3.7 Mucolytics

  • 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)


  • Patients with a chronic cough productive of sputum


  • 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


  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 2500 units in 2.5ml


  • Management of cystic fibrosis patients with a forced vital capacity (FVC) of greater than 40% of predicted to improve pulmonary function


  1. A Jet Nebuliser used exclusively for dornase alfa is required for administration
  • Tablets 150mg


  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)
  • Inhalation powder, hard capsule (for use with disposable inhaler device) mannitol 40mg


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


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