N-acetyl Cysteine (nac) - Fotivda (Tivozanib Hydrochloride) Interaction
Herbal: N-acetyl Cysteine (nac)
Also Known As: Acetyl Cysteine, Mucomyst
Drug: Tivozanib Hydrochloride
Brand names:
Fotivda
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 01, 2024
Interaction Details
Tivozanib Hydrochloride is classified as belonging to the following category: Anticoagulant/Antiplatelet Drugs
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Clinical research suggests that intravenous N-acetyl cysteine decreases prothrombin time, prolongs coagulation time, decreases platelet aggregation, and increases blood loss in surgical patients. Furthermore, in vitro research suggests that N-acetyl cysteine increases the anticoagulant activity of nitroglycerin.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
Pharmacist Analysis
There are some concerns about the safety of taking NAC with certain medications, including anticoagulants or antiplatelet drugs.
Anticoagulants and antiplatelet drugs are medications that help prevent blood clots, which can be dangerous and potentially life-threatening. Research suggests that taking NAC with these drugs can potentially increase the risk of bleeding, which can also be dangerous.
Clinical research has suggested that intravenous N-acetyl cysteine may decrease prothrombin time, prolong coagulation time, decrease platelet aggregation, and increase blood loss in surgical patients. This means that NAC can interfere with the normal clotting process and increase the risk of bleeding.
However, and this is an important note, these findings were based on intravenous administration of NAC, and it is unclear if the same effects would occur with oral supplementation. However, caution should still be exercised when taking NAC with anticoagulants or antiplatelet drugs.
Be sure to let your doctor know about everything you are taking so you can be monitored appropriately.
- Dr. Brian Staiger, PharmDReferences
- Loscalzo J. N-Acetylcysteine potentiates inhibition of platelet aggregation by nitroglycerin. J Clin Invest. 1985;76(2):703-8.
- Niemi, T. T., Munsterhjelm, E., Poyhia, R., Hynninen, M. S., and Salmenpera, M. T. The effect of N-acetylcysteine on blood coagulation and platelet function in patients undergoing open repair of abdominal aortic aneurysm. Blood Coagul.Fibrinolysis 2006;1
- Wijeysundera, D. N., Karkouti, K., Rao, V., Granton, J. T., Chan, C. T., Raban, R., Carroll, J., Poonawala, H., and Beattie, W. S. N-acetylcysteine is associated with increased blood loss and blood product utilization during cardiac surgery. Crit Care Me
- 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.
Tivozanib Hydrochloride Overview
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Tivozanib is used to treat advanced renal cell carcinoma (RCC; cancer that begins in the kidneys) that has returned or did not respond to at least two other medications. Tivozanib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop or slow the spread of cancer cells.
N-acetyl Cysteine (nac) - More Interactions
N-acetyl Cysteine (nac) interacts with 290 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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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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