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Nebulizer and compressor options
Questions to consider

Nebulizer and compressor options for Pulmozyme dosing1,18

Your patients and/or their caregivers will likely have questions about how to administer Pulmozyme. Each Pulmozyme treatment, dosed QD or BID, requires the following items1:

  • One ampule of Pulmozyme
    • Pulmozyme is supplied in single-use ampules. It should be stored in refrigeration and protected from strong light1
  • One jet nebulizer approved for use with Pulmozyme that can be connected to an air compressor OR a nebulizer system2
  • Tubing and other components that come with the nebulizer1
  • A mouthpiece or a face mask (for younger patients unable to inhale or exhale consistently using a mouthpiece)1

Several nebulizer and compressor options are FDA-approved for use with Pulmozyme1

Jet Nebulizer* Compressor
Hudson T Up-draft II® Pulmo-Aide® or legally marketed compressor of identical pressure and flow rate (maximum 30 psi, 12 LPM).
Marquest Acorn II®
PARI LC® Plus PARI PRONEB® or legally marketed compressor of identical pressure and flow rate (maximum 24 psi, 9 LPM).
ƗPARI BABY™
Durable Sidestream® MOBILAIRE™, Porta-NEB® or legally marketed compressor of identical pressure and flow rate (maximum 45 psi, 7 LPM).

One nebulizer system is FDA-approved1

eRapid Nebulizer system

eRapid® (PARI) Nebulizer Systemǂ

The eRapid system delivers treatment in a system that is small and portable§

For more information on eRapid, call PARI at (866) 335-6943, or visit PARI.com

*Follow Manufacturer’s Instructions for Use
ƗPatients who are unable to inhale or exhale orally throughout the entire nebulization period may use the PARI BABY™ nebulizer.
ǂConsisting of the eRapid® Nebulizer Handset with eBase™ Controller.
§The average nebulization time for the eRapid Nebulizer System is approximately 2-3 minutes compared to the LC® Plus Jet Nebulizer, which is 6-10 minutes.

Learn how to prepare and administer Pulmozyme

A step-by-step guide to taking Pulmozyme, including a list of equipment needed.

Download the Instructions for Use

Questions to consider when helping patients choose a nebulizer and compressor combination

  • What is your patient's lifestyle like?

Patients may want to consider what conveniences they need. For example, nebulizers/compressors may have different delivery times and cleaning instructions.

  • Will a child use it?

Certain nebulizers are designed especially for younger children and have features such as a mask instead of a mouthpiece.

  • How much will it cost?

Costs, out-of-pocket expenses, and insurance coverage can vary.

  • Which specialty pharmacies distribute eRapid®?

If you are considering eRapid for your patient, visit www.PARI.com to locate specialty pharmacies that distribute eRapid.

Remember to communicate these important instructions to patients/caregivers18:

  • Do not dilute or mix Pulmozyme with other drugs in the nebulizer1
  • Mixing of Pulmozyme with other drugs could lead to adverse physicochemical and/or functional changes in Pulmozyme or the admixed compound1
  • Follow the manufacturer's instructions on the use and maintenance of the equipment, including cleaning and disinfection procedures1

Have your patients download patient-friendly, step-by-step instructions on administering Pulmozyme.1

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Next Page: Pulmozyme Dosing

Indication and Usage

Pulmozyme (dornase alfa) is indicated, in conjunction with standard therapies, for the management of pediatric and adult patients with cystic fibrosis (CF) to improve pulmonary function.

In CF patients with an FVC ≥ 40% of predicted, daily administration of Pulmozyme has also been shown to reduce the risk of respiratory tract infections requiring parenteral antibiotics.

Important Safety Information

Pulmozyme is contraindicated in patients with known hypersensitivity to dornase alfa, Chinese Hamster Ovary cell products, or any component of the product.

