What Are Mucolytic Agents?

Mucolytics may help prevent COPD exacerbations

senior man using nebulizer
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Patients with COPD frequently have thick sputum, or mucus, that narrows or blocks airways, making breathing difficult. Mucolytics are a type of medication that thin mucus so it is easier to cough up.

According to the Global Initiative for Obstructive Lung Disease (GOLD), mucolytics are not considered part of the current standard of care for COPD treatment. The 2013 GOLD guideline for treatment states the mucolytic agents may be of small benefit for patients with thick sputum.

However, some studies have suggested that they may help reduce the number of COPD exacerbations that a patient suffers annually.

A 2015 Cochrane review of 34 trials, including more than 9,000 patients with COPD, found those who took mucolytics were less likely to experience exacerbations. Overall, preventive mucolytic use was associated with a reduction of one exacerbation every three years.

How Are Mucolytics Administered?

Mucolytics are available in tablets, syrups and inhaled gasses delivered through a nebulizer. Be sure to read all instructions provided with your medication. Some tablets can be swallowed whole, while others need to be dissolved prior to ingesting.

While many brands of mucolytics are available as over the counter medicine, patients with COPD should only use them under the advice of your doctor.

Many mucolytic medications are available in generic formulations, including erdosteine, acetylcysteine, bromhexine, carbocysteine, guaifenesin, and iodinated glycerol.

There are some side effects associated with mucolytic agents. Tablets may cause nausea or diarrhea while liquid formulations may cause breathing spasms, nausea, and rashes. Always talk to your doctor or pharmacist about any side effects from medications.

How To Use A Nebulizer

If you have COPD, you have probably used a nebulizer before.

Mucolytics are sometimes prescribed as a nebulizer treatment.

A nebulizer is a small machine that turns liquid medicine into an inhalable mist. As you breathe through a connected mouthpiece, the medicine goes directly into the lungs, where it can start working quickly.

To use the nebulizer, first, connect the hose to the air compressor, then fill the medicine cup with your prescription, and attach the hose and mouthpiece to the medicine cup. To avoid spills, make sure you close the medicine cup tightly and hold the mouthpiece straight up and down.

Put your lips firmly around the mouthpiece and take slow deep breaths through your mouth until all of the medicine has been used. This typically takes about 10 to 15 minutes. Using a nose clip may help you to breathe only through your mouth.

Once you are done, take the time to clean your nebulizer thoroughly to eliminate any bacteria and ensure the machine continues to work properly.


What Are Mucolytic Agents? American Thoracic Society website.​ http://www.thoracic.org/copd-guidelines/for-patients/what-kind-of-medications-are-there-for-copd/what-are-mucolytic-agents.php. Updated February 2015. Accessed February 9, 2016.

Global Initiative for Chronic Obstructive Lung Disease: Pocket Guide for COPD Diagnosis, Management, and Prevention. Global Initiative for Chronic Obstructive Lung Disease website. http://www.goldcopd.org/uploads/users/files/GOLD_Pocket_2013_Mar27.pdf. Updated 2013. Accessed February 9, 2016.

Poole P, Chong J, Cates CJ. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015 Jul 29;7:CD001287. doi: 10.1002/14651858.CD001287.pub5.

How To Use A Nebulizer. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000006.htm. Updated April 24, 2014. Accessed February 9, 2016.

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