PULMOCLEAR Sterile Isotonic 0.9% Sodium Chloride - NaCl Inhalation Sterile Saline Solution for Airway Humification – 20 X 2.5 ml Unit Dose Vial, Pharmaceutical Grade

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Sachets more cost effective and preferred to liquid or consider acetylcysteine (most cost effective option and given Once daily- see above). Common side effects of the disease may include vomiting, nausea, abdominal pain, drowsiness, gastrointestinal discomfort and heartburn. Other symptoms that are rare in occurrence are shortness of breath, loss of appetite, esophageal obstruction, airway inflammation, increased white blood cell count, urticaria, rashes, itching, constipation and diarrhoea. The time duration for which this medicine remains effective in the body is subject to variations based on the form of medicine consumed. It was found that Hypertonic Saline inhaled twice per day reducedepisodes of chest infection and was linked to lung function andquality of life improvement, and better attendance at school or work.

Nottingham and Nottinghamshire ICB, Greener Inhaler Alternatives Medicines Optimisation Toolkit for ADULTS It was found that Hypertonic Saline inhaled twice per day reduced episodes of chest infection and was linked to lung function andquality of life improvement, and better attendance at school or work. Acetylcysteine- Drug Information Portal [Internet]. druginfo.nlm.nih.gov. 2019 [Cited 09 May 2019]. Available from: This dietary supplement is enriched with high fat, low carbohydrate and adequate protein, which helps in breathing, meets high energy requirements during respiration and strengthens respiratory musclesThe medications need to be administered orally post-meal. Do not overuse or eliminate the intake of medication immediately as it can cause several side effects and withdrawal symptoms. Consult your medical professional for the right dosage as per your age, gender and severity of the case. PULMOCLEAR Inhalation Solution is not subject to any age limit restrictions and may therefore also be administered to small children. Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice and has a working experience and knowledge within a speciality area Approved in accordance with the NHS England Clinical Commissioning Policy / Urgent Policy Statements for the treatment of cystic fybrosis in patients aged 4 months and older with named mutations

Approved in accordance with NHS England ClinicalCommissioning UrgentPolicy Statementsfor the treatment ofcystic fibrosis in patients 6 years and older with named mutations. Usedin combination with ivacaftor.The Pulmocare supplement strengthens respiratory muscles and boosts the energy required for the respiration process Ans : Pulmoclear is a xanthine derivative. It contains Acebrophylline and AcetylCysteine as active ingredients. Bronchiectasis: British Thoracic Society Guidelines for the treatment of non-CF bronchiectasis suggest that hypertonic sodium chloridemay be considered for use prior to airway clearance to increasesputum yield, reduce sputum viscosity and improve ease of expectoration (BTS July 2010). Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market. No new patients to receive prescriptions in primary care. Patients already receiving Red Medicines in primary care should be handled on a case by case basis with the support of the Medicines Optimisation team.

Preferred brands in primary care are PulmoClear ® 0.9%, Salineb 0.9%, Knoxzy 0.9% or Respi-Clear ® 0.9%. See Preferred Prescribing List NHS England: Clinical Commissioning Urgent Policy Statement ivacaftor for cystic fibrosis: “off-label” use in patients with named rarer mutations For nebulisation (unlicensed use, not recommended) - Use 1-5mL of 20% injection, diluted up to 5ml with normal saline, TDS. (Higher doses less tolerable). Precede with salbutamol as may cause bronchoconstriction. No conclusive proof of efficacy has yet been found.Ans : Dizziness, drowsiness, chest tightness, cough, and epigastric tenderness, etc are common side effects. PULMOCLEAR Inhalation Solution restores sufficient moisture to the mucous membranes of your respiratory passages, preventing the discomfort of them drying out. This supports the natural cleaning process of the respiratory tract, a noticeably positive contribution in cases of inflammation as well as in cases of increased exposure to dust and air pollution (e.g. caused by dust or tobacco smoke). This medicine is not recommended for use by pregnant women. Consult your doctor immediately if a pregnancy is suspected while taking this medicine.