Mucolytics

Mucolytic therapy should be considered in COPD patients not receiving inhaled corticosteroids with a chronic cough productive of sputum. It may reduce exacerbations, however while a few patients will benefit from this treatment the overall benefits seem to be small.

Mucolytic therapy should NOT be prescribed routinely to prevent exacerbations in people with stable COPD.

  • Prescribe NACSYS® (acetylcysteine) oral 600mg effervescent tablet once daily. Dissolve in half a glass of water preferably in the morning.
  • Review NACSYS® 4 weeks after starting therapy and if no benefit is seen, then discontinue.
  • If a patient is taking antibiotics concurrently it is advised that the antibiotic should be avoided 2 hours before or after NACSYS® administration.
  • Caution is advised in patients on a sodium restricted diet as NACSYS® contains 115mg of sodium per dose in the form of sodium hydrogen carbonate.
  • Acetylcysteine can react with rubber and metal (e.g. iron, nickel, copper) so if administration is required via enteral feeding tubes only glass or plastic delivery systems are recommended.
Guideline reviewed December 2022
Page updated January 2023



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