The most common adverse reactions associated with the use of Pulmozyme include: voice alteration, pharyngitis, rash, laryngitis, chest pain, conjunctivitis, rhinitis, decrease in FVC of ≥ 10%, fever, dyspepsia, and dyspnea. There have been no reports of anaphylaxis attributed to the administration of Pulmozyme. Mild to moderate urticaria and mild skin rash have been observed and have been transient.

Pediatric Use

The safety and effectiveness of Pulmozyme in conjunction with standard therapies for cystic fibrosis have been established in pediatric patients. Use of Pulmozyme in pediatric patients is supported by evidence in the following age groups:

  • Patients 5 to 17 years of age: A randomized, placebo-controlled trial of 303 of clinically stable cystic fibrosis patients 5 to 17 years of age who received Pulmozyme.
  • Patients less than 5 years: Extrapolation of efficacy data in patients 5 years of age and older with additional safety data in 65 pediatric patients aged 3 months to less than 5 years who received Pulmozyme 2.5 mg daily by inhalation for 2 weeks.

The safety of Pulmozyme, 2.5 mg by inhalation, was studied with 2 weeks of daily administration in 98 pediatric patients with cystic fibrosis 3 months to 10 years of age (65 aged 3 months to < 5 years, 33 aged 5 to ≤ 10 years). The PARI BABY™ reusable nebulizer (which uses a facemask instead of a mouthpiece) was utilized in patients unable to demonstrate the ability to inhale or exhale orally throughout the entire treatment period (54/65, 83% of the younger; and 2/33, 6% of the older patients). Overall, the nature of adverse reactions was similar to that seen in the placebo-controlled trials in older patients. The number of patients reporting cough was higher in the younger age group as compared to the older age group (29/65, 45%; compared to 10/33, 30%) as was the number reporting moderate to severe cough (24/65, 37%; compared to 6/33, 18%). The number of patients reporting rhinitis was higher in the younger age group as compared to the older age group (23/65, 35%; compared to 9/33, 27%) as was the number reporting rash (4/65, 6% as compared to 0/33, 0%).

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

For further information, please see the Pulmozyme full Prescribing Information.

    • Pulmozyme [package insert]. South San Francisco, CA: Genentech, Inc; 2021.

      Pulmozyme [package insert]. South San Francisco, CA: Genentech, Inc; 2021.

    • Harms HK, Matouk E, Tournier G, et al; DNase International Study Group. Multicenter, open-label study of recombinant human DNase in cystic fibrosis patients with moderate lung disease. Pediatr Pulmonol. 1998;26(3):155-161.

      Harms HK, Matouk E, Tournier G, et al; DNase International Study Group. Multicenter, open-label study of recombinant human DNase in cystic fibrosis patients with moderate lung disease. Pediatr Pulmonol. 1998;26(3):155-161.

    • Chmiel JF, Konstan MW. Anti-inflammatory medications for cystic fibrosis lung disease: selecting the most appropriate agent. Treat Respir Med. 2005;4(4):255-273. 

      Chmiel JF, Konstan MW. Anti-inflammatory medications for cystic fibrosis lung disease: selecting the most appropriate agent. Treat Respir Med. 2005;4(4):255-273. 

    • Puchelle E, de Bentzmann S, Zahm JM. Physical and functional properties of airway secretions in cystic fibrosis—therapeutic approaches. Respiration. 1995;62(suppl 1):2-12. 

      Puchelle E, de Bentzmann S, Zahm JM. Physical and functional properties of airway secretions in cystic fibrosis—therapeutic approaches. Respiration. 1995;62(suppl 1):2-12. 

    • King M. Mucolytics and mucus clearance. In: Rubin BK, van der Schans CP, eds. Therapy for Mucus-Clearance Disorders. New York, NY: Marcel Dekker Inc; 2004:201-224. 

      King M. Mucolytics and mucus clearance. In: Rubin BK, van der Schans CP, eds. Therapy for Mucus-Clearance Disorders. New York, NY: Marcel Dekker Inc; 2004:201-224. 

