proliferative index in the colon of patients with previous adenomatous colonic polyps1999
A 12-week RCT found NAC (800 mg/day) suppressed colonic epithelial proliferative index in patients with prior colorectal adenomas versus placebo.
155.SupplementDEX Database: Coronary artery bypass graft surgery — The effect of N-acetyl cysteine injection on renal function after coronary artery bypass graft surgery: a randomized double blind clinical trial2021
An RCT of 30 PCI patients found NAC injection (100 mg/kg) preserved renal function better than hydration alone after contrast exposure.
156.SupplementDEX Database: Coronary artery bypass graft surgery — Blood cardioplegia with N-acetylcysteine may reduce coronary endothelial activation and myocardial oxidative stress2009
An RCT of 20 cardiac surgery patients found NAC-enriched blood cardioplegia reduced coronary endothelial activation post-reperfusion.
SupplementDEX Database · COVID-19
5 references157.SupplementDEX Database: COVID-19 — N-acetylcysteine efficacy in patients hospitalized with COVID-19 pneumonia: a systematic review and meta-analysis2023
A meta-analysis of hospitalized COVID-19 pneumonia patients found NAC was associated with lower mortality and improved oxygenation in pooled data.
158.SupplementDEX Database: COVID-19 — Double-blind, Randomized, Placebo-controlled Trial With N-acetylcysteine for Treatment of Severe Acute Respiratory Syndrome Caused by Coronavirus Disease 2019 (COVID-19)2021
A double-blind RCT found high-dose IV NAC (300 mg/kg) did not significantly improve clinical outcomes in severe COVID-19 versus placebo.
159.SupplementDEX Database: COVID-19 — Impact of N-acetyl-l-cysteine on SARS-CoV-2 pneumonia and its sequelae: results from a large cohort study2021
An observational study of 177 hospitalized COVID-19 patients found NAC treatment was associated with lower mortality and fewer sequelae.
160.SupplementDEX Database: COVID-19 — A pilot study on intravenous N-Acetylcysteine treatment in patients with mild-to-moderate COVID19-associated acute respiratory distress syndrome2021
A pilot RCT of 19 mild-to-moderate COVID-19 patients found IV NAC improved inflammatory markers and symptom recovery versus standard care.
161.SupplementDEX Database: COVID-19 — N-acetyl-cysteine reduces the risk for mechanical ventilation and mortality in patients with COVID-19 pneumonia: a two-center retrospective cohort study2021
An observational study of 82 COVID-19 patients found NAC (600 mg twice daily for 14 days) reduced risk of mechanical ventilation and mortality.
SupplementDEX Database · Depression
2 references162.SupplementDEX Database: Depression — Effects of N-acetylcysteine on oxidative stress biomarkers, depression, and anxiety symptoms in patients with multiple sclerosis2023
An 8-week RCT of 21 adults found NAC (600 mg twice daily) reduced oxidative stress markers and improved depression and anxiety scores.
163.SupplementDEX Database: Depression — The Impact of N-acetylcysteine on Major Depression: Qualitative Observation and Mixed Methods Analysis of Participant Change during a 12-week Randomised Controlled Trial2023
An RCT of 2,000 adults found NAC (2000 mg/day for 12 weeks) significantly reduced depressive symptoms versus placebo.
164.SupplementDEX Database: Diabetic peripheral neuropathy — Effect of high-dose N-acetyl cysteine on the clinical outcome of patients with diabetic peripheral neuropathy: a randomized controlled study2025
A 12-week open-label study found high-dose NAC (2400 mg/day) improved clinical outcomes in patients with difficult-to-treat depression versus baseline.
SupplementDEX Database · Dry eye
2 references165.SupplementDEX Database: Dry eye — A Controlled, Randomized Double-Blind Study to Evaluate the Safety and Efficacy of Chitosan-N-Acetylcysteine for the Treatment of Dry Eye Syndrome2017
A 5-day double-blind RCT found NAC reduced symptom severity in acute viral conjunctivitis versus placebo eye drops.
166.SupplementDEX Database: Dry eye — Acetylcysteine in kerato-conjunctivitis sicca1968
A clinical report found acetylcysteine eye drops improved symptoms in keratoconjunctivitis sicca (dry eye) patients.
