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Bronchitol® and NaCl 5.85%

Question
Dear expert team,
I (26, CF, FEV1 about 65%) inhale for years a lot with NaCl 5.85% (20 minutes in the morning, 30 minutes in the afternoon and 30 minutes in the evening) as I can cough up my suptum very well with this and I breathe easier after this. For a few months, I inhale after that in the morning and evening additionally 10 capsules Bronchitol® (Mannitol) each time, by what I can then also cough up again.

My physiotherapist draw my attention to the point that Bronchitol® would make the inhalation with NaCl needless, as the Bronchitol® alone would losen as much sputum as the combination with NaCl 5.85%.

What is your opinion about this? I do not dare to try it, as I have worries, that I would do worse without NaCl.
Many thanks for your help in advance.
Many greetings,
L.
Answer
Hello L.,
try it!
There are no studies in that both substances have been given, respectively that have compared what happens if one takes both and then stop one.
Your lung function is still relatively good and I would not expect, that it deteriorates if you inhale less NaCl.
Just do it pragmatically: reduce first of all one dosage NaCl and observe - probably with lung function. If it stays the same and you do the same, you go on reducing. Talk with your treating physician, who prescribes you both medications, if he agrees. In the end you could save relatively much time, that you could make use of otherwise.
Best regards,
Prof. Dr. Joachim Bargon
11.12.2013