Dornase Alfa (inhalation)

Overview

Caused by a defective gene, cystic fibrosis is a condition which tends to affect patients from birth. When cystic fibrosis occurs, the patient's cells don't work as they should. Specifically, the movement of water and salt in and out of the body's cells is affected. As a result, patients experience a build-up of mucus in the digestive system, the lungs and other organs.

This excess fluid can result in a number of symptoms occurring. Patients often have trouble breathing, instances of wheezing, a persistent cough, as well as sinus problems and reduced body weight. In addition to this, patients can suffer from regular infections. In many cases, these infections are particularly serious and require in-patient medical care.

Although there is not currently a cure for cystic fibrosis, various medications are used to manage the condition and to ease the patient's symptoms. Dornase Alfa, for example, helps to improve the patient's lung function. As a solution of human deoxyribonuclease I, Dornase Alfa is an enzyme which effectively splits extracellular DNA which is present in the excess mucus. By doing so, the excess mucus in the patient's body is thinned.

With less thick mucus blocking the patient's airways, they can breathe more easily and expel secretions more easily. As well as easing the symptoms of the condition, Dornase Alfa can help to reduce the number of lung infections the patient develops.

This is particularly important as serious lung infections can be life-threatening, particularly for patients with cystic fibrosis. By reducing the amount of mucus in the patient's body, however, Dornase Alfa prevents bacteria from accumulating and reduces the opportunity for infections to take hold.

Administered as an inhalant, Dornase Alfa is fairly fast-acting. However, cystic fibrosis is an on-going condition and patients will need to use the medication on a long-term basis in order to benefit from it. Although Dornase Alfa is effective in treating some of the symptoms associated with cystic fibrosis, it is normally used in conjunction with other medicines. When used as part of a combined medicinal approach, Dornase Alfa is extremely effective at reducing the patient's symptoms and enabling them to function more easily.

Conditions Treated

Type Of Medicine

  • Protein based therapy
  • Inhalant

Side Effects

When using any medication, patients may experience some side-effects. In the case of Dornase Alfa, patients may develop the following adverse effects:

  • Sour or acid stomach
  • Heartburn
  • Belching
  • Indigestion
  • Sneezing
  • Rash
  • Stomach pain, upset or discomfort
  • Dry, itching or burning eyes
  • Stuffy nose
  • Excessive tearing or discharge
  • Swelling, pain or redness of the eyelid, eye or inner lining of eyelid

Unless they are severe, the side-effects listed above may not need medical attention. In many instances, patients will experience some side-effects when they first start using the medication but these will reduce in time. However, if patients are concerned about the presence of side-effects or if they do not diminish over time, they should seek medical advice.

Patients may experience additional side-effects while using Dornase Alfa and these do tend to require medical attention. If patients experience the following adverse effects when using Dornase Alfa, they should seek medical advice:

  • Body pain or aches
  • Pain in chest
  • Changes to voice
  • Trouble swallowing
  • Congestion
  • Difficulty breathing
  • Cough
  • Soreness or dryness of the throat
  • Fever
  • Runny nose
  • Hoarseness
  • Swollen, tender glands in neck

Although these are the most common side-effects to occur following treatment with Dornase Alfa, it is possible that patients will develop other, unlisted side-effects. If so, they should obtain medical assistance. Furthermore, patients can report the presence of additional side-effects to the Food and Drug Administration on 1-800-FDA-1088.

Dosage

When patients are prescribed Dornase Alfa, their physician will explain how the medication should be used and when is the optimum time to use it. The patient's condition, current presentation, age, weight and medical history will all have an impact on the dose which has been prescribed. The patient's dose of Dornase Alfa may also be dependent on any other medications they are using.

Generally, patients over the age of five years will be advised to use 2.5mg of Dornase Alfa in a nebulizer every day. As Dornase Alfa is available in 2.5mg capsules, patients may simply be told to add one capsule to the nebulizer before inhaling.

Although children between the ages of three months and four years may be prescribed the same dose of Dornase Alfa, their physician may prefer to prescribe a lower starting dose and increase the amount of Dornase Alfa they use over time.

Before using a nebulizer, patients should be given thorough instructions and should feel confident about how to administer their medication. In addition to this, their family members, next-of-kin and/or guardian should be shown how the use their medical equipment, if appropriate.

Typically, the nebulizer will be connected to an air compressor and this will ensure that the Dornase Alfa ampule is converted into a fine mist or spray. The patient can then place the mouthpiece of the nebulizer into their mouth and inhale the medication. In some cases, patients may use a nebulizer with a face back if they are unable to use a nebulizer with a mouthpiece. Generally, patients will need to use the nebulizer for approximately 10-15 minutes or until the medication has been fully inhaled.

