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Respiratory Handbook

The professional's guide to product selection

Mucolytics

Bronchitol - Mannitol

Mucolytic to facilitate expectoration by reducing sputum viscosity.

• Adult: by inhalation of powder, over initiation dose (see product literature), then 400 mg, twice daily. The dose should be administered 5–15 minutes after a bronchodilator and before physiotherapy. The second daily dose should be taken 2–3 hours before bedtime.

Carbocisteine - AAH Pharmaceuticals Ltd

Reduction of sputum viscosity. 

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Accord Healthcare Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Alliance Healthcare (Distribution) Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Bristol Laboratories

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Brown & Burk UK Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - DE Pharmaceuticals

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Esteve

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Flamingo Pharma (UK) Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Glenmark Pharmaceuticals Europe Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves

Carbocisteine - HBS Healthcare Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Lucis Pharma Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Medihealth (Northern) Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Milpharm Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - NorthStar Healthcare Unlimited Company

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Phoenix Healthcare Distribution Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Roma Pharmaceuticals Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Sigma Pharmaceuticals Plc

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Teva UK Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Typharm

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Viatrus

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Carbocisteine - Zentiva Pharma UK Ltd

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Erdotin - Erdosteine

Mucolytic to facilitate expectoration by reducing sputum viscosity.

• Over 18 years: 300 mg, twice daily for up to 10 days.

Kaftrio - Tezacaftor with Ivacaftor and Elexacaftor

Mucolytic to facilitate expectoration by reducing sputum viscosity in the case of cystic fibrosis.

Kaftrio 37.5 mg/25 mg/500 mg
Child 6–11 years (body-weight up to 30 kg): 2 tablets, to be taken in the morning and, Ivacaftor 75 mg to be taken in the evening (about 12 hours apart).

Kaftrio 75 mg/50 mg/100 mg
Child over 6 years with body weight greater than 30 kgs and adult: 2 tablets to be taken in the morning in combination with Ivacaftor 150 mg in the evening.

Kalydeco - Ivacaftor

A cystic fibrosis transmembrane conductance regulator (CFTR) protein potentiator that increases chloride transport in the abnormal CFTR protein.

By mouth using granules
Child 4–5 months (body-weight 5 kg and above): 25 mg every 12 hours.
Child 6 months–17 years (body-weight 5–6 kg): 25 mg every 12 hours.
Child 6 months–17 years (body-weight 7–13 kg): 50 mg every 12 hours.
Child 6 months–17 years (body-weight 14–24 kg): 75 mg every 12 hours.

By mouth using tablets
Child 6–17 years (body-weight 25 kg and above): 150 mg every 12 hours.
Adult: 150 mg every 12 hours – specialist use only.

MucoClear - Hypertonic sodium chloride

Mucolytic to facilitate expectoration by reducing sputum viscosity.

MucoClear 3%
Inhalation of nebulised solution, 4 ml, 2–4 times daily.
MucoClear 6%
Inhalation of nebulised solution, 4 ml, twice daily.

Mucodyne - Carbocisteine

Mucolytic to facilitate expectoration.

• Child 2–4 years: 62.5–125 mg, 4 times daily
• Child 5–11 years: 250 mg, 3 times daily
• Over 12 years: initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.

Orkambi - Lumacaftor with Ivacaftor

Lumacaftor increases the number of proteins that each the cell surface. Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) protein potentiator that increases chloride transport in the abnormal CFTR protein.

By mouth using granules
Child 2–5 years (body-weight up to 14 kg): 100/125 mg every 12 hours.
Child 2–5 years (body-weight 14 kg and above): 150/188 mg every 12 hours.

By mouth using tablets
Child 6–11 years: 200/250 mg every 12 hours.
Child 12–17 years: 400/250 mg every 12 hours.
Adult: 400/250 mg every 12 hours – specialist use only.

Osmohale - Mannitol - Chapper Healthcare

Mucolytic 

Osmohale is used for an indirect osmotic bronchial challenge test which can be used to identify bronchial hyperresponsiveness, a clinical feature of some respiratory conditions such as asthma.

Contraindications: Use with caution in renal impairment and to avoid in pregnancy. The Osmohale test should not be used in patients below 6 years of age due to their inability to provide reproducible spirometric measurements.

There is limited information on the use of Osmohale in patients 6-18 years of age therefore Osmohale is not recommended in this population.

Dose: See manufacturers’ instructions for more information. The test should be repeated until the patient has a positive response or 635 mg has been administered. 

PulmoClear - Hypertonic sodium chloride

For Inhalation Use Only.

The recommended dose of Hypertonic saline solution for inhalation is one unit-dose vial 2 to 4 times a day, undiluted via a nebuliser.

 

PulmcoClear strength and dose should be individualised based on the status of the patient, age group and should be assessed at regular intervals of symptoms.

 

Pulmozyme - Dornase alfa

Mucolytic to facilitate expectoration by reducing sputum viscosity.

• Over 5 years: inhalation of nebulised solution (by jet nebuliser), 2,500 units (2.5 mg) once daily (patients over 21 years may benefit from twice daily dosage).

Resp-Ease - Hypertonic sodium chloride

Mucolytic to facilitate expectoration by reducing sputum viscosity.

4ml nebuliser solution up to twice daily undiluted. It can be used in conjunction with chest hygiene clearance which has been assessed in secondary care.

Symkevi - Tezacaftor with Ivacaftor

Mucolytic to facilitate expectoration by reducing sputum viscosity in the case of cystic fibrosis.

By mouth
Child 6–11 years (body-weight up to 30 kg): 50/75 mg, to be taken in the morning and, Ivacaftor 75 mg to be taken in the evening (about 12 hours apart).
Child 6–11 years (body-weight 30 kg and above): 100/150 mg, to be taken in the morning and, Ivacaftor 150 mg to be taken in the evening (about 12 hours apart).
Child 12–17 years: 100/150 mg, to be taken in the morning and, Ivacaftor 150 mg to be taken in the evening (about 12 hours apart).
Adult: 100/150 mg, to be taken in the morning in combination with Ivacaftor 150 mg in the evening.