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Reviewed by the Scan Dose Research Team and Clinical Advisory Board

N-Acetylcysteine

MODERATE EVIDENCESupplementLast updated April 5, 2026

SCAN DOSE SUMMARY

NAC is a precursor to glutathione — your body's master antioxidant. It has anti-inflammatory, antioxidant, and mucus-thinning properties. Our research, from 16 RCTs, 20 meta-analyses, and 39,369 participants, shows broad moderate evidence across respiratory conditions (COPD), psychiatric conditions (bipolar, OCD, addiction), and general antioxidant support. It's also the clinical antidote for acetaminophen overdose. Key safety concern: it impairs blood clotting and causes severe hypotension when combined with nitroglycerin.

EVIDENCE GRADES

COPD symptomsModerate
B
Psychiatric conditions (bipolar, OCD, addiction)Moderate across multiple conditions
B
Autism symptomsModerate
B
Antioxidant capacityModerate
B

OPTIMAL DOSAGE

  • General use: 600-1,800mg/day, divided into 2-3 doses
  • Up to 3,000mg/day generally well tolerated
  • Routes: Oral, IV (medical), inhaled (respiratory)
  • Take with: Food to reduce GI effects
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DRUG INTERACTIONS

NitroglycerinSevere

Severe hypotension + headache

Avoid combination.

Blood-thinning drugs (warfarin, etc.)Unknown

Increased bleeding risk

Use caution. Discontinue before surgery.

BP-lowering drugsUnknown

Additive hypotension

Monitor BP.

SAFETY PROFILE

Side Effects

  • Common: Nausea, vomiting, dyspepsia, heartburn, diarrhea, headache, joint pain, dizziness
  • Inhaled: Cough, bronchospasm
  • IV: Itching, rash, tachycardia, low BP

Drug Interactions

Precautions

  • Pregnancy: Caution. 600mg/day for 4-5 months appears safe. Crosses placental barrier. Longer-term safety not well studied.
  • Breastfeeding: Caution. No reliable safety data.
  • Asthma: Higher risk of allergic-like (anaphylactoid) reactions. Avoid unless medically indicated.
  • Surgery: Discontinue before surgery — impairs clotting, increases surgical blood loss risk.
  • Bleeding disorders: Use with caution.

WADA Status

Conditionally Prohibited. IV infusion >100mL per 12-hour period without medical indication is prohibited.

WHO SHOULD BE CAREFUL

HOW SCAN DOSE SCORES THIS

Present at 600-1,200mg:✅ Green flag — well-studied, broad evidence base
Combined with nitroglycerin:🔴 Red flag — severe hypotension documented
Pre-surgery without discontinuation guidance:⚠️ Yellow flag — bleeding risk
In someone with asthma:⚠️ Yellow flag — anaphylactoid reaction risk

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Scan Your N-Acetylcysteine SupplementBrowse all ingredients

Reviewed by the Scan Dose Research Team and Clinical Advisory Board | Last updated: April 5, 2026

Not medical advice. Based on published clinical research and systematic reviews.

Safety

N-Acetyl Cysteine (NAC): Drug Interactions

Use with caution

Moderate interactions. Monitoring, timing separation, or dose adjustment may be required.

  • Nitroglycerin

    NAC potentiates nitric oxide vasodilation.

    RiskSevere hypotension and headache.
    ActionAvoid combination or use with extreme caution.

    Source: Clinical pharmacology

  • Activated charcoal

    Charcoal adsorbs NAC, reducing efficacy.

    RiskTreatment failure (relevant in acetaminophen overdose treatment).
    ActionSeparate by 1 to 2 hours.

    Source: Emergency medicine standard

  • Anticoagulants

    NAC has mild antiplatelet properties.

    RiskSlight bleeding risk increase.
    ActionLow clinical significance. Monitor.

    Source: Clinical consensus

Timing Separation Rules

  • Activated charcoal1 to 2 hours

Educational information only. This is not medical advice. These statements have not been evaluated by the FDA. Talk to your prescriber before starting, stopping, or combining any supplement with prescription medication.

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