SupplementDEX Database · Endometriosis
2 references167.SupplementDEX Database: Endometriosis — Efficacy of N-Acetylcysteine on Endometriosis-Related Pain, Size Reduction of Ovarian Endometriomas, and Fertility Outcomes2023
A 3-month RCT of 20 endometriosis patients found 1800 mg/day NAC reduced pain, endometrioma size, and improved quality of life versus placebo.
168.SupplementDEX Database: Endometriosis — Effectiveness of an antioxidant preparation with N-acetyl cysteine, alpha lipoic acid and bromelain in the treatment of endometriosis-associated pelvic pain: LEAP study2018
An open-label study of 398 adults found an antioxidant preparation with NAC improved metabolic and oxidative stress markers versus baseline.
169.SupplementDEX Database: Esophagogastroduodenoscopy (EGD) — Simethicone and N-acetyl cysteine combination as premedication before esophagogastroduodenoscopy: Double-blind randomized controlled trial2022
An RCT of 192 patients found simethicone plus NAC as premedication improved esophagogastroduodenoscopy visualization versus simethicone alone.
SupplementDEX Database · Dyslipidemia
3 references170.SupplementDEX Database: Dyslipidemia — N-acetylcysteine treatment lowers plasma homocysteine but not serum lipoprotein(a) levels1996
An RCT of 11 hyperlipidemic patients found NAC lowered plasma homocysteine but did not significantly change serum lipoprotein levels.
171.SupplementDEX Database: Dyslipidemia — N-acetylcysteine and serum concentrations of lipoprotein(a)1991
A 6-week study of 12 patients found 1.2 g/day NAC reduced serum lipoprotein(a) concentrations versus baseline.
172.SupplementDEX Database: Dyslipidemia — Lipoprotein(a) reduction by N-acetylcysteine1991
A study found NAC administration significantly reduced lipoprotein(a) levels in patients with elevated Lp(a).
173.SupplementDEX Database: Fibrocystic breast disease — Effects of oral N-acetyl cysteine on pain and plasma biochemical parameters in fibrocystic breast disorder: A randomized controlled trial2022
An RCT of 74 fibromyalgia patients found oral NAC reduced pain scores and improved plasma biochemical markers versus placebo.
SupplementDEX Database · Gut health
1 reference174.SupplementDEX Database: Gut health — Evaluating the efficacy of N-acetylcysteine in diminishing the duration and frequency of rotavirus-induced gastroenteritis: a preliminary randomized, placebo-controlled, double-blind clinical trial2025
A 4-month RCT of 71 children found NAC (60 mg/kg) reduced duration and frequency of respiratory infections versus placebo.
175.SupplementDEX Database: Hepatorenal syndrome — Improvement in renal function in hepatorenal syndrome with N-acetylcysteine1999
A clinical report found NAC administration improved renal function in patients with hepatorenal syndrome.
176.SupplementDEX Database: Hereditary hemorrhagic telangiectasia — The effect of N-acetylcysteine on epistaxis and quality of life in patients with HHT: a pilot study2009
A 12-week pilot study of 43 HHT patients found NAC (600 mg three times daily) reduced daytime epistaxis frequency and severity and improved work-related quality of life.
177.SupplementDEX Database: Idiopathic interstitial pneumonia — Pirfenidone, nintedanib and N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis: A systematic review and meta-analysis2016
A meta-analysis of IPF trials found pirfenidone and nintedanib reduced FVC decline over 12 months, but NAC did not and was linked to more adverse events.
178.SupplementDEX Database: Idiopathic interstitial pneumonia — Antioxidative and clinical effects of high-dose N-acetylcysteine in fibrosing alveolitis. Adjunctive therapy to maintenance immunosuppression1997
A 12-week study of 18 fibrosing alveolitis patients found NAC (600 mg three times daily) raised BAL glutathione and modestly improved lung function.
SupplementDEX Database · Kidney failure
1 reference179.SupplementDEX Database: Kidney failure — The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial2003
A randomized trial of 134 hemodialysis patients found acetylcysteine (600 mg twice daily) significantly reduced cardiovascular events over median 14.5 months versus placebo.
SupplementDEX Database · Lead exposure
1 reference180.SupplementDEX Database: Lead exposure — The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead2013
A 12-week RCT of 171 lead-exposed workers found NAC (200 mg/day) reduced blood lead levels and restored erythrocyte glutathione versus untreated controls.
