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Mucolytic (recombinant DNase enzyme)

Dornase alfa (recombinant human DNase)

Brand names: Pulmozyme

Dornase alfa is a nebulised recombinant human deoxyribonuclease used to improve mucociliary clearance and lung function in cystic fibrosis. It is given by inhalation via an appropriate nebuliser, usually once daily.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It cleaves the extracellular DNA released from degraded neutrophils that accumulates in purulent cystic fibrosis sputum, markedly reducing its viscosity. Thinner secretions are easier to expectorate.

Prescribing in practice

  • It must only be given by inhalation through a recommended nebuliser and must never be diluted or mixed with other solutions in the chamber, to preserve activity and avoid contamination.
  • Voice changes (hoarseness), pharyngitis, and transient lung-function dips can occur but rarely require discontinuation.
  • It is not interchangeable with oral mucolytics and is reserved for cystic fibrosis.

Monitoring

Monitor lung function and symptomatic response, and review correct nebuliser use and device maintenance.

Counselling the patient

  • Use only your recommended nebuliser and do not mix it with any other medicine.
  • A temporary hoarse voice or sore throat may occur and usually settles.
  • Clean and maintain the nebuliser regularly to keep it working properly.

Evidence & guidelines

Dornase alfa is established in UK cystic fibrosis care for improving lung function and reducing exacerbations as part of airway clearance.

Reference: SmPC Pulmozyme; CF Trust Standards of Care 2024; Fuchs et al. NEJM 1994; 331:637; NICE NG78 (CF management); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways