Mucolytics: use, side effects, dosage, precautions.

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Mucolytics are a class of medications used to thin and thin mucus, making it easier to clear from the airways. They are used to treat respiratory conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, and other conditions, including the common cold, which is characterized by excess mucus and a productive cough.

Types of mucoactive agents include expectorants, mucolytics, mucoregulators, and mucokinetics, and they are often taken orally or inhaled through a nebulizer. Mucolytics work best when taken consistently.

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Applications

Excess mucus production in the lungs, which is usually seen in COPD or sometimes lower respiratory tract infections, is caused by inflammation, leading to an increase in both the number and size of the so-called goblet cells that line the airways.

While goblet cells generally secrete mucus as a defense, for example in COPD, overproduction can clog the ducts, making it difficult to breathe.

One way to get rid of this buildup is with an oral or aerosol medicine called a mucolytic. Mucolytics dissolve chemical bonds in secretions and break them down to facilitate throat clearing.

Your healthcare provider may prescribe or recommend a mucolytic if thick mucus is a major contributing factor to your symptoms. You usually only take one mucolytic and they are usually used short-term, but some people need to take the mucolytic again if the condition recurs.

Use not indicated on the label

Although mucolytics are not considered part of the current standard treatment for COPD , the 2017 guidelines issued by the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) suggest that these medications may be helpful for people who cannot take inhaled corticosteroids . They can also be helpful for those who have trouble with manual inhalers.

Given concerns about the safety of long-term use of corticosteroids, it has been suggested that mucolytics may be appropriate in advanced COPD when the risk of exacerbation is high regardless of steroid use. In these cases, mucolytics can help reduce flare-ups and improve quality of life.

Before drinking

Mucolytics can be taken orally in the form of tablets or syrup, or inhaled through a nebulizer . Some of the more common types of mucolytics include:

  • Mucinex (guaifenesin)
  • Carbocysteine
  • Pulmozyme (dornase alfa)
  • Erdosteine
  • Metcysteine
  • Bromhexine
  • Hyperosmolar saline solution
  • Mannitol powder

Different types of mucolytic agents have different effects:

  • Expectorants increase the water in the airways to help clear mucus.
  • Mucoregulators increase mucus movement when coughing.
  • Mucokinetics suppress the mechanisms that cause excessive mucus secretion.

Carbocysteine, for example, is a mucolytic that acts on goblet cell metabolism and also has antioxidant and anti-inflammatory properties. In contrast, guaifenesin increases the water content of mucus, making it thinner so you can cough.

Your healthcare provider will determine which mucolytic you are taking based on your symptoms and other medications you are taking.

Precautions and contraindications.

Most mucolytics are very safe, but they should not be used in children under 6 years of age. Do not take mucolytics if you have a stomach ulcer.

Talk to your doctor or pharmacist before taking mucolytics if you are pregnant or breastfeeding.

Dose

The dose of mucolytics depends on the type of medicine you are taking and the condition you are taking it for, and whether you are taking a pill, liquid, or nebulizer. Since some mucolytics do not stay in the body for long, you may need to take them continuously over a period of time.

Talk to your doctor about the correct dose, route of administration, and duration for your condition.

Side effects

Side effects can also vary depending on the type of drug and its composition. Generally speaking, nausea and diarrhea are the most common side effects associated with pills, while fluids can also cause bronchospasm and rashes.

Similarly, aerosol formulations can cause a sore throat, runny nose, and white patches in the mouth or lips.

In general, mucolytics are considered safe and are associated with a low risk of side effects. With that said, it is always important to speak with your healthcare professional about any side effects, interactions, or contraindications associated with a mucolytic product, whether prescribed or purchased over the counter.

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