3.7 Mucolytics

General guidance

• Mucolytics are sometimes prescribed to facilitate expectoration by reducing sputum viscosity in chronic asthma and bronchitis. However, efficacy data is generally lacking and their use should be avoided.
• Steam inhalation with postural drainage, is good expectorant therapy in bronchiectasis and chronic bronchitis.
• Dornase alfa is used in cystic fibrosis, it should only be initiated and treatment assessed by suitable specialists.

Recommended drugs

Dornase Alfa

Carbocisteine

N-Acetylcysteine for patients with fibrosing alveolitis 

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low