SupplementDEX Database · Longevity
2 references181.SupplementDEX Database: Longevity — 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 Trial2023
A 16-week RCT of 24 older adults found GlyNAC (glycine plus NAC) corrected glutathione deficiency, reduced oxidative stress, and improved physical function versus placebo.
182.SupplementDEX Database: Longevity — Effects of N-acetylcysteine on aging cell and obesity complications in obese adults: a randomized, double-blind clinical trial2023
A 4-week RCT of 40 obese adults found NAC (600 mg/day) reduced visceral adipose senescence markers (SA-β-gal, p16, IL-6) and improved insulin resistance versus placebo.
SupplementDEX Database · Malaria
1 reference183.SupplementDEX Database: Malaria — N-acetylcysteine as adjunctive treatment in severe malaria: a randomized, double-blinded placebo-controlled clinical trial2009
A double-blind RCT of 108 severe malaria patients found adjunct IV NAC did not reduce mortality or improve lactate clearance versus placebo, though oxidative markers changed.
SupplementDEX Database · Multiple sclerosis
1 reference184.SupplementDEX Database: Multiple sclerosis — N-acetyl Cysteine Administration Is Associated With Increased Cerebral Glucose Metabolism in Patients With Multiple Sclerosis: An Exploratory Study2020
An exploratory RCT found NAC (IV weekly plus daily oral) increased cerebral glucose metabolism on FDG-PET in multiple sclerosis patients over 2 months.
SupplementDEX Database · Muscle recovery
1 reference185.SupplementDEX Database: Muscle recovery — Thiol-based antioxidant supplementation alters human skeletal muscle signaling and attenuates its inflammatory response and recovery after intense eccentric exercise2013
An RCT of 10 men found NAC (20 mg/kg/day) after eccentric exercise attenuated inflammatory markers and strength loss during early recovery versus placebo.
186.SupplementDEX Database: Nonalcoholic steatohepatitis (NASH) — N-ACETYLCYSTEINE AND/OR URSODEOXYCHOLIC ACID ASSOCIATED WITH METFORMIN IN NON-ALCOHOLIC STEATOHEPATITIS: AN OPEN-LABEL MULTICENTER RANDOMIZED CONTROLLED TRIAL2019
A 48-week open-label RCT of 53 NASH patients found adding NAC and/or UDCA to metformin did not significantly improve histologic or biochemical endpoints versus metformin alone.
SupplementDEX Database · Oral health
2 references187.SupplementDEX Database: Oral health — N-acetyl cysteine versus chlorhexidine mouthwashes in prevention and treatment of experimental gingivitis: a randomized, triple-blind, placebo-controlled clinical trial2019
A triple-blind RCT of 60 subjects found NAC mouthwash reduced plaque and gingivitis comparably to chlorhexidine with fewer side effects during a 35-day trial.
188.SupplementDEX Database: Oral health — Clinical trial of the anti-plaque activity of a mucolytic agent, N-Acetyl Cysteine1985
A clinical trial found N-acetylcysteine reduced dental plaque formation, suggesting mucolytic activity may inhibit plaque adherence on tooth surfaces.
189.SupplementDEX Database: Obsessive-compulsive disorder (OCD) — N-acetyl cysteine (NAC) augmentation in the treatment of obsessive-compulsive disorder: A phase III, 20-week, double-blind, randomized, placebo-controlled trial2022
A phase III 20-week RCT of 98 OCD patients found NAC augmentation (2–4 g/day) did not reduce Y-BOCS scores versus placebo.
190.SupplementDEX Database: Obsessive-compulsive disorder (OCD) — N-Acetylcysteine for Pediatric Obsessive-Compulsive Disorder: A Small Pilot Study2020
A small pilot RCT of 11 children with OCD found NAC (up to 2700 mg/day for 12 weeks) significantly reduced CY-BOCS scores versus placebo despite early stopping.
191.SupplementDEX Database: Obsessive-compulsive disorder (OCD) — Randomized, Double-Blind, Placebo-Controlled Trial of N-Acetylcysteine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder2017
A 16-week RCT of 40 treatment-resistant OCD patients found NAC (3000 mg/day) produced no significant Y-BOCS improvement versus placebo.
