Adult patients with cystic fibrosis are set to benefit from the approval of the Pharmaxis product Bronchitol following the publication of the latest technology appraisals from NICE. However, use is restricted to patients:
- who cannot receive recombinant human deoxyribonuclease (rhDNase) owing to ineligibility, intolerance or who have not adequately responded to rhDNase and
- whose forced expiratory volume in 1 second (FEV1) has declined by >2% annually and
- for whom other osmotic agents are inappropriate.
Initiation and dosage recommendations
Before starting dosing with the inhaler, patients must be assessed for bronchial hyperresponsiveness to inhaled mannitol according to the SPC. Following initial dose assessment, the recommended dosage is 400mg (contents of 10 capsules) inhaled using the provided inhaler twice daily.