Medicines that help loosen and clear mucus from the airways are called mucoactive drugs. They are often used as part of bronchiectasis and NTM care. These medicines may be used alone or with airway clearing techniques or devices.
Depending on the medicine, these drugs may:
- Draw water into the mucus.
- Thin or loosen thick mucus, making it easier to cough up.
- Help reduce mucus production.
- Increase coughing to help removal.1
Your health care team can help you decide which option is best for you, how much to take, and when to take it.
Hypertonic Saline
What It Is – Hypertonic saline is a concentrated saltwater solution inhaled through a nebulizer. Common strengths include 3% and 7%.
How It May Help – Hypertonic saline can draw water into the airway, helping to loosen thick mucus, making it easier to move and cough out.2
Important Tip – Hypertonic saline can sometimes cause airway spasms, leading to chest tightness or more coughing. Ask your health care provider if you should use medicine like albuterol before treatment. Albuterol helps open the airways and may reduce the risk of airway spasms.2
Guaifenesin
What It Is – Guaifenesin is an over-the-counter medicine taken by mouth and sold under brand names such as Mucinex™ and Robitussin™.3
How It May Help – Guaifenesin may help make mucus thinner and less sticky. By making mucus less sticky and easier to move, it may help the lungs clear mucus more effectively.4
Important Tip – For mucus clearance, avoid products that combine guaifenesin with cough suppressants (such as dextromethorphan) unless your health care provider recommends them.
Acetylcysteine
(Also called N-acetyl cysteine, N-acetyl-L-cysteine, or NAC)
What It Is – Acetylcysteine is a mucus-thinning medicine taken by mouth or inhaled through a nebulizer.5
How It May Help – Acetylcysteine may change the structure of mucus, making it thinner and less sticky. It may also help protect the airways by supporting the body’s natural defenses, caused by inflammation (swelling), infection, pollution, smoke, and other irritants.5
Important Tip – Acetylcysteine can sometimes cause airway spasms. This may cause chest tightness or more coughing. Ask your health care provider if you should use medicine like albuterol before treatment. Albuterol helps open the airways and may reduce the risk of airway spasms.
Carbocysteine
(Also called S-Carboxymethyl-L-cysteine)
What It Is – Carbocysteine is a medicine taken by mouth. It is used in some countries but is not approved or available in the United States.
How It May Help – Carbocysteine may help make mucus thinner and easier to cough up. It may help the airways produce healthier mucus, keep mucus moist, calm inflammation (swelling), and protect airway cells from damage and make it more difficult for some germs to stick to the airway lining.1,6
Important Tip – Ask your health care provider whether it is available and right for you.
Inhaled Mannitol
What It Is – Mannitol is a dry-powder medication inhaled into the lungs.
How It May Help – Mannitol draws water into the airways, helping to plump and loosen mucus so it is easier to clear. It may also help the movement of cilia, the tiny hair-like structures that help move mucus out of the lungs.7,8
Important Tip – Inhaled mannitol is not commonly used for bronchiectasis in the United States. It may cause coughing or tightening of the airways and is not appropriate for everyone.7,8
Other Supportive Therapies
Albuterol, Levalbuterol, and Ipratropium
These medications are bronchodilators, which means they help open the airways. They may be used before certain airway-clearance treatments or inhaled medications that can cause sudden airway narrowing, also called bronchospasm.
Albuterol may be prescribed as a nebulized solution or as a metered-dose inhaler (MDI).
Hydration
Drinking fluids, especially water, can help mucus from becoming thicker. Follow your health care provider’s advice about how much fluid is appropriate for you each day.
The Bronchiectasis and NTM Association advises that you consult with your health care provider before making any changes to your medicines or therapies. It is also important to take prescribed medicines exactly as directed. Report any side effects to your health care provider soon after they occur.
