Safety and Efficacy Study of a New Formulation of Acetylcysteine Injection

This study has been terminated.
Information provided by (Responsible Party):
Cumberland Pharmaceuticals Identifier:
First received: May 4, 2010
Last updated: June 21, 2013
Last verified: June 2013

The primary purpose of this study is determine if a new formulation of Acetadote is at least as effective as the current formulation in the prevention and treatment of acetaminophen overdose related liver injury.

Condition Intervention Phase
Acetaminophen Overdose
Drug: Acetadote EF [Ethylenediaminetetraacetic Acid (EDTA) - Free]
Drug: Acetadote
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multi-center, Double-blind, Randomized, Controlled Study to Determine the Efficacy and Safety of a New Formulation of Acetylcysteine Injection

Resource links provided by NLM:

Further study details as provided by Cumberland Pharmaceuticals:

Primary Outcome Measures:
  • The incidence of hepatoxicity [ Time Frame: 21 hours ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • The percentage of subjects requiring continued therapy [ Time Frame: 21 hours ] [ Designated as safety issue: No ]
  • The incidence of hepatoxicity [ Time Frame: 42 hours ] [ Designated as safety issue: No ]
  • Incidence of treatment emergent adverse events [ Time Frame: 21-42 hours ] [ Designated as safety issue: Yes ]
  • Incidence of anaphylactoid reaction. [ Time Frame: 1 hour ] [ Designated as safety issue: Yes ]

Enrollment: 17
Study Start Date: September 2010
Study Completion Date: May 2013
Primary Completion Date: November 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Acetadote without EDTA
Acetadote EF [Ethylenediaminetetraacetic Acid (EDTA) - Free]
Drug: Acetadote EF [Ethylenediaminetetraacetic Acid (EDTA) - Free]
Acetadote EF [Ethylenediaminetetraacetic Acid (EDTA) - Free] {new formulation} 200 mg/kg in 1000 ml diluent over 4 hours; then 100 mg/kg in 1000 ml diluent over 16 hours
Other Name: acetylcysteine
Active Comparator: Acetadote
Acetadote [Old formulation containing EDTA]
Drug: Acetadote
Acetadote [old formulation] 150 mg/kg in 200 mL diluent over 60 minutes; then Acetadote 50 mg/kg in 500 mL diluent over 4 hours; then Acetadote 100 mg/kg in 1000 mL diluent over 16 hours.
Other Name: acetylcysteine

Detailed Description:

The primary objective of this study is to demonstrate non-inferiority of efficacy determined by the proportion of subjects who develop hepatotoxicity when treated with a new formulation of Acetadote and the proposed new dosing regimen compared to the rate of hepatotoxicity with the current formulation of Acetadote and the current dosing regimen.


Ages Eligible for Study:   12 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

1) Any subject requiring treatment with acetylcysteine for acute acetaminophen toxicity

Exclusion Criteria:

  1. History of allergy or hypersensitivity to acetylcysteine or any component of Acetadote.
  2. Exposed to investigational drugs within 30 days before Clinical Trial Material (CTM) administration.
  3. Pregnant or nursing.
  4. Less than 12 years of age.
  5. Have a baseline alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >1000 U/L.
  6. Have a baseline International Normalized. Ratio (INR) > 2.0
  7. Be on dialysis or having existing renal injury such that the volume of the study drug administration would render the patient unsuitable for the study, in the opinion of the investigator.
  8. Have congestive heart failure such that the volume of the study drug administration would render the patient unsuitable for the study, in the opinion of the investigator.
  9. Inability to understand the requirements of the study. Subjects must be willing to provide written informed consent or consent of parent/legal guardian (as evidenced by signature on an informed consent document approved by an Institutional Review Board [IRB]), and agree to abide by the study restrictions. (If the subject is incapacitated, informed consent will be sought from a legally acceptable representative).
  10. Refusal to provide written authorization for use and disclosure of protected health information.
  11. Be otherwise unsuitable for the study, in the opinion of the Investigator.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01118663

United States, Arizona
Maricopa Medical Center
Phoenix, Arizona, United States, 85008
United States, California
Loma Linda University Medical Center
Loma Linda, California, United States, 92350
University of California Irvine Medical Center
Orange, California, United States, 92868
UCSD Medical Center
San Diego, California, United States, 92103
United States, Colorado
University of Colorado Hospital
Aurora, Colorado, United States, 80045
Denver Health and Hospital Authority
Denver, Colorado, United States, 80204
United States, Connecticut
Hartford Hospital
Hartford, Connecticut, United States, 06102
United States, Louisiana
LSU Health Sciences Center - Shreveport
Shreveport, Louisiana, United States, 71130
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
UMass Memorial Medical Center
Worcester, Massachusetts, United States, 01655
United States, Michigan
Spectrum Health Butterworth Hospital
Grand Rapids, Michigan, United States, 44506
United States, North Carolina
East Carolina University Medical Center
Greenville, North Carolina, United States, 27834
United States, Ohio
Toledo Hospital
Toledo, Ohio, United States, 43606
United States, Texas
Scott & White Medical Center
Temple, Texas, United States, 76508
Sponsors and Collaborators
Cumberland Pharmaceuticals
Study Director: Art Wheeler, MD Cumberland Pharmaceuticals Inc
  More Information

Responsible Party: Cumberland Pharmaceuticals Identifier: NCT01118663     History of Changes
Other Study ID Numbers: CPI-NAC-001
Study First Received: May 4, 2010
Last Updated: June 21, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Cumberland Pharmaceuticals:
Acetaminophen overdose; induced hepatotoxicity, liver injury

Additional relevant MeSH terms:
Substance-Related Disorders
Pentetic Acid
Edetic Acid
Antiviral Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions
Respiratory System Agents
Free Radical Scavengers
Molecular Mechanisms of Pharmacological Action
Protective Agents
Physiological Effects of Drugs
Chelating Agents
Iron Chelating Agents
Hematologic Agents processed this record on July 29, 2014