3.7 Mucolytics

Carbocisteine
  • Capsules 375mg (£15.69 = 2.25g daily)
  • Oral liquid 250mg/5ml (£35.24 = 2.25g daily)
  • Sachets 750mg/10ml sugar-free oral solution (£21.56= 2.25g daily)

Indications

  • COPD patients with a chronic cough productive of sputum

Dose

  • Initially 2.25g daily in divided doses, then 1.5g daily in divided doses as condition improves; child 2–5 years 62.5–125mg 4 times daily, 5–12 years 250mg 3 times daily

Notes

  1. Carbocisteine sachets are licensed for adults and children over 15 years for recent respiratory disorder with expectoration difficulties.
  2. Mucolytic therapy can be considered for patients with a chronic productive cough and continued only if there is symptomatic improvement following a 4-week trial.
Dornase alfa
  • Nebuliser solution 1,000 units/ml

Indications

  • Cystic fibrosis

Notes

  1. For use undiluted with jet nebulisers only; ultrasonic nebulisers are unsuitable
Ivacaftor
  • Tablets 150mg

Notes

  1. See NHS England Clinical Commissioning Policy: Ivacaftor for Cystic Fibrosis
Lumacaftor/Ivacaftor (Orkambi®)
  • NICE TA398 Lumacaftor-ivacaftor is not recommended for treating cystic fibrosis homozygous for the F508del mutation (July 2016)

Mannitol

Mannitol
  • Inhalation powder, hard capsule 40mg

Notes

  1. See NICE TA266 Cystic fibrosis - mannitol dry powder for inhalation (November 2012)

 

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