Explanation

Dornase alfa (also called Pulmozyme) is a man-made version of an enzyme called DNase, which is made naturally in your body. It is used to treat cystic fibrosis.

What does it do?

Dornase alfa works by breaking down the thick mucus that builds up in your lungs. It thins and loosens the mucus, making it easier to cough up from your lungs. This means you have less chance of getting infections and less chance of your lungs getting more damaged.

What does it look like?

Dornase alfa is a clear, colourless, or slightly yellowish-coloured, liquid that you have to use in a compressed air-driven (jet) nebuliser. It comes in clear plastic ampoules, which come in boxes of either six or 30.

When do I have to take it?

You should use dornase alfa every day. If you don't use it every day, then your symptoms might get worse again.

How do I take it?

You should take dornase alfa through a compressed air-driven (jet) nebuliser . Most types of ultrasonic nebulisers may stop dornase alfa from working the way it should, so you should NOT use them.

If you're unsure, you should talk to your doctor, and he or she will be able to tell you which nebulisers you can use with dornase alfa.

But what if I don't feel like taking it?

It's important that you keep taking your dornase alfa, even if you don't feel like it, or even if you're feeling better. If you stop using dornase alfa, your chest symptoms may get worse. Talk to your doctor if you'd like to stop using it, but don't stop unless he or she says it's okay to do so.

What should I do if I forget to take it or I take too much?

If you forget to take a dose, you should take it as soon as you remember if you are not very late. If it's nearly time for your next dose, you should skip the missed dose and take the next one as planned.

Don't take an extra dose to make up for the dose you forgot - remember the three Ds: DON'T DOUBLE DOSE!

If you use more dornase alfa than you should, talk to a doctor straight away.

How much do I use?

Usually, you will have one ampoule every day through your nebuliser. If your doctor tells you to take a different amount from this, then you should take exactly the amount that he or she has told you to.

What are the most likely side effects I might get?

You're not likely to get side effects from dornase alfa. If you do though, some of them can be dangerous, so it's important that you look out for them. The things you might get are:

pains in your chest

fever

an upset stomach (called indigestion)

changes to your voice, including hoarseness or losing your voice

sore throat

having trouble breathing

runny or blocked nose and sneezing (called rhinitis)

redness and itchiness in your eye, and gooey yellowish-white stuff in your eye (called conjunctivitis)

skin rash, which may be lumpy and itchy (hives)

You may notice that you produce more mucus than normal when you start using dornase alfa. This is normal and will go away over time.

Is it safe for me to be taking it?

You shouldn't take dornase alfa if you know you are allergic to it. Make sure you tell your doctor if you DO have an allergy, as it could be very dangerous to take this medicine.

Is it okay for me to take dornase alfa if I'm already taking other medicines?

Tell your doctor or pharmacist if you are taking, or have recently taken, any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because dornase alfa may affect the way some medicines work. Also, some other medicines may affect the way dornase alfa works.

It is safe for you to take other medicines for cystic fibrosis, like antibiotics, bronchodilators, pancreatic enzymes, vitamins, inhaled and systemic corticosteroid, and analgesics, but you should tell your doctor about ALL of the other medicines you're taking just to be sure.

Is there anything else I need to know about dornase alfa?

The other important things you need to remember when you are using dornase alfa are:

don't mix dornase alfa with any other liquids or medicines in your nebuliser

always throw away any left over dornase alfa - NEVER use it

if you have a 're-usable' nebuliser, you should clean it after every time you use it.

make sure you store your dornase alfa ampoules in the fridge in the original carton, to protect them from light. You can still use an ampoule if it has been left out of the fridge for less than 24 hours at room temperature, but you can't use it if it's been left out for longer than that

don't throw away any leftover ampoules. You should return them to your pharmacist, so that they can do it carefully

What if I have any more questions?

If you have any other questions, you can ask your doctor, or you can join the Medikidz forums and talk to other people with cystic fibrosis.