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Acepiro
Acepiro Prescribe Acepiro
® ®
®
600 mg Effervescent Tablets
600 mg Effervescent Tablets by brand
Acetylcysteine
Acetylcysteine
Stirlescent is the only effervescent naproxen Acepiro is indicated in adults as a mucolytic agent
®
available in the UK . for the treatment of respiratory tract diseases in SIMPLE
1
still want to prescribe which a reduction in bronchial secretion viscosity is
Naproxen Choice of NSAID: Naproxen is one of the first required to facilitate expectoration.
1
choices because it combines good efficacy
with a low incidence of side-effects . EFFECTIVE
2
Prescribing Acepiro by brand is the least
®
Contraindicated in patients with moderate or expensive way of prescribing a mucolytic even
severe renal impairment. compared to prescribing by generic name . ECONOMICAL
2,3
®
Naproxen is the most widely prescribed NSAID Prescribing Acepiro (Acetylcysteine
Can’t 3 600 mg effervescent tablets) by brand would save
swallow in England, Scotland and Wales . £18.26m to the NHS when compared to generic
For the treatment of rheumatoid arthritis, Carbocisteine, Mucodyne , generic Acetylcysteine
®
Don’t osteoarthritis, ankylosing spondylitis, acute and Nacsys . (PACT data to February 2023).
®
give me musculoskeletal disorders, dysmenorrhoea and
syrup acute gout in patients aged 18 years or over with Manufacturer Discount Scheme available to
Don’t a creatinine clearance of at least 30 ml/min. 30%
crush dispensing practices offering a discount of
tablets Manufacturer Discount Scheme
NHS
available to dispensing practices 30% Product Code Price MDS Net Rebate
PIP
Don’t like offering a discount of
tablets Acepiro 600mg 4197638 £3.65 30% £2.56 £1.09
®
effervescent tablets x20
Prefer to Product PIP NHS MDS Net Rebate
®
dissolve in Code Price *Compared to generic and branded carbocisteine and generic and branded acetylcysteine (Nacsys ).
water Stirlescent 250 mg
®
Effervescent tablets 4022232 £52.72 40% £31.63 £21.09 Acepiro 600 mg effervescent tablets – Abbreviated have been reported by at least one in a thousand and less than one in a hundred
®
x20 Prescribing Information patients treated with acetylcysteine – hypersensitivity reactions, headache, tinnitus,
tachycardia, stomatitis, abdominal pain, nausea, vomiting, diarrhoea, pruritus,
Please refer to the Summary of Product Characteristics (SmPC) before prescribing urticaria, exanthema, rash, angioedema, pyrexia and lowered blood pressure. The
Acepiro 600mg effervescent tablets. incidence of facial oedema has not been established. Overdose There have been
®
no reports of toxic overdose with oral acetylcysteine. In the case of an overdose of
Stirlescent ® a clear solution Each tablet contains 600 mg acetylcysteine. Uses Acepiro is indicated in adults as a Acepiro , management should be supportive. Effects on the ability to drive and/or
®
®
mucolytic agent for the treatment of respiratory tract diseases in which a reduction
operate machines Acepiro has no effect on the ability to drive or operate machines.
®
in bronchial secretion viscosity is required to facilitate expectoration. Dosage and
Administration One tablet daily after food. Each tablet should be dissolved in half a Legal category: POM
glass of water. Duration of therapy should be determined by the treating physician. Pack size: 20 or 30 effervescent tablets in strips of laminated aluminium paper foil.
Stirlescent 250 mg Effervescent Tablets – such as oral corticosteroids, warfarin, low dose aspirin, other NSAIDs, antiplatelet Special Warnings and Precautions Hypersensitivity to the active substance or Shelf life: 3 years.
®
®
Abbreviated Prescribing Information agents or selective serotonin-reuptake inhibitors. Stirlescent should be discontinued to any of the excipients. Acepiro should not be used by adolescents or children. NHS price: 20 effervescent tablets = £3.65
at the first sign of a skin rash, mucosal lesion or any other sign of hypersensitivity.
Use with caution in patients with a history of asthma or bronchospasm. Should
Please refer to the appropriate Summary of Product Characteristics (SmPC) before Monitoring of renal function is recommended in patients with impaired renal bronchospasm occur Acepiro should be discontinued immediately. Very rarely, 30 effervescent tablets = £4.40
®
function, cardiac impairment, liver dysfunction, those taking diuretics, angiotensin
prescribing naproxen 250 mg effervescent tablets. converting enzyme inhibitors, angiotensin-II receptor antagonists and the elderly. serious skin reactions such as Stevens-Johnson syndrome and Lyell syndrome have Marketing Authorisation Holder: Stirling Anglian Pharmaceuticals Ltd, Hillington
Each tablet contains 250 mg of naproxen with 341.89 mg of sodium and the following Interaction with other medicinal products Refer to the SmPC for detailed advice. been reported. Patients should be advised to seek immediate medical advice in the Park Innovation Centre, 1 Ainslie Road, Hillington Park, Glasgow G52 4RU
excipients – anhydrous citric acid, sodium hydrogen carbonate, anhydrous sodium SmPC Use in pregnancy and lactation: Stirlescent is contraindicated in the third presence of new skin or mucosal lesions. Administer with caution in patients with Marketing Authorisation Number: PL 42582/0015
carbonate, sodium cyclamate, saccharin sodium, sodium citrate, povidone K30, trimester. Do not use naproxen during labour or breastfeeding. Do not use during a reduced cough reflex for example elderly or frail patients. Postural drainage and
macrogol 6000, mannitol, simeticone, docusate sodium and flavour Cassis ‘NAP’, the first two trimesters unless the benefits outweigh the perceived risks. Ability broncho-aspiration should be performed in patients unable to cough up bronchial Further information is available at medinfo@stirlinganglianpharmaceuticals.com
code 410. Indications: For the treatment of rheumatoid arthritis, osteoarthritis, to drive and use machinery: If affected by dizziness, drowsiness do not drive or secretions effectively. Incompletely dissolved tablets present a risk of choking and or via the office number 0141 585 6352
ankylosing spondylitis, acute musculoskeletal disorders, dysmenorrhoea and acute operate machinery. Overdose: Refer to the SmPC for detailed advice. aspiration, particularly to elderly patients. Use with caution in patients with a history Date of preparation: 23 December 2022
gout in patients aged 18 years or over with a creatinine clearance of at least 30 of peptic ulcer disease or histamine intolerance. Hepatic and renal impairment
ml/min. Dosage and administration: Rheumatoid arthritis, osteoarthritis and Legal category: POM can reduce clearance and increase systemic acetylcysteine plasma levels which Unique Code: API-004-22-001 2.0
ankylosing spondylitis: Initially 250 mg twice daily, increasing if necessary to 500 Pack size: 20 effervescent tablets in polypropylene tubes with desiccant included in may result in an increase in adverse drug reactions due to drug accumulation.
