Mucoclear® (hypertonic saline)

Question

Hello,
Is RhDNase (Pulmozyme®) more efficient than hypertonic saline (Mucoclear®) ? I have observed that nebulization of hypertonic saline induced more sputum in my son. It’s really efficient for him in term of fluidity. He feels well cleared. Tolerance is excellent. Therefore the physiotherapist of the CF centre said that a maximum of 3 nebulizations per week would be enough because of a possible irritation. I don’t understand why this treatment has to be limited as tolerance is excellent in my son and benefice is evident ?

Answer

Hello,
RhDNase and 7% hypertonic saline are mucoregulators with different mechanisms of action. For different more or less known reasons, some patients have a better effect with the one or the other drug. Tolerance is usually good, but some patients may cough, wheeze or even have a bleeding in the bronchi because of irritation. The higher the daily number of inhaled treatments (1 or 2 mucoregulators, antibiotics, etc.), the higher is the risk of bad tolerance. That’s maybe why your physiotherapist recommended to reduce the number of nebulizations. However, the nebulization of 7% hypertonic saline, has been full validated with 4 ml two times a day for nearly 1 year.
I hope I have answered your questions. With my best regards,
Prof Jean-Christophe Dubus

03.12.2014