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The professional's guide to product selection
The professional's guide to product selection
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.
When administered by inhalation, mannitol improves mucus clearance. It is licensed for use as an adjunct therapy in the treatment of cystic fibrosis. Assessment for bronchial hyper-responsiveness to inhaled mannitol must be undertaken before commencing the therapeutic dose regimen. An initiation dose assessment must be carried out under medical supervision. Details of the initiation dose regimen can be found in the product literature.
The Scottish Medicines Consortium stated that mannitol (Bronchitol) was only accepted for restricted use within NHS Scotland for the treatment of cystic fibrosis in adults aged 18 years and over as an adjunct therapy to best standard of care. Mannitol is only available to patients who did not respond to, where intolerant of, or were not eligible for dornase alfa and have rapidly declining lung function. Other osmotic agents must also be ruled out as unsuitable. For further ifnormation see: https://www.scottishmedicines.org.uk/medicines-advice/mannitol-bronchitol-resubmission-83713/
Please refer to the NICE guidance: Mannitol dry powder for inhalation for treating cystic fibrosis, available at: https://www.nice.org.uk/guidance/ta266
Manufactorer suggests caution in renal impairment and to avoid in pregnancy and breast feeding.
Inhalation powder
Inhalation powder
Bronchitol 40 mg, 10 capsules with 1 disposable inhaler device
Bronchitol 40 mg, 280 capsules with 2 disposable inhaler devices
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.
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.
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.
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.
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.
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.