NICE recommends inhaled mucolytic in cystic fibrosis

New guidance from NICE approves the use of the dry powder mannitol inhaler, Bronchitol, in patients with rapidly deteriorating disease who are unable to take rhDNase or other osmotic agents.

The build-up of mucus in the lungs (as pictured in this X-ray) is broken down by the influx of water into the airway following inhalation of hyperosmotic mannitol | SCIENCE PHOTO LIBRARY

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.

NICE guidance on mannitol dry powder inhalation for cystic fibrosis

Follow MIMS on Twitter

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Already registered?
Sign in

More from MIMS

Products coming soon - live tracker

EXCLUSIVE TO SUBSCRIBERS Monitor forthcoming UK drug...

New products - live tracker

EXCLUSIVE TO SUBSCRIBERS See the latest products added...

An empty tablet blister pack.

Ezetimibe supply update

Availability issues have been reported for the lipid-lowering...

Woman holding blister strip of contraceptive pills

Pharmacists across England to initiate oral contraceptives

Pharmacy Contraception Service (PCS) could allow almost...