Mucolytics are medicines that make the mucus (sputum), which is made in your lungs, less thick and sticky and easier to cough up. They are usually prescribed for people who have a chronic (long-term) cough. They work best if they are taken regularly.
What are mucolytics?
Mucolytics are medicines that make the mucus (sputum), which is made in your lungs, less thick and sticky and easier to cough up. They are helpful if you have a chronic (long-term) cough because they help you cough up mucus (sputum) from your lungs.
There are a number of mucolytics available to prescribe in the UK. These include carbocisteine (trade name Mucodyne®), erdosteine (trade name Erdotin®) and mecysteine (trade name Visclair®). These are available as capsules, tablets or oral liquids. Another type of mucolytic available to prescribe is called dornase alfa (trade name Pulmozyme®). This medicine is inhaled via a nebuliser, but is usually only prescribed for people with cystic fibrosis (CF).
How do mucolytics work?
The mucus in your lungs is held together by certain bonds. Mucolytics work by breaking these bonds. When these bonds are broken, the mucus becomes less sticky or less thick and is easier to cough up. This may also have a knock-on effect of making it harder for bacteria (germs) to infect the mucus and cause chest infections.
When are mucolytics prescribed?
They are normally prescribed for people with a chronic (long-term) productive cough. A productive cough is where the lungs make a lot of mucus (sputum) and you cough this up. Examples of people who may have a chronic productive cough include people with chronic obstructive pulmonary disease (COPD) and people with CF.
If you have COPD, they are most likely to help if you have moderate or severe COPD and have frequent or bad flare-ups (exacerbations). The number of flare-ups of symptoms tends to be less in people who take a mucolytic.
Dornase alfa is usually only prescribed for people with CF who have a reduced lung capacity. As well as helping to make it easier to cough up thick mucus, it is also thought to improve how well the lungs work, and it limits any further damage to the lungs. This medicine is usually started by a doctor who specialises in treating patients with CF.
How should I take mucolytics?
Mucolytics work best when they are taken regularly.
Carbocisteine, erdosteine, and mecysteine are usually taken twice a day. Your doctor may stop these medicines if you have taken them for one month and they don't seem to be helping your symptoms.
Dornase alfa is inhaled into the lungs once or twice a day using a machine called a nebuliser.
What about side-effects?
Side-effects of treatment with mucolytics occur only rarely, but some people have reported bleeding from the gastrointestinal tract (gut) - this is rare. If you develop black stools (faeces), stop taking carbocisteine, erdosteine, or mecysteine and let your doctor know as soon as possible. Black stools are a sign of bleeding from the gut.
Who cannot have mucolytics?
Most people are able to take a mucolytic; however, they should not be used in people who have a stomach ulcer.
Can I buy mucolytics?
You can only buy mecysteine (trade name Visclair®) from a pharmacy. The rest of these medicines require a prescription.
How to use the Yellow Card scheme
If you think you have had a side-effect to one of your medicines, you can report this on the Yellow Card Scheme. You can do this online at the following web address: www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that your medicines may have caused. If you wish to report a side-effect, you will need to provide basic information about:
- The side-effect.
- The name of the medicine which you think caused it.
- Information about the person who had the side-effect.
- Your contact details as the reporter of the side-effect.
It is helpful if you have your medication and/or the leaflet that came with it with you while you fill out the report.
Further help & information
Further reading & references
- Chronic obstructive pulmonary disease; NICE Clinical Guideline (June 2010)
- British National Formulary; 64th Edition (Sep 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Chronic obstructive pulmonary disease; NICE CKS, November 2010 (UK access only)
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Mrs Jenny Whitehall
Mrs Jenny Whitehall
Dr Tim Kenny