ACC contains acetylcysteine, a mucolytic — a medicine that thins mucus so it can be coughed up more easily. It is used for chesty, productive coughs and for conditions where thick mucus is the problem. It comes as effervescent tablets, commonly ACC 200 and ACC 600, and as an oral solution.
What is Acc?
ACC contains acetylcysteine (also called N-acetylcysteine or NAC). The name is simply an abbreviation of the ingredient.
| Product | Contains |
|---|---|
| ACC 200 | Acetylcysteine 200 mg effervescent tablet |
| ACC 600 | Acetylcysteine 600 mg effervescent tablet |
| ACC oral solution | Acetylcysteine 20 mg/ml |
The strength difference is about how often you take it, not how severe your cough is. A lower strength is generally taken more frequently through the day, a higher strength less often. Follow the pack instructions.
Acetylcysteine is a mucolytic, and it works chemically rather than by suppressing anything. Mucus owes its thickness to long protein chains held together by disulphide bridges. Acetylcysteine carries a free sulfhydryl group that breaks those bridges, cutting the chains apart. The mucus becomes thinner and less sticky, so the airways’ natural clearing mechanisms — the cilia and the cough reflex — can move it.
This makes it the opposite of a cough suppressant, and the distinction genuinely matters:
- A mucolytic thins mucus so you can cough it up. It may briefly make you cough more — which is the medicine working, not failing.
- A suppressant such as codeine or dextromethorphan reduces the urge to cough.
Suppressing a productive cough is usually the wrong approach. If there is mucus in the airways, it needs to come out; stopping the cough leaves it there. The two types of cough medicine should not be combined without advice, since they work against each other.
Acetylcysteine has a second, unrelated hospital use: it is the antidote for paracetamol overdose, given intravenously. That is a different setting entirely and not what these tablets are for.
What is Acc commonly used for?
- Chesty, productive coughs where mucus is thick and difficult to clear.
- Acute bronchitis, to help clear secretions.
- COPD and chronic bronchitis, where thick mucus is an ongoing problem.
- Bronchiectasis, where mucus clearance is impaired.
- Cystic fibrosis, as part of specialist management.
- Sinusitis with thick secretions, sometimes.
It does not treat infection. ACC has no antibacterial or antiviral action — it makes mucus easier to move while the underlying illness resolves or is treated separately.
It is not for a dry, tickly cough. With no mucus to thin, there is nothing for it to act on.
Drink plenty of water while taking it. Hydration genuinely helps thin secretions, and a mucolytic works better in someone who is well hydrated. This is not a throwaway instruction — it is part of how the treatment works.
How Acc fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Mucolytics | Acetylcysteine (ACC), bromhexine, carbocisteine | Thin mucus so it can be cleared |
| Expectorants | Guaifenesin | Intended to loosen secretions |
| Cough suppressants | Codeine, dextromethorphan | Reduce the urge to cough — for dry coughs |
| Antihistamines | Cetirizine, chlorphenamine | Allergic symptoms |
| Decongestants | Pseudoephedrine, oxymetazoline | Nasal blockage, short-term |
| Bronchodilators | Salbutamol | Open narrowed airways in asthma and COPD |
Matching the medicine to the type of cough is the single most useful thing to get right. See the allergy, cold, flu and respiratory medicines hub.
What to check before using Acc
Dissolve the effervescent tablet fully in a glass of water and drink it. It has a characteristic sulphurous smell — this is normal and comes from the sulphur group that does the work.
Do not take it at the same time as an antibiotic. Acetylcysteine can interact with some antibiotics in the gut and reduce their absorption. Separate them by about two hours.
Do not combine it with a cough suppressant without advice. Thinning mucus while suppressing the cough that clears it can allow secretions to accumulate.
Speak to a pharmacist or doctor first if you:
- Have asthma. Acetylcysteine can occasionally trigger bronchospasm, so use it with caution and stop if wheezing develops.
- Have a history of stomach ulcers or gastritis.
- Have kidney or liver disease.
- Have difficulty coughing effectively, or a weak cough — thinned secretions still need to be cleared.
- Are pregnant or breastfeeding.
- Are giving it to a child, where suitability depends on age and strength.
- Are diabetic or on a salt-restricted diet. Effervescent tablets contain sodium, and some contain sweeteners — check the label.
- Take other medicines, particularly antibiotics or nitrates.
Possible cautions and when to ask a pharmacist or doctor
Common effects are nausea, vomiting, diarrhoea, heartburn and abdominal discomfort. Taking it with food or after a meal helps. Some people find the smell unpleasant.
Stop and seek medical attention if you develop:
- Wheezing, chest tightness or difficulty breathing — possible bronchospasm, particularly relevant if you have asthma.
- Swelling of the face, lips or tongue.
- A widespread rash, hives, blistering or peeling skin.
- Vomiting blood, or black, tarry stools.
- Severe or persistent vomiting.
See a doctor rather than continuing self-treatment if:
- The cough lasts more than two to three weeks.
- You are coughing up blood.
- You have breathlessness, chest pain, or wheezing.
- You have a high fever, or fever that persists.
- You have unintended weight loss or night sweats. In South Africa these, with a persistent cough, warrant prompt assessment for tuberculosis.
- Mucus is green or foul-smelling with feeling unwell.
- You have COPD or asthma and your symptoms are worsening.
- The cough wakes you at night or is getting worse rather than better.
A persistent cough is a symptom, not a diagnosis. A mucolytic makes it easier to clear secretions; it does not establish why they are there.
Related medicine guides
- Browse Allergy, Cold, Flu & Respiratory Medicines guides
- Read: Austell Cetirizine used for
- Read: Rhineton used for
Frequently asked questions
What is ACC 600 used for? Thinning thick mucus in chesty, productive coughs and conditions such as bronchitis and COPD. Each tablet contains acetylcysteine 600 mg.
What is ACC 200 used for? The same purpose at a lower strength, generally taken more often through the day.
Is ACC a cough syrup that stops coughing? No — the opposite. It thins mucus so you can cough it up. It may briefly increase coughing, which means it is working.
Can I use it for a dry cough? No. With no mucus to thin, it has nothing to act on. A dry cough needs a different approach.
Is ACC an antibiotic? No. It has no effect on infection. Do not take it at the same time as an antibiotic — separate them by about two hours.
Why does it smell like sulphur? The sulphur-containing group is what breaks the bonds holding mucus together. The smell is normal.
Can I take it with a cough suppressant? Not without advice. Suppressing the cough while thinning mucus can let secretions accumulate.
How long should I take it? For a short course while a chesty cough clears. A cough lasting more than two to three weeks needs a doctor.