dornase

Dornase, commonly referred to as dornase alfa, is a recombinant human DNase I enzyme used as a mucolytic therapy in cystic fibrosis to reduce the viscosity of airway mucus and promote mucus clearance.

Mechanism of action: Dornase alfa enzymatically cleaves extracellular DNA found in purulent CF sputum, which is released from degenerating neutrophils. By breaking down this DNA, the viscoelastic properties of the mucus are reduced, improving mucociliary transport and airway drainage.

Medical use: It is indicated as an inhaled therapy to improve lung function and reduce the risk of respiratory tract infections in people with cystic fibrosis. It is intended as an adjunct to chest physiotherapy and antibiotic therapy. It is not a cure for CF and is used as a long-term, ongoing treatment under medical supervision.

Administration and dosing: Dornase alfa is administered by inhalation as a sterile solution, typically at a dose of 2.5 mg once daily via a jet nebulizer, with the nebulization taking about 5 to 7 minutes. Dosing can be adjusted by a clinician. Do not mix with other medications in the same nebulizer; use separate sessions if multiple therapies are prescribed.

Safety and adverse effects: Common adverse effects include voice alteration, throat irritation, laryngitis, chest pain, conjunctival irritation, and rash. Rare but serious reactions such as hypersensitivity or anaphylaxis can occur. Bronchospasm may happen in some patients, particularly if they have a history of airway hyperreactivity. Patients should be monitored during initial administration and consult a clinician if adverse effects occur.

History and availability: Dornase alfa is produced in Chinese hamster ovary cells and was first approved for clinical use in the early 1990s. It is commercially available under various brand names, most notably Pulmozyme, and is widely used as standard adjunctive therapy in cystic fibrosis care.