Pari eRapid/eFlow first impressions

I did contact pari regarding using it for other meds. Their answer was- ask the doctor because Pari tested it only for pulmozyme and do not recommend for other meds. I found an article that discussed a trial of nebulized cromolyn sodium with Pari erapid so I experimented yesterday and after all the washing and boiling it worked well today on levalbuterol. Of course I take a risk how long the aerosol had will function but cromolyn takes me about 20 minutes to nebulize so i use pari erapid and will see. I will update you.

I only just realized that I have the e flow already. Or could there be different versions of it? They call it the Altera Nebulizer system and I got it when I was prescribed Cayston inhalation. It is made by Pari and looks EXACTLY like the eflow. I wonder if they make different versions? I doubt it. When you do an AI search it comes up with (see attached).

That's a CYA answer if I ever heard one! How did you word your question?

I posed this question "can i use my altera nebulizer saline solution" and got the opposite answer.
"Yes, you can use saline solution with your Altera nebulizer, as it is often used to help prepare the medication for inhalation. Always follow the specific instructions provided with your nebulizer and medication. (cff.org) (Wikipedia)
Using Saline Solution with the Altera Nebulizer
Purpose of Saline Solution
Saline solution is often used in conjunction with nebulizers to help hydrate the airways and improve the delivery of medications. It can also help to thin mucus, making it easier to clear from the lungs.
Compatibility with Altera Nebulizer
Recommended Use: The Altera Nebulizer is designed to work with saline solutions, particularly when used alongside medications like CAYSTON (aztreonam for inhalation).
Preparation: Always mix the saline with your medication as directed by your healthcare provider. Ensure that the saline is sterile and appropriate for inhalation.
Storage and Handling
Room Temperature: Saline can be stored at room temperature for up to 28 days when kept with CAYSTON.
Refrigeration: For longer storage, saline should be refrigerated.
Cleaning and Maintenance
Post-Use Care: After using the nebulizer with saline, clean and disinfect the device according to the manufacturer's instructions to prevent infections.
Using saline with your Altera Nebulizer is safe and effective when done correctly. Always follow your doctor's instructions for the best results." (cff.org) (Mayo Clinic)

This is the BEST argument I have seen yet for not using AI to drive our decisions!!!

I asked the following: can the altera nebulizer system be used with hypertonic saline 7%

You do mix the Cayston with saline so perhaps your answer was based on that? I would not count out the use of AI but certainly it should not drive our decisions.

See Dr. Falkinham’s response to the distilled water question in this recent thread that I started. Bottom line, it IS OK to use the distilled water for sterilizing (but not drinking) and you can use the same pot of distilled water over and over again. Here’s the link to the thread:
https://connect.ntminfo.org/discussion/is-it-ok-to-reusereboil-distilled-water
Also, I asked Pari when I ordered the erapid if it was OK to use with just saline, and they said yes. If someone else wants to call, ask and confirm, that would be great.

Various searches seem to indicate that the Pari Altera Neb system is specially formulated to be used with only Cayston and is NOT the same as the eFlow and yet they do not specify how it is different. I will try to call Pari next week to see if I can get a straight answer. But it could be one is ok with hypertonic saline and the other is not.

@irenea8 I have the exact same question about the Pari system used for Arikayce. It’s called Lamira. It looks exactly the same as the eflow, but it says only to be used for Arikayce. What is the difference? Is it the mesh piece? What other differences could there be and how different are they really. Is it all just marketing? Also, is anyone other than me bothered by the fact that a nebulizer made exclusively for treating NTM says to boil only 5 mts? I am afraid to boil mine for 10 mts, out of fear the pieces will melt. I have contact Insmed’s care coordinator about the perceived disconnect, but no answer yet.

I’ve been boiling mine for 11 minutes at a time and they’re holding up fine.

Upon closer examination (looking at photos) I do see a difference in the part that holds/dispenses the medication (eFlow vs Altera). So that difference could be very important. In light of that I would now see why one many be ok for hypertonic saline and the other is not. The main unit is most likely the exact same. See if you can find pictures of the Lamira and compare to similar profiles of the e Flow. You will probably see a difference in that part.

I am just guessing here, but probably the only place there could be a difference is in the mesh insert itself. I believe those are replaceable, so you might be able to get the regular "eRapid" one. Also, the neb heads are replaceable for under $150, so if you already have the system, you could ask if that is interchangeable.