Mannitol Dry Powder for Inhalation for Treating Cystic Fibrosis (TA266)

Technology Appraisal Guidance No. 266

Source: National Institute for Health and Care Excellence

1. Guidance

1.1 Mannitol dry powder for inhalation is recommended as an option for treating cystic fibrosis in adults:

  • who cannot use rhDNase because of ineligibility, intolerance or inadequate response to rhDNase and
  • whose lung function is rapidly declining (forced expiratory volume in 1 second [FEV1] decline greater than 2% annually) and
  • for whom other osmotic agents are not considered appropriate.

1.2 People currently receiving mannitol whose cystic fibrosis does not meet the criteria in 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.

The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at

This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

© Copyright National Institute for Health and Care Excellence. All rights reserved. This material may be freely reproduced for educational and not for profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute.

Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA.

Mannitol dry powder for inhalation for treating cystic fibrosis
Issue Date: November 2012

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