dornase alfa

Breaks down excessive amounts of DNA found in the respiratory tract of patients with cystic fibrosis. Excessive DNA contributes to increased sputum viscosity and risk of infection.

Therapeutic effects:

Decreased infection rates and requirement for parenteral anti-infectives.
Improved pulmonary function.

Pharmacokinetics ⬆ ⬇

Absorption: Negligible absorption following inhalation.

Distribution: Action is primarily local.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(effect on noted parameters)

ROUTE	ONSET	PEAK	DURATION
Inhalation	within 15 min‡	3 days–1 wk‡ weeks–months§	48 hr

‡Significant concentrations in sputum.

‡Improvement in respiratory function.

§Decreased incidence of respiratory tract infections.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to dornase alfa or Chinese Hamster Ovary cell products.

Use Cautiously in:

Pedi: ↑incidence of cough, rhinitis, and rash in children;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding.

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain

Derm: rash

EENT: rhinitis, sore throat, voice alteration, conjunctivitis, hoarseness

Resp: cough, dyspnea

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

None reported.

Route/Dosage ⬆ ⬇

Inhaln (Adults and Children ): 2.5 mg once or twice daily.

Availability ⬆ ⬇

Solution for inhalation: 1 mg/mL

Assessment ⬆ ⬇

Assess vital signs and respiratory status (lung sounds, respiratory rate, amount and color of sputum, dyspnea) periodically during therapy. Incidence of cough, rash, and rhinitis is greater in children under 5 yr.

Implementation ⬆ ⬇

Dornase alfa must be administered every day to maintain therapeutic effect. Pulmonary function decreases within 48 hr of discontinuation.
Inhaln: Dornase alfa inhalation solution is administered via eRapid Nebulizer System or via a jet nebulizer (Hudson T Up-draft II or Marquest Acorn II with Pulmo-Aide; PARI LC Plus or PARI BABY with PARI PRONEB; or Durable Sidestream with MOBILAIRE; or Durable Sidestream with Porta-Neb) connected to an air compressor with an adequate air flow and equipped with a mouthpiece or suitable face mask. If administered with eRapid Nebulizer System, advise patients to replace handset after 90 uses. Other nebulizers are not recommended. A legally marketed compressor of identical pressure and flow rate may also be used.
- Use the mouthpiece provided with each nebulizer for administration; a face mask may reduce delivery of medication to the lungs.
- Do not mix or dilute dornase alfa with other medications in nebulizer cup because of possible incompatibilities. Other concurrently used medications may be administered before or after dornase alfa.
- Do not administer solution that is cloudy or discolored or from ampules that have been opened previously or are outdated.
- Store ampules in refrigerator in foil pouches; do not freeze. Do not leave at room temperature for more than 24 hr. Protect ampules from light.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take dornase alfa exactly as directed, at the same time each day. If a dose is missed, take as soon as possible; if almost time for next dose, skip missed dose and return to regular dosing schedule.
- Emphasize the importance of continuing other medications for cystic fibrosis during dornase alfa therapy.
- Instruct patient in proper technique for dornase alfa administration. Wash hands before assembling nebulizer and adding medication. Use a clean surface to assemble nebulizer, and keep nebulizer parts clean according to manufacturer’s directions. Open ampule and empty into nebulizer cup; use all of medication in ampule. Administer according to manufacturer’s directions. Clean nebulizer following use.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