N-acetyl Cysteine (nac) - Nitrostat (Nitroglycerin) Interaction
Herbal: N-acetyl Cysteine (nac)
Also Known As: Acetyl Cysteine, Mucomyst
Drug: Nitroglycerin
Brand names:
Nitrostat, Nitrogard SR, Sustachron, Nitro-Bid, Sustachron ER Buccal, Nitroglyn, Nitro Time, Nitrong, Nitrogard, Nitrocine Timecaps, Nitroquick, Rectiv, Gonitro
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jun 15, 2025
Interaction Details
Nitroglycerin is classified as belonging to the following category: Nitroglycerin
N-acetyl cysteine can increase the risk for hypotension and headaches when taken with intravenous or transdermal nitroglycerin.
Clinical research shows that concomitant administration of N-acetyl cysteine and intravenous or transdermal nitroglycerin can cause severe hypotension and intolerable headaches. Furthermore, in vitro research suggests that N-acetyl cysteine increases the anticoagulant activity of nitroglycerin.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
References
- Ardissino D, Merlini PA, Savonitto S, et al. Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris. J Am Coll Cardiol 1997;29:941-7.
- Horowitz JD, Henry CA, Syrjanen ML, et al. Nitroglycerine/N-acetylcysteine in the management of unstable angina pectoris. Eur Heart J 1988;9:95-100.
- Iversen HK. N-acetylcysteine enhances nitroglycerin-induced headache and cranial arterial responses. Clin Pharmacol Ther 1992;52:125-33.
- Loscalzo J. N-Acetylcysteine potentiates inhibition of platelet aggregation by nitroglycerin. J Clin Invest. 1985;76(2):703-8.
- Chirkov, Y. Y. and Horowitz, J. D. N-Acetylcysteine potentiates nitroglycerin-induced reversal of platelet aggregation. J Cardiovasc.Pharmacol 1996;28(3):375-380.
N-acetyl Cysteine (nac) Overview
N-acetyl cysteine (NAC) is derived from the amino acid cysteine. It is used as a prescription medication to treat acetaminophen overdose and to help thin mucus in people with certain respiratory conditions. It is also used as a dietary supplement.
NAC has a number of potential health benefits. It is a source of the antioxidant enzyme glutathione, which is important for protecting cells from oxidative stress and supporting immune function. It also may have anti-inflammatory effects and studies show it may support healthy brain function.
It is generally considered safe to take NAC supplements in recommended doses.
Nitroglycerin Overview
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Nitroglycerin ointment (Nitro-Bid) is used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). Nitroglycerin ointment can only be used to prevent attacks of angina; it cannot be used to treat an attack of angina once it has begun. Nitroglycerin ointment (Rectiv) is used in adults to treat pain from anal fissures (a split or tear in the tissue near the rectal area). Nitroglycerin is in a class of medications called vasodilators. Nitroglycerin ointment prevents angina by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen. Nitroglycerin ointment treats anal fissure pain by relaxing the blood vessels, which reduces the pressure in the anal tissues.
N-acetyl Cysteine (nac) - More Interactions
N-acetyl Cysteine (nac) interacts with 291 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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