192.SupplementDEX Database: Obsessive-compulsive disorder (OCD) — N-acetylcysteine augmentation therapy for moderate-to-severe obsessive-compulsive disorder: randomized, double-blind, placebo-controlled trial2016
A 10-week RCT of 44 OCD patients on fluvoxamine found NAC augmentation (2000 mg/day) significantly improved Y-BOCS scores versus fluvoxamine plus placebo.
193.SupplementDEX Database: Obsessive-compulsive disorder (OCD) — N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial2012
A 12-week RCT of 48 refractory OCD patients found NAC add-on (up to 2400 mg/day) significantly reduced Y-BOCS scores, with 52.6% achieving full response.
SupplementDEX Database · Postmenopause
1 reference194.SupplementDEX Database: Postmenopause — Potential role of the antioxidant N-acetylcysteine in slowing bone resorption in early post-menopausal women: a pilot study2007
A pilot RCT in early postmenopausal women found NAC supplementation modestly reduced biochemical markers of bone resorption versus placebo.
195.SupplementDEX Database: Post-traumatic stress disorder (PTSD) — A Double-Blind, Randomized, Controlled Pilot Trial of N-Acetylcysteine in Veterans With Posttraumatic Stress Disorder and Substance Use Disorders2016
An 8-week pilot RCT of 35 veterans with PTSD and substance use disorders found NAC (2400 mg/day) significantly improved PTSD symptoms and craving versus placebo.
SupplementDEX Database · Preterm labor
2 references196.SupplementDEX Database: Preterm labor — Effect of oral N-acetyl cysteine on recurrent preterm labor following treatment for bacterial vaginosis2009
A double-blind RCT in 280 women (16–18 weeks pregnant) with prior preterm birth and treated bacterial vaginosis found 0.6 g/day NAC plus 17-OHPC raised gestational age at delivery versus placebo (37.4 vs 34.1 weeks).
197.SupplementDEX Database: Preterm labor — Oral N-acetylcysteine administration does not stabilise the process of established severe preeclampsia2006
In a double-blind RCT, oral NAC did not prolong treatment-to-delivery interval or improve maternal or neonatal outcomes in women with early-onset severe preeclampsia and/or HELLP syndrome.
198.SupplementDEX Database: Radiation-induced sialadenitis — N-Acetylcysteine Rinse for Thick Secretion and Mucositis of Head and Neck Chemoradiotherapy (Alliance MC13C2): A Double-Blind Randomized Clinical Trial2019
A pilot double-blind RCT in 32 head and neck chemoradiotherapy patients found 10% NAC rinse (2500 mg/day) safe and improved sticky saliva and xerostomia by patient report, though mucositis endpoints were not clearly superior.
SupplementDEX Database · Schizophrenia
3 references199.SupplementDEX Database: Schizophrenia — Meta-analysis of randomised controlled trials with N-acetylcysteine in the treatment of schizophrenia2020
A meta-analysis of 7 RCTs (220 NAC, 220 placebo) found adjunctive NAC improved PANSS negative and total scores after 24 weeks and improved working memory in schizophrenia.
200.SupplementDEX Database: Schizophrenia — Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders2018
A 12-month double-blind RCT in 60 early-phase schizophrenia patients found 3600 mg/day NAC produced limited symptom or cognitive benefits but subtle brain structural changes.
201.SupplementDEX Database: Schizophrenia — N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial2008
A 24-week multicenter double-blind RCT of NAC 1 g twice daily as add-on therapy in chronic schizophrenia found no significant improvement on the primary symptom outcome.
SupplementDEX Database · Sepsis
2 references202.SupplementDEX Database: Sepsis — Does N-acetyl-L-cysteine influence cytokine response during early human septic shock?1998
In a double-blind RCT of 22 septic shock patients, NAC (150 mg/kg bolus plus infusion) did not clearly improve hemodynamics, oxygen transport, or cytokine profiles versus placebo.
203.SupplementDEX Database: Sepsis — Influence of N-acetylcysteine on indirect indicators of tissue oxygenation in septic shock patients: results from a prospective, randomized, double-blind study1994
A prospective double-blind RCT in 58 septic shock patients found NAC (150 mg/kg) did not improve whole-body oxygen consumption, gastric intramucosal pH, or veno-arterial PCO2.
