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

  • 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 2500 units in 2.5ml

Indication

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

Notes

  1. A Jet Nebuliser used exclusively for dornase alfa is required for administration
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
  • Inhalation powder, hard capsule (for use with disposable inhaler device) mannitol 40mg

Notes

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

 

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