Possible Interaction: Acetylcysteine and Sodium Bicarbonate

“In mouse … with sodium bicarbonate , which can raise the intratumoral pH. Furthermore, the protein levels of … GRP78, were also increased in response to acidic pH. The antioxidant NAC , which reduces ROS accumulation, alleviated acid-mediated ER stress and autophagy, … that autophagy was induced by acidic pH through ER stress.”

“ Sodium bicarbonate plus N-acetylcysteine (OR 0.17, 95% CI 0.04 to 0.79; p=0.024) was better than sodium bicarbonate alone (OR 0.71, 95% CI 0.48 to 1.03; p=0.071).”

“Combined treatment with NAC and NaHCO3 may reduce the risk of renal dysfunction after 30 days.”

“However, an increase in serum creatinine >25% from the baseline value to 30 day was significantly lower in patients treated with combined NAC and NaHCO3 (18.7% versus 19.1% versus 9.2% versus 21.3%; P=0.033).”

“ N-acetylcysteine has been shown to be effective in reducing CIN incidence and in improving clinical outcomes after emergency or primary PCI, particularly when administered as a high-dose intravenous bolus or with sodium bicarbonate (4, 5).”

“The use of isotonic sodium bicarbonate combined with N‐acetylcysteine appears promising in providing further benefits.”

“However, limited data are available regarding whether sodium bicarbonate hydration, proven to be beneficial alone, can further improve outcomes when given with NAC.”

“When both the epoxide 6 and its 19-… 7 were subjected separately to a reaction with N-acetyl-L-cysteine in … of NaHCO3 , the 19-oxo compound 6 disappeared from the reaction mixture more rapidly (t1/… = 6.0 min) than the 19-methyl analog 7 (t1/2 = 16 min).”

“When both the epoxide 6 and its 19-… 4 were subjected separately to reaction with N-acetyl-L-cysteine in the … of NaHCO3 , the 19-oxo steroid 6 disappeared from the reaction mixture more rapidly (T1/… = 40 sec) than the 19-methyl analog 4 (T1/2 = 3.0 min).”

“In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.”