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Types of Mucus Thinners Used to Treat Cystic Fibrosis

Just as the name implies, mucus thinner (mucolytics) help thin the thick, sticky mucus that clogs the airways of people with cystic fibrosis (CF). Mucus thinners are inhaled either before or during airway clearance techniques because they assist with moving the mucus out of the lungs. Getting extra mucus out of the airways helps prevent infections and slows damage to the lungs.

Types of mucus thinners

The most common types of mucus thinners prescribed for people with CF are:

  • Hypertonic saline
  • Dornase alfa (Pulmozyme®)1

If using both, the CF Foundation recommends that hypertonic saline be used first and then dornase alfa. They also recommend that mucus thinners be used after a bronchodilator and before airway clearance techniques. An inhaled antibiotic follows at the end so that the infection-fighting drugs get deeper into the lungs.1 After use, all equipment must be cleaned and disinfected to prevent the spread of germs.

What is hypertonic saline?

Hypertonic saline, a sterile saline solution (salty liquid), comes in concentrations of 3% or 7%. It helps thin mucus by increasing the amount of salt in the airways. This salt attracts water to the mucus, thinning it and making it easier to cough out. Research shows that using hypertonic saline twice a day reduces the number of lung infections in people with CF.2

How is hypertonic saline administered?

Hypertonic saline is most often inhaled as a mist through a nebulizer or compressor. It does not remain in the system, so its benefits are temporary. Anyone prescribed hypertonic saline should buy it from a specialty pharmacy to ensure that the right amount of salt is in the solution. Hypertonic saline should not be taken at the same time as other medications.

Because it is salty, hypertonic saline can damage computers and other electronic equipment. Therefore, it should not be used too close to electronics.

What are side effects of hypertonic saline?

Common side effects of hypertonic saline include:

  • Increased cough
  • Sore throat
  • Tightness in the chest3

What is dornase alfa?

Dornase alfa (Pulmozyme®) also helps thin mucus when inhaled. This drug acts like scissors cutting up the long DNA strands in white blood cells. Cutting the strands into shorter bits helps break up the thick, sticky mucus of CF.

How is dornase alfa administered?

The CF Foundation recommends dornase alfa, or DNase, for people with CF who are age 6 and older to improve lung function and reduce exacerbations.3 Dornase alfa should be refrigerated until it is used. The drug is delivered to the lungs through a nebulizer. The prescription often must be filled at a specialty pharmacy.

What are side effects of dornase alfa?

Common side effects of dornase alfa include:

  • Change of loss of voice
  • Throat discomfort
  • Red, watery eyes
  • Rash
  • Dizziness
  • Fever
  • Runny nose3

If your insurance plan will not cover the cost of hypertonic saline or dornase alfa, contact the CF Foundation’s Compass service for help at:

Phone: 1-844-COMPASS (1-844-266-7277)
Email: [email protected]
Monday – Friday, 9 a.m. – 7 p.m. ET

Written by: Jessica Johns Pool | Last reviewed: September 2019
  1. Mogayzel PJ, et al. Cystic Fibrosis Pulmonary Guidelines. Am J Respir Crit Care Med. 2013;187(7):680-689. doi:10.1164/reccm.201207-1160E.
  2. CF Foundation. Saltwater Solution Offers Novel Therapy for Cystic Fibrosis Patients. Available at: https://www.cff.org/About-Us/Media-Center/Press-Releases/Saltwater-Solution-Offers-Novel-Therapy-for-Cystic-Fibrosis-Patients. Accessed 6/3/2019.
  3. CF Foundation. Mucus Thinners. Available at: https://www.cff.org/Life-With-CF/Treatments-and-Therapies/Medications/Mucus-Thinners. Accessed 6/3/2019.