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One selection filters the source overview, clinical facts, reports and dose calculator. Literature references are not species-filtered.
Choose one species for its overview and dose calculator, or all species to browse the full evidence.
Source overview
Recorded excerpts for one species. Each dose remains a separate source entry; no regimen is selected.
Choose one species to view its source overview. All-species evidence remains available below.
View full clinical evidence and sources ↓Clinical evidence
Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications4
Acetaminophen toxicity (the antidote); xylitol and phenol hepatotoxicity; any glutathione-depleted oxidative liver injury
DogCatExtra-label (EXTRA_LABEL)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Acetaminophen toxicity (the antidote); xylitol and phenol hepatotoxicity; any glutathione-depleted oxidative liver injury — Extra-label (human drug)
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Acetaminophen toxicity (the antidote); xylitol and phenol hepatotoxicity; any glutathione-depleted oxidative liver injury — Extra-label (human drug)
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Nebulized mucolytic (bronchial secretions); topical ophthalmic (melting corneal ulcers — see appendix); investigational chronic URI anti-inflammatory in cats
DogCatExtra-label (EXTRA_LABEL)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Nebulized mucolytic (bronchial secretions); topical ophthalmic (melting corneal ulcers — see appendix); investigational chronic URI anti-inflammatory in cats — Extra-label
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Nebulized mucolytic (bronchial secretions); topical ophthalmic (melting corneal ulcers — see appendix); investigational chronic URI anti-inflammatory in cats — Extra-label
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens6
This calculator performs arithmetic only on the sourced dosing field shown for each result — it does not verify the field's accuracy, does not select which field to use for a patient, and does not replace a veterinarian's order. Not for clinical use. Confirm every result against the primary source before dispensing.
Choose one species above to view its dose calculator.
Adverse effects191
Nausea/vomiting (oral), rare urticaria — Main effects
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Bronchospasm/hypersensitivity when nebulized — Pulmonary-route risk
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
IV rate-related reactions — Infuse slowly
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
These are counts of spontaneously reported events, not proven adverse effects, causal relationships, or incidence rates.
Bars compare report counts within each species; they do not show incidence.
More reportsFewer reportsDog
- Elevated alanine aminotransferase (ALT)36 reports
- Elevated total bilirubin34 reports
- Vomiting26 reports
- Abnormal ultrasound finding23 reports
- Death by euthanasia21 reports
- Icterus20 reports
- Anorexia18 reports
- Other abnormal test result NOS16 reports
- Elevated serum alkaline phosphatase (ALP)15 reports
- Leucocytosis NOS15 reports
- Lethargy (see also Central nervous system depression in Neurological)14 reports
- Not eating14 reports
Cat
- Hypotension4 reports
- Death3 reports
- Dehydration3 reports
- Hypophosphataemia3 reports
- Anaphylaxis2 reports
- Breathing difficulty2 reports
- Death by euthanasia2 reports
- Decreased haematocrit2 reports
- Diarrhoea2 reports
- Dull2 reports
- Elevated alanine aminotransferase (ALT)2 reports
- Elevated total bilirubin2 reports
Monitoring1
Methemoglobin %, PCV, liver enzymes/bilirubin, clinical coloration; supportive: IV fluids ± ascorbic acid, SAMe, blood/Oxyglobin
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications1
None for antidotal use; hypersensitivity only for pulmonary use
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions5
Bronchospastic disease with nebulization; space 2–3 h from activated charcoal (charcoal adsorbs NAC)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
140 then 70×7 — the NAC protocol number pair to memorize (identical to human medicine); earlier treatment = better outcome, but benefit persists hours post-ingestion.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Cats are the sentinel species: acetaminophen (even 1 tablet) → NAPQI + methemoglobinemia (limited glucuronidation + saturated sulfation) — NAC + ascorbic acid is the core rescue.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Charcoal-first sequencing: adsorb the toxin, WAIT 2–3 hours, then NAC (or use IV NAC to bypass the interaction).
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Same glutathione logic reuses for xylitol, phenol, and any oxidative hepatic insult — plus nebulized mucolytic and topical ophthalmic lives of the same molecule.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions2
Activated charcoal — Binds oral NAC — separate doses
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Oxidizing agents — NAC opposes (therapeutic logic)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics3
Mechanism (antidote) — Cysteine precursor → restores glutathione; alternate conjugation substrate for NAPQI
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Mechanism (mucolytic) — Free sulfhydryl breaks mucoprotein disulfide bonds — best at pH 7–9
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Metabolism — GI absorption → hepatic deacetylation to cysteine
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
No specific restriction flagged; antidotal use overrides concerns.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 30–31 — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Literature references17
References are linked to this drug. Species applicability is not recorded here, so the species filter does not narrow this list. Imported dates do not retain their original precision; confirm dates in the original citation.
- Antioxidant efficacy of N-acetylcysteine against acrylamide-induced toxicity in Leydig cells by modulating p53/Bax/Caspase-3 pathway.
Study summary not available in the imported record. Open the original citation to review the study.
- N-Acetylcysteine, Dichloroacetate, and Metformin Restore Mitochondrial Homeostasis by Counteracting Oxidative Stress and Fusion-Fission Imbalance in Palmitic Acid-Induced Lipotoxicity.
Study summary not available in the imported record. Open the original citation to review the study.
- Potential of N-acetylcysteine as an adjuvant to amoxicillin against mastitis-associated Staphylococcus aureus and Escherichia coli.
Study summary not available in the imported record. Open the original citation to review the study.
- Pharmacological Strategies for Mitigating Cytarabine-Induced Multi-Organ Toxicity: A Scoping Review on Mechanisms, Efficacy and Clinical Implications.
Study summary not available in the imported record. Open the original citation to review the study.
- The effect of N-acetylcysteine use in high-fat diet-exposed pregnant rats on glucose metabolism and oxidative status in dams and their offspring.
Study summary not available in the imported record. Open the original citation to review the study.
Sources: PubMed, National Library of Medicine; openFDA, U.S. Food and Drug Administration; Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.