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What is ACC 200?

ACC 200 is an over-the-counter (OTC) medication that you can buy at a pharmacy.1 ACC 200 is a mucolytic, which means that it is a medication that breaks down or disrupts mucus.1,2 In South Africa, it is available as an effervescent tablet that dissolves in water.1


How does ACC 200 work?

ACC 200 contains an active ingredient called N-acetylcysteine (NAC).1 NAC acts directly on thick and sticky mucus in the respiratory airways,3,4 breaking down the bonds that hold the mucus together. It does this without significantly increasing the quantity of mucus or fluid in the airways.4

NAC’s action thins thick mucus quickly, and makes it less sticky,4,5 so that the runnier, more liquid mucus is easier to blow, sneeze or cough out of the airways.3,4 NAC has been shown to improve the rate at which mucus clears from the airways by 35%.6


How does NAC treat a cough?

NAC thins thick, sticky phlegm (a form of mucus produced by the lower airways) quickly and makes it more liquid so that it is easier to clear from the lungs.4,5

NAC has been shown to reduce coughing within 4 – 5 days of starting treatment.4  

Clearing the thick, sticky mucus stuck in your airways may also help to prevent a new or different infection developing there.7,8


How does NAC treat sinus congestion?

Because NAC thins thick, sticky mucus quickly and makes it more liquid, it becomes easier to clear the mucus from the nasal passages and sinuses.6 Clearing mucus from the sinuses improves the oxygenation and airflow in this area,9 which reduces sinus congestion and decreases its associated pain and pressure.3

Most patients report a decrease in sinus discomfort and ‘heaviness’ in the first days after starting treatment with NAC.3

Clearing the thick, sticky mucus stuck in your sinuses may also help to prevent a new or different infection developing there.7,8


Where can I find ACC 200? 

ACC 200 is a registered medication by the South African Health Products Regulatory Authority (SAHPRA) in South Africa.1 It is a Schedule 1 medication, which means you can buy it from any pharmacy which stocks OTC medications.1 Your doctor may also prescribe it for you.


Who makes ACC 200?

ACC 200 is manufactured by Sandoz (a division of Novartis). ACC 200 has been available on the South African market for over 20 years.1


How long can I use ACC 200 for?

You can use it for up to 14 days.1  If you would like to use it for longer than 14 days, please consult your doctor.1


Can I use ACC 200 with other medications?

ACC 200 has no known harmful interactions with other medications,1 but please do check with your doctor or pharmacist about whether it may interact with medications you are taking.

When taking an antibiotic, you should allow at least a two-hour interval between taking the antibiotic and taking ACC 200, so that both medications can work well.1 


Remember that most acute coughs and sinusitis are caused by a virus11,12 and that antibiotics do not help to treat viruses.13 

Can I give ACC 200 to my children?

In South Africa, ACC 200 is approved for use in children from the age of two years.1


What dose of ACC 200 should I take?1

The effervescent tablet should be dissolved in a glass of water before use.

Children 2 – 5 years of age  Half an effervescent tablet 2 – 3 times daily (equivalent to 200 to 300 mg NAC/day)
Children 6 – 14 years of age 1 effervescent tablet twice daily (equivalent to 400 mg NAC/day)   
Adolescents from 14 years of age, and adults 1 effervescent tablet 2 – 3 times daily (equivalent to 400 to 600 mg NAC/day)


Can anyone take ACC 200?1

If you suffer from any of the following, please consult your pharmacist or doctor before taking ACC 200:

  • asthma
  • peptic ulcer
  • lactose intolerance
  • diabetes
  1. Sandoz SA (Pty) Ltd. ACC 200 approved package insert 2018.
  2. Zeiger RS. Prospects for ancillary treatment of sinusitis in the 1990s. J Allergy Clin Immunol 1992; 90:478-495.
  3. Kryukov A.I., et al. Treatment of Acute Sinusitis. Russian Medical Journal. Otorhinolaryngology, 2012, No. 9, pp. 485-488
  4. Zaitseva OV. Rational choice of mucolytic therapy in treatment of respiratory diseases in children. RMJ 2009; 17(19):1217-1221.
  5. Kakhnovsky IM et al. Evaluation of potency of acetylcysteine effects on rheological properties of phlegm.Clin Pharm Ther 1997; 1.
  6. Helms S and Miller AL. Natural treatment of chronic rhinosinusitis. Altern Med Rev 2006; 11(3):196-207.
  7. Mutie M. Acute and chronic cough presentations in pharmacy. Pharmacy Education Jun 2014; 65-67.
  8. Knowles MR and Boucher RC. Mucus clearance as a primary innate defense mechanism for mammalian airways. J Clin Invest 2002 01 Mar; 109(5):571-577.
  9. Macchi A et al. Recurrent acute rhinosinusitis: a single blind clinical study of N-Acetylcysteine vs Ambroxol associated to corticosteroid therapy. Int J Immunopathol Pharmacol 2012; 25(1):207-217.
  10. Zheng CH et al. The effects of S-Carboxymethylcysteine and N-Acetylcysteine on the adherence of Moraxella catarrhalis to human pharyngeal epithelial cells. Microbiol Immunol 1999; 43(2):107-113.
  11. Scheid DC and Hamm RM. Acute bacterial rhinosinusitis in adults: part 1. Evaluation. Am Fam Physician; 70(9):1685-1692.
  12. Morice A and Kardos P. Comprehensive evidence-based review on European antitussives. BMJ Open Resp Res 2016Aug; 3(1):e000137.
  13. BMJ Best Practice. Common cold. Last updated: 10 Dec 2018. Available at: accessed May 2019.