Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
3. Respiratory system

3.7. Mucolytics

Preferred List
ACETYLCYSTEINE (NACSYS) (Effervescent tablets)

Prescribing Notes:

  • Prescribe by brand name. Only NACSYS brand is formulary
  • NACSYS effervescent tablets contain 600mg acetylcysteine
  • Discontinue use after 4-6 weeks if the patient fails to derive any benefit

BNF Link

Total Formulary
CARBOCISTEINE

Prescribing Notes:

Discontinue use after 4 weeks if the patient fails to derive any benefit (see BNF).  The dose of carbocisteine should be reduced to a maintenance dose of 1.5g daily in divided doses as the patient's condition improves. Typically, such a dose reduction would be done after one month of treatment

BNF Link

Specialist and GP
DORNASE ALFA

Restrictions:

Restricted to specialist initiation.

Prescribing Notes:

Responsibility for initiation, review and any necessary monitoring rests with specialist service.

BNF Link

Specialist and GP
MANNITOL (BRONCHITOL) (powder for inhalation)

Restrictions:

Restricted to specialist initiation for use in cystic fibrosis patients who are not currently using dornase alfa due to lack of response, intolerance or ineligibility and have rapidly declining lung function and in whom other osmotic agents are considered unsuitable.

BNF Link