    • Flume PA, Van Devanter DR. State of progress in treating cystic fibrosis respiratory disease. BMC Med. 2012;10:88.

      Flume PA, Van Devanter DR. State of progress in treating cystic fibrosis respiratory disease. BMC Med. 2012;10:88.

    • Drug development pipeline. Cystic Fibrosis Foundation website. https://www.cff.org/trials/pipeline. Accessed October 4, 2021.

      Drug development pipeline. Cystic Fibrosis Foundation website. https://www.cff.org/trials/pipeline. Accessed October 4, 2021.

    • Research milestones. Cystic Fibrosis Foundation website. https://www.cff.org/Our-Research/Our-Research-Approach/Research-Milestones. October 4, 2021.

      Research milestones. Cystic Fibrosis Foundation website. https://www.cff.org/Our-Research/Our-Research-Approach/Research-Milestones. October 4, 2021.

    • Fuchs HJ, Borowitz DS, Christiansen DH, et al. Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. N Engl J Med. 1994;331(10):637-642.

      Fuchs HJ, Borowitz DS, Christiansen DH, et al. Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. N Engl J Med. 1994;331(10):637-642.

    • Data on file. Genentech, a member of the Roche Group.

      Data on file. Genentech, a member of the Roche Group.

    • Cystic Fibrosis Foundation Patient Registry 2019 Annual Data Report. Bethesda, MD. ©2020 Cystic Fibrosis Foundation.

      Cystic Fibrosis Foundation Patient Registry 2019 Annual Data Report. Bethesda, MD. ©2020 Cystic Fibrosis Foundation.

    • Sly PD, Brennan S, Gangell C, et al. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med. 2009;180(2):146-152. 

      Sly PD, Brennan S, Gangell C, et al. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med. 2009;180(2):146-152. 

    • Sly PD, Gangell CL, Chen L, et al. Risk factors for bronchiectasis in children with cystic fibrosis. N Engl J Med. 2013;368(21):1963-1970.

      Sly PD, Gangell CL, Chen L, et al. Risk factors for bronchiectasis in children with cystic fibrosis. N Engl J Med. 2013;368(21):1963-1970.

    • Bakker EM, Volpi S, Salonini E, et al. Small airway deposition of dornase alfa during exacerbations in cystic fibrosis; a randomized controlled clinical trial. Pediatr Pulmonol. 2020;49(2):154-161.

      Bakker EM, Volpi S, Salonini E, et al. Small airway deposition of dornase alfa during exacerbations in cystic fibrosis; a randomized controlled clinical trial. Pediatr Pulmonol. 2020;49(2):154-161.

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      Trikafta [Package insert]. Boston, MA: Vertex Pharmaceuticals Incorporated; 2021. 

    • Heijerman HGM, McKone EF, Downey DG, et al. Efficacy and safety of the elexacaftor plus tezacaftor plus ivacaftor combination regimen in people with cystic fibrosis homozygous for the F508del mutation: a double-blind, randomised, phase 3 trial. Lancet. 2019;394(10212)1940-1948. 

      Heijerman HGM, McKone EF, Downey DG, et al. Efficacy and safety of the elexacaftor plus tezacaftor plus ivacaftor combination regimen in people with cystic fibrosis homozygous for the F508del mutation: a double-blind, randomised, phase 3 trial. Lancet. 2019;394(10212)1940-1948. 

    • Middleton PG, Mall MA, Dřevínek P, et al. Elexacaftor–tezacaftor–ivacaftor for cystic fibrosis with a single Phe508del allele. N Engl J Med. 2019;381(19):1809-1819. 

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    • Pulmozyme Instructions for Use. South San Francisco, CA: Genentech, Inc; 2021.

      Pulmozyme Instructions for Use. South San Francisco, CA: Genentech, Inc; 2021.

    Non-US Residents visit: Pulmozyme.global