mg twice daily. Acute musculoskeletal conditions and dysmenorrhoea: Initial the stopper. Shelf life: 36 months. NHS list price: 20 effervescent tablets = £52.72 Contraindications Hereditary problems of galactose intolerance, total lactase
dose of 500 mg followed by 250 mg every 6–8 hours. Maximum dose after the first Marketing Authorisation Holder: Stirling Anglian Pharmaceuticals Ltd, Hillington deficiency or glucose-galactose malabsorption. Interactions with other medicinal Adverse events should be reported. Reporting forms and information can 0040030021 v 1.0 | Date of preparation: May 2023
day is 5 tablets daily. Acute gout: Initial dose of 750 mg followed by 250 mg every Park Innovation Centre, 1 Ainslie Road, Hillington Park, Glasgow G52 4RU, United products In vitro tests indicate that (tetracycline, aminoglycosides and penicillin be found at http://yellowcard.mhra.gov.uk or downloaded from Google Play
8 hours until the attack has passed. Elderly patients: Use the lowest effective dose Kingdom. are inactivated when mixed directly with acetylcysteine. Where concomitant use
for the shortest possible duration. Renal/Hepatic impairment: Consider lowering of Acepiro and oral antibiotics is required, separate administration by an interval or the Apple App store. Adverse events should also be reported to JensonR+
®
the dose in patients with renal or hepatic impairment. Method of administration: Marketing Authorisation Number: PL42582/0009 of at least two hours. Acetylcysteine may potentiate the vasodilatory effect of on 01271 314 320 or Stirling Anglian Pharmaceuticals on 0141 585 6352.
Doses of 1 to 2 tablets must be dissolved in at least 150 ml (a glass) of water and Further information is available at medinfo@stirlinganglianpharmaceuticals.com nitroglycerine. Do not administer concurrently with ACE inhibitors or antitussives.
doses of 3 to 4 tablets must be dissolved in 300 ml of water. Preferably to be taken or via the office number 0141 585 6352 Acetylcysteine may reduce the bioavailability of certain heavy metal salts and should
with or after food. Contraindications: Hypersensitivity to the active drug or any of be taken separately at different times of the day. Pregnancy fertility and Lactation
the other excipients, Active peptic ulcer or GI haemorrhage, History of recurrent Date of preparation: November 2017 Administration of acetylcysteine during pregnancy and lactation should take
peptic ulceration, perforation or GI haemorrhage, previous hypersensitivity Unique Code: STIPI 171101 Stirlescent place only after a strict risk benefit assessment. Side Effects The following events
reactions to aspirin, ibuprofen or other NSAIDs, Severe hepatic, renal or cardiac
failure. Stirlescent should not be administered at the same time as any other NSAID.
Use with caution in patients with asthma or allergic disorders hypertension or mild Adverse events should be reported. Reporting forms and information can 0030030017 v 1.0 | Date of preparation: May 2023
to moderate congestive heart failure. Patients at high risk of GI bleeding, ulceration be found at http://yellowcard.mhra.gov.uk or downloaded from Google Play
or perforation should be considered for co-prescribing of a gastroprotective agent or the Apple App store. Adverse events should also be reported to JensonR+
such as misoprostol or a proton pump inhibitor. Caution is necessary in patients on 01271 314 320 or Stirling Anglian Pharmaceuticals on 0141 585 6352.
receiving other medication that could increase the risk of ulceration or bleeding
References References:
1. BNF Naproxen products available at https://bnf.nice.org.uk/drugs/naproxen/medicinal-forms/#effervescent-tablet. Date accessed May 2023 1. Acepiro Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/product/13849/. Date accessed May 2023
2. BNF. Choice of NSAID available at https://bnf.nice.org.uk/treatment-summaries/non-steroidal-anti-inflammatory-drugs/. Date accessed May 2023 2. British National Formulary available at https://bnf.nice.org.uk/drugs/acetylcysteine. Date accessed May 2023
3. Haymarket Medical Media. MIMS. Available at: http://www.mims.co.uk/. Date accessed May 2023 3. NHS England and Wales Drug Tariff March 2023 available at https://www.drugtariff.nhsbsa.nhs.uk/#/00834576-DD_1/DD00834564/Home. Date accessed May 2023
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