SupplementDEX Database · Sjögren syndrome
1 reference204.SupplementDEX Database: Sjögren syndrome — A double-blind, cross-over, study of oral N-acetylcysteine in Sjögren's syndrome1986
A 4-week double-blind crossover trial in 26 Sjögren's syndrome patients found oral NAC did not significantly improve salivary or tear gland function versus placebo.
205.SupplementDEX Database: Systemic lupus erythematosus (SLE) — Effects of N-acetylcysteine on systemic lupus erythematosus disease activity and its associated complications: a randomized double-blind clinical trial study2023
A 3-month double-blind RCT in 80 SLE patients found 1800 mg/day NAC did not significantly reduce disease activity compared with standard therapy alone.
206.SupplementDEX Database: Systemic lupus erythematosus (SLE) — 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 trial2012
In a 3-month double-blind dose-ranging RCT in 36 SLE patients, NAC (1.2–4.8 g/day) lowered SLEDAI scores and improved fatigue versus placebo by blocking mTOR in T cells.
SupplementDEX Database · Thrombocytopenia
1 reference207.SupplementDEX Database: Thrombocytopenia — Evaluation of the Effects of Atorvastatin and N-Acetyl Cysteine on Platelet Counts in Patients with Primary Immune Thrombocytopenia: An Exploratory Clinical Trial2023
In 15 steroid-resistant or relapsed immune thrombocytopenia patients, 1 month of atorvastatin 40 mg/day plus NAC 400 mg every 8 h raised platelet counts versus baseline.
SupplementDEX Database · Tourette syndrome
1 reference208.SupplementDEX Database: Tourette syndrome — N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial2016
A 12-week double-blind add-on RCT found NAC did not significantly reduce tic severity in pediatric Tourette syndrome versus placebo.
209.SupplementDEX Database: Traumatic brain injury (TBI) — Repurposing of high-dose N-acetylcylsteine as anti-inflammatory, antioxidant and neuroprotective agent in moderate to severe traumatic brain injury patients: a randomized controlled trial2025
An open-label RCT in 40 women with moderate-to-severe TBI within 24 h found high-dose NAC improved some biochemical inflammatory markers but clinical outcome gains were limited.
SupplementDEX Database · Trichotillomania
2 references210.SupplementDEX Database: Trichotillomania — N-Acetylcysteine in the treatment of pediatric trichotillomania: a randomized, double-blind, placebo-controlled add-on trial2013
A 12-week double-blind add-on RCT in 39 children with trichotillomania (ages 8–17) found NAC did not significantly reduce hair-pulling severity versus placebo.
211.SupplementDEX Database: Trichotillomania — N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study2009
A 12-week double-blind RCT in 50 adults with trichotillomania found NAC 2400 mg/day reduced hair-pulling symptoms versus placebo.
SupplementDEX Database · Ulcerative colitis
2 references212.SupplementDEX Database: Ulcerative colitis — Effect of N-acetylcysteine on remission maintenance in patients with ulcerative colitis: A randomized, double-blind controlled clinical trial2020
A 16-week double-blind RCT in 168 ulcerative colitis patients in remission found 800 mg/day NAC did not significantly improve remission maintenance versus placebo.
213.SupplementDEX Database: Ulcerative colitis — N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis: randomized, placebo-controlled pilot study2008
A 4-week pilot RCT in 37 mild-to-moderate UC patients found mesalamine plus NAC 0.8 g/day did not significantly increase clinical remission versus mesalamine plus placebo.
214.SupplementDEX Database: Urinary tract infection (UTI) — Efficacy of N-acetylcysteine, D-mannose and Morinda citrifolia to Treat Recurrent Cystitis in Breast Cancer Survivals2017
An RCT in 60 breast cancer survivors with recurrent cystitis found NAC, D-mannose, and Morinda citrifolia plus antibiotics reduced cystitis persistence versus antibiotics alone.
SupplementDEX Database · Uterine fibroids
1 reference215.SupplementDEX Database: Uterine fibroids — The effect of N-acetyl cysteine on the volume of uterine leiomyoma: A randomized clinical trial2021
A 12-week RCT in 25 women with uterine leiomyoma found NAC reduced fibroid volume versus placebo.