Oral mucolytics
- There is currently no high-quality evidence base for oral mucolytic therapy in people with bronchiectasis, however carbocisteine and acetylcysteine are widely used in Scotland to improve sputum clearance. Their use should be accompanied by support for airway clearance techniques.
- Acetylcysteine has once daily dosing which may assist with adherence to therapy.
- At least annual review of effectiveness of oral mucolytics is strongly recommended if either agents are trialled in any individual.
- If a mucolytic is started in secondary care it can be reviewed in either primary or secondary care for effectiveness. See the chart in the prescribing of mucolytics for prescribing in different Health Boards.
- Acetylcysteine should not be given at the same time of day as antibiotic therapy as it potentially reduces antibiotic absorption.