Hoarseness with Pulmozyme® (rhDNAse)- what to do?

Question

Dear expert team,

For 2 days I inhale one time daily with Pulmozyme® (rhDNAse). From today on, a strong hoarseness has begun. If it should continue to such an extent, I will be forced to discontinue Pulmozyme®, as in my case the voice is all alone important for my profession. Pulmozyme® however, seems to losen my sputum well.

Therefore my questions:
Are there any chances or ways of therapy that the hoarseness may again disappear inspite of continuation of the Pulmozyme® inhalation?
Many thanks for the answer and tips and especially thank you for the running of this forum.

Best regards,

Answer

Hello,

in the package leaflet of Pulmozyme® the occurence of hoarseness is mentioned as a potential side effect. Dependet on the degree of hoarseness a continuation of the therapy with this drug has to be discussed individually. In this case the effect has to be weightened against the side effect (benefit against harm). Before, however, you decide for a discontinuation of the therapy, it has absolutely to be checked if the inhalation is done correctly with respect to the temperature of the inhaled drug. It is important that Pulmozyme® has indeed to be stored in the fridge, however it should not be inhaled at fridge-temperature! Pulmozyme® should have room-temperature at the time of inhalation, so do not inhale it directly from the fridge. The cold chain can be interrupted for up to 24 hours, therefore the Pulmozyme® vial to inhale can be removed from the fridge even a few hours before inhalation. The protection against light should however be maintained also outside the fridge. Probably this advice can protect you from hoarseness, as it is the case in many patients. First of all you should pause the inhalation with Pulmozyme® for a few days (until your voice has recovered again) and then start another attempt with adherence to the above mentioned recommendation.

Best regards,
Dr. Christina Smaczny

22.01.2013