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It is generally well-tolerated, with the following side effects [9][18]: GI symptoms (most common): Nausea, vomiting, diarrhea, and abdominal discomfort, particularly at doses above 1,200 mg/day Sulfurous taste/smell: NAC has a distinct sulfur odor and taste that some find unpleasant Headache: Occasionally reported Anaphylactoid reactions (IV use only): Infusion-related reactions including flushing, itching, bronchospasm, and hypotension occur in approximately 10-20% of patients receiving IV NAC for acetaminophen overdose [18] Upper limit: There is no established UL for NAC

1 H NMR (400 MHz, Chloroform-d) = 9.30 (d, J = 5.7 Hz, 1H), 8.50 (d, J = 7.9 Hz, 1H), 8.21 8.07 (m, 3H), 7.69 (t, J = 6.8 Hz, 1H), 7.09 (dd, J = 9.3, 4.7 Hz, 2H), 6.17 (d, J = 6.3 Hz, 1H), 5.85 (dd, J = 15.4, 6.5 Hz, 2H), 5.69 (d, J = 6.3 Hz, 1H), 4.37 4.28 (m, 2H), 3.92 (s, 2H), 2.50 (s, 3H), 2.33 2.21 (m, 1H), 2.14 (p, J = 6.1 Hz, 2H), 1.08 (d, J = 6.9 Hz, 3H), 0.99 (d, J = 6.9 Hz, 3H)

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These modified proteins can be taken up by antigen-presenting cells (APCs), processed, and presented to T cells, leading to the activation of autoreactive T cells and the production of autoantibodies