When patients are inhaling Dornase Alfa, the fine mist produced should be clear. If it is discolored or cloudy, patients should stop using the nebulizer and seek medical advice. Furthermore, patients should not suddenly stop using Dornase Alfa, unless they are advised to do so by a medical practitioner. If patients suddenly stop using their medication, their condition could worsen significantly.

Normally, patients are advised to use Dornase Alfa with a nebulizer on a daily basis. If possible, patients should try to administer Dornase Alfa at the same time each day as this can help to improve the effects of the medication. Although patients may notice an improvement in their condition within a few days, it can take a number of weeks for the medication to be fully effective.

If patients use other inhalation medications, they should not attempt to place them in the nebulizer at the same time as Dornase Alfa. Instead, patients should inhale one medicine at a time, cleaning the nebulizer thoroughly between each use. The patient's physician should provide advice regarding when to use each medicine and in what order they should be administered.

If patients miss a dose of Dornase Alfa, they should use their medication as soon as they remember to do so. However, if their next dose is almost due, they should skip the dose they've missed and continue with their normal treatment schedule. Patients should not attempt to take a double dose of Dornase Alfa, even if they have missed a previous dose.

Potential Drug Interactions

Before using Dornase Alfa, patients should discuss any other medications they're using with their physician. As some medicines can interact with one another, it may not be safe or effective for some combinations to be used. Similarly, patients should seek medical advice before using Dornase Alfa alongside over-the-counter medicines, supplements and/or vitamins.

If patients have a known allergy to Chinese hamster ovary cell products, they should not be prescribed Dornase Alfa. As Chinese hamster ovary cells are used in the production of this medication, it is not appropriate for patients with an allergy to its ingredients to use it.

Warnings

When patients are using Dornase Alfa, they will need to attend regular consultations with their physician. This will enable their doctor to ensure that the medication is working properly and that it isn't causing any unwanted effects. Furthermore, doctors will use this opportunity to modify the patient's dose of medication, if it is necessary to do so.

If Dornase Alfa seems to be less effective after the patient has used it for some time, they will need to seek medical advice. Patients should not attempt to alter their dose of Dornase Alfa or use more medication than they have been prescribed.

Similarly, if the patient's symptoms become worse whilst using Dornase Alfa, they should seek immediate medical help.

Although it is rare, patients may exhibit signs of an allergic reaction when using Dornase Alfa. Symptoms of a reaction can include:

  • Increased wheezing
  • Hives
  • Trouble breathing
  • Swelling of the lips, face, throat and/or mouth

As this type of reaction can be life-threatening, patients will need to access emergency medical assistance if they begin to exhibit an allergic reaction.

Storage

When storing Dornase Alfa, it is vital that patients follow the manufacturer's instructions. This ensures that the medication is stored safely and that it can be used without the risk of unnecessary adverse effects occurring.

In many cases, Dornase Alfa will need to be kept in a refrigerator. Often, the medicine is supplied in foil pouches and these can be placed straight into the refrigerator so that they are kept cool. If the medicine is left out of a refrigerated environment for over 24 hours, the medication should not be used and should be disposed of.

Although Dornase Alfa normally needs to be refrigerated, it should not be frozen. When storing any medicine at home, including Dornase Alfa, patients should ensure that children and/or pets cannot gain access to it.

Furthermore, if patients are advised to stop using Dornase Alfa or if the medicine reaches its use-by date, it will need to be disposed of. Patients should not keep medication which is out-of-date or which they are no longer taking. However, it is not appropriate to throw medication out with regular household waste.

As discarded medicines can be harmful to other people, patients should seek out an appropriate disposal route. Many physician's offices and pharmacies will assist in the disposal of unused medicines so patients should contact them for further advice regarding the disposal of Dornase Alfa.

Summary

Despite ongoing research, a cure for cystic fibrosis is not yet available. However, research has enabled doctors to discover more about the condition, what causes it and how it affects patients. Based on this, physicians are able to provide more effective treatments for patients and can ensure that their condition is managed properly.

Dornase Alfa is just one medication used in the treatment of cystic fibrosis. Characterized by excess mucus occurring in the lungs and airways, cystic fibrosis can cause patients to have trouble breathing. By targeting the extracellular DNA in the patient's mucus, Dornase Alfa can effectively thin mucus and clear the patient's airways. As a result, patients should be able to breathe more easily following treatment with Dornase Alfa.

Once Dornase Alfa has reduced the amount of mucus in the airways, the chance of an infection occurring is reduced. As bacteria has a less hospitable environment in which to replicate, patients should suffer from fewer lung infections when Dornase Alfa is used to manage their condition.

Normally prescribed in addition to other medications, Dornase Alfa is a vital medication in the management of cystic fibrosis. When the appropriate treatment regimen is prescribed for the patient, Dornase Alfa can help to lessen their symptoms and improve their quality of life considerably.