NAC in COVID-19 Protocol

Concept: Administer NAC for symptomatic patients with respiratory sxs/findings (especially O2 requirement) to prevent progression to cytokine storm and development of ARDS

Goal is to enhance the body's immune response without letting it be overwhelmed by the same immune response.

NAC in COVID-19 Protocol

  • Pt's clinical picture should be at a phase where the body is already mounting an immune response; not given when completely asymptomatic (not given prophylactically).

  • Update 12/8/2020 - Administer if any influenza-like symptom is present:

    • diarrhea

    • vomiting

    • fever (subjective or measured)

    • chills

    • myalgias

    • fatigue

    • sore throat

    • headache

    • cough

    • nasal/sinus congestion or rhinorrhea

    • shortness of breath

    • chest pain


NAC DOSING

Outpatient dosing:

  • 2400 mg PO x 1 (using NAC 600 mg capsules x 4)

  • Rx for 1200 mg PO BID x 2 weeks


For patients with moderate symptoms requiring admission to the hospital (any level of care) and who are able to tolerate POs:

  • Order 150 mg/kg/day divided q4hrs = 25 mg/kg PO rounded up to nearest 600 mg q4hrs

  • Inpatient units to continue with

      • 25 mg/kg [rounded UP to nearest 600 mg] PO q4hrs until discharge

      • discharge on 1200 mg PO BID x 2 weeks