Meta Information
ID:nac
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/nitrates
Target name:
Nitrate Medications
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NAC potentiates the vasodilatory effects of nitrates (e.g., nitroglycerin), which can lead to a dangerous drop in blood pressure (hypotension) and severe headaches.
Actionable advice:
Avoid taking NAC with nitrate medications unless under strict medical supervision.
Target id:
/condition/bleeding-disorders
Target name:
Bleeding Disorders
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Due to its ability to inhibit platelet aggregation, NAC can increase the risk of bleeding in individuals with pre-existing bleeding disorders like hemophilia.
Actionable advice:
Avoid NAC if you have a known bleeding disorder.
Target id:
/procedure/surgery
Target name:
Scheduled Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
NAC's antiplatelet effects increase the risk of excessive bleeding during and after surgical procedures.
Actionable advice:
Discontinue NAC at least 2 weeks before any scheduled surgery.
Target id:
/intervention/activated-charcoal
Target name:
Activated Charcoal
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Activated charcoal is a potent adsorbent that will bind to NAC in the gastrointestinal tract, preventing its absorption into the bloodstream.
Actionable advice:
Separate NAC from activated charcoal by at least 2 hours.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NAC has antiplatelet properties that can additively increase the risk of bleeding when combined with medications like warfarin, clopidogrel, or aspirin.
Actionable advice:
Use with caution and under medical supervision if you are taking any blood-thinning medications.
Target id:
/class/chemotherapy-radiation
Target name:
Cytotoxic Cancer Therapies (Chemotherapy & Radiation)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
As a potent antioxidant, NAC could theoretically protect cancerous cells from the oxidative damage intended by chemotherapy or radiation, potentially reducing treatment efficacy.
Actionable advice:
Do not take NAC during active cancer treatment unless specifically directed by your oncologist.
Target id:
/condition/asthma-copd
Target name:
Asthma and COPD
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
While more common with inhaled NAC, oral NAC can rarely trigger bronchospasm (airway narrowing) in susceptible individuals with asthma.
Actionable advice:
Use with caution and start with a low dose if you have asthma; discontinue if you experience wheezing.
Target id:
/condition/peptic-ulcer-disease
Target name:
Peptic Ulcer Disease (PUD)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NAC can break down the protective gastric mucus layer, which may irritate the stomach lining and potentially worsen active peptic ulcers.
Actionable advice:
Avoid NAC if you have an active peptic ulcer, or take it with food if you have a history of ulcers.
Target id:
/condition/histamine-intolerance
Target name:
Histamine Intolerance
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NAC can inhibit diamine oxidase (DAO), the primary enzyme for breaking down histamine, potentially worsening symptoms like flushing or headaches in those with histamine intolerance.
Actionable advice:
Avoid or use with extreme caution if you have known histamine intolerance.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
2
Description:
Food, particularly protein, can compete with NAC for absorption in the small intestine, reducing its bioavailability by up to 30%.
Actionable advice:
Take NAC on an empty stomach, at least 1 hour before or 2 hours after a meal.
Target id:
/biomarker/urine-ketone-test
Target name:
Urine Ketone Test Strips
Severity:
moderate
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
The sulfhydryl group in NAC can react with the sodium nitroprusside reagent on urine test strips, causing a false-positive result for ketones.
Actionable advice:
Be aware that NAC can cause false-positive urine ketone tests; use a blood ketone meter for accuracy.
Target id:
/intervention/glycine
Target name:
Glycine
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Glycine is a required precursor alongside cysteine (from NAC) for the synthesis of glutathione; co-administration ensures both building blocks are available.
Actionable advice:
Take glycine at the same time as NAC to support optimal glutathione production (often as a combined GlyNAC supplement).
Target id:
/intervention/selenium
Target name:
Selenium
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Selenium is an essential cofactor for the enzyme glutathione peroxidase, which utilizes the glutathione produced from NAC to neutralize oxidative damage.
Actionable advice:
Ensure adequate selenium intake from diet or supplements when taking NAC for long-term antioxidant support.
Target id:
/intervention/exercise
Target name:
Exercise
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High-dose antioxidant supplementation around the time of exercise may blunt the natural oxidative stress signals that are necessary for training adaptations like mitochondrial biogenesis.
Actionable advice:
Avoid taking NAC within 2 hours before or after your workout to maximize training benefits.
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
NAC may enhance the blood pressure-lowering effect of ACE inhibitors, potentially by improving endothelial function and nitric oxide availability.
Actionable advice:
Monitor blood pressure if you start taking NAC while on an ACE inhibitor.
Target id:
/intervention/molybdenum
Target name:
Molybdenum
Severity:
minor
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Molybdenum is a cofactor for sulfite oxidase, an enzyme that metabolizes sulfites, which can be produced during NAC metabolism.
Actionable advice:
Ensure adequate molybdenum intake, as deficiency could lead to sulfite sensitivity when supplementing with NAC.
Target id:
/intervention/carbamazepine
Target name:
Carbamazepine
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
There is weak evidence from case reports suggesting that high-dose NAC might increase the clearance of carbamazepine, potentially lowering its therapeutic levels.
Actionable advice:
If taking carbamazepine, discuss NAC use with your doctor as monitoring of drug levels may be warranted.