Mucolytic Pregnancy: Caution — avoid in first trimester

Carbocisteine (ENT — Mucolytic)

Brand names: Mucodyne

Adult dose

Dose: 750 mg TDS (with meals) initially, reduce to 375 mg TDS when mucus normalises

Route: Oral

Frequency: TDS

Max: 2250 mg/day

For chronic sinusitis, chronic otitis media with effusion (glue ear), and COPD with excessive mucus. Reduces sputum viscosity. Used to facilitate drainage in ENT conditions.

Paediatric dose

Route: Oral syrup

Frequency: BD–TDS

Max: 750 mg/day

Concentration: 125 mg/5 mL or 250 mg/5 mL mg/ml

Children 2–5 years: 62.5–125 mg TDS. Children 5–12 years: 250 mg TDS. Reduce to BD after improvement.

Dose adjustments

Renal

No dose adjustment required

Hepatic

Caution in severe hepatic impairment

Clinical pearls

Otitis media with effusion (glue ear): mucolytics may help drain middle ear mucus in chronic OME; limited evidence but commonly prescribed in practice
Chronic rhinosinusitis: adjunct to saline irrigation and intranasal steroids — mucolytic reduces mucus viscosity and improves sinonasal drainage
Cochrane review: mucolytics reduce COPD exacerbation rates — also applies in recurrent sinusitis

Contraindications

Active peptic ulcer disease

Side effects

Nausea
GI disturbance
Rash (rare)

Interactions

None significant

Monitoring

Symptom improvement (mucus viscosity, drainage)
GI symptoms

Reference: BNFc; BNF; ENT-UK Sinusitis Guidelines; Cochrane Review. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways