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Dornase Alfa

( Recombinant Human Deoxyribonuclease ; DNase )

Pronunciation: DOR-nace AL-fuh
Class: Mucolytic

Trade Names

Pulmozyme
- Solution for inhalation 1 mg/mL

Pharmacology

Cleaves DNA released by neutrophils that are mobilized to respiratory tract in response to infection, reducing viscoelasticity of purulent lung secretions, increasing airflow, and decreasing risk of infection.

Indications and Usage

Treatment of cystic fibrosis.

Contraindications

Hypersensitivity to Chinese hamster ovary cell products.

Dosage and Administration

Adults and Children older than 5 yr of age

Inhalation 2.5 mg once daily by oral inhalation via nebulizer; patients older than 21 yr of age and those with baseline forced vital capacity more than 85% benefit from 2.5 mg twice daily.

General Advice

  • Discard solution if cloudy or discolored.
  • Discard unused portions of ampules.
  • Do not dilute or mix drug with other drugs in nebulizer.

Storage/Stability

Keep refrigerated and protected from strong light. Storing at room temperature for less than 24 h does not adversely affect product.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Chest pain.

Dermatologic

Rash.

EENT

Conjunctivitis; sore throat; voice alterations; hoarseness.

Respiratory

Hoarseness; pharyngitis; laryngitis.

Precautions

Monitor

Perform auscultation to determine quality of breath sounds. Note characteristics of cough and sputum. Perform chest physiotherapy (percussion and postural drainage) as ordered.


Pregnancy

Category B .

Lactation

Undetermined.

Children

Safety and efficacy in children younger than 5 yr of age not established.

Secretions

Assess patient's ability to clear secretions. Provide assistance with coughing, positioning (semi-Fowler's or sitting upright) and suctioning. Provide hydration to liquefy secretions and replace fluids.

Patient Information

  • Teach patient to follow manufacturer's instructions on use and maintenance of nebulizer and compression system.
  • Instruct patient in proper administration and storage of drug.
  • Tell patient that drug may cause sore throat, voice alterations, or hoarseness, and to inform health care provider if these or any other symptoms become bothersome.
  • Inform patient that benefits of treatment may not become apparent for months.
  • Emphasize importance of avoiding contraction of respiratory infections.

Copyright © 2009 Wolters Kluwer Health.

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