Two mainstays make CF mucus easier to clear. Dornase alfa (Pulmozyme) is an inhaled enzyme that breaks down the DNA released by dead white blood cells, which makes the mucus dramatically less sticky. Hypertonic saline is a strong (7%) salt solution that draws water into the airways to hydrate and loosen mucus. Both are inhaled through a nebulizer, usually before or during airway clearance, and are among the most established daily CF therapies for preserving lung function.
Inhaled through a nebulizer, typically once or twice daily and timed with airway clearance. Hypertonic saline is often preceded by a bronchodilator and can cause coughing as it works. Device cleaning is important to prevent infection.
These are ongoing daily maintenance medicines. Used consistently they reduce flare-ups and help maintain lung function; they complement — not replace — airway clearance and other CF therapies.