Pulmosal vs normal hypertonic saline

Posted by bklynprof @bklynprof, Jul 13, 2023

My pharmacy has been having difficulty ordering Pulmosal, which is the only kind of hypertonic saline I've ever used. Has anyone tried both and found a difference, in efficacy or in irritation of the lungs? My pulmonologist prescribed it because she thinks it might be less irritating to my lungs, which I appreciate, but not sure if it really makes a difference
Thanks!

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Have been nebbing 7% for awhile and I often get different manufacturers' products each month, all 7%. The first few inhalations make me cough; a pause and a drink of water, gets me back on track.

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I use pulmosal and thus far there has been no issue with getting it. I do think it seems less irritating but not a big difference. I originally wanted to try it because they claimed that pseudomonas does not like it's more alkaline environment. My recent sputum test showed fewer pseudomonas but who knows if there is any correlation. My Pulmo would sure not think so. But I plan to keep using it as long as I can get it.

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What is the difference between pulmosal and generic sodium chloride? Thanks

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@irenea8

I use pulmosal and thus far there has been no issue with getting it. I do think it seems less irritating but not a big difference. I originally wanted to try it because they claimed that pseudomonas does not like it's more alkaline environment. My recent sputum test showed fewer pseudomonas but who knows if there is any correlation. My Pulmo would sure not think so. But I plan to keep using it as long as I can get it.

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irenea8 - I've had recurring Pseudomonas over the past 5 years since being diagnosed. I've asked my current pulm doc to prescribe 7% because of what I've read posting from those using it here on Mayo Connect. I've also seen some of the studies that support it. My previous doc did not have a problem prescribing it when I requested it. My current pulm doc says the science does not support that it is better than 3% so he will not prescribe it.
My thinking is that if it's not harmful why not let the patient use it? We're all just trying to get better. I'm sure I have pseudomonas right now (not on any meds) but quality of life is good and I want to keep it that way.

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@fdixon63

irenea8 - I've had recurring Pseudomonas over the past 5 years since being diagnosed. I've asked my current pulm doc to prescribe 7% because of what I've read posting from those using it here on Mayo Connect. I've also seen some of the studies that support it. My previous doc did not have a problem prescribing it when I requested it. My current pulm doc says the science does not support that it is better than 3% so he will not prescribe it.
My thinking is that if it's not harmful why not let the patient use it? We're all just trying to get better. I'm sure I have pseudomonas right now (not on any meds) but quality of life is good and I want to keep it that way.

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When I originally asked my pulmo about 3 vs 7 he said the same thing but he would have prescribed it if i had asked for it! I cannot remember if he told me later on to try 7% or if I just did it on my own (ordered from Amazon)? But when I switched to 7% I had less exacerbations. It did help more than the 3% for sure. So I would not listen to that instruction and see how you tolerate the 7%. At first you might adjust to it. Now I have a prescription for Pulmosal 7% but I still use the Amazon brand also since I nebulize 1.5 vials in the morning session. I use one of Pulmosal and 1/2 of the Amazon brand afterwards just to extend my treatment time.

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@fdixon63

irenea8 - I've had recurring Pseudomonas over the past 5 years since being diagnosed. I've asked my current pulm doc to prescribe 7% because of what I've read posting from those using it here on Mayo Connect. I've also seen some of the studies that support it. My previous doc did not have a problem prescribing it when I requested it. My current pulm doc says the science does not support that it is better than 3% so he will not prescribe it.
My thinking is that if it's not harmful why not let the patient use it? We're all just trying to get better. I'm sure I have pseudomonas right now (not on any meds) but quality of life is good and I want to keep it that way.

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Hi Faye - My pulmo says the same, but shrugs and prescribes it anyway. I figure if NJH, Mayo and UT Tyler all say 7%, their collective experience tips the scale for me. My primary also told me she would do it if the pulmo didn't.
Sue

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Ditto my pulmo 3% for pseudomonas and won't give 7%. Not sure I could handle it anyway and the 3% causes so much coughing, nose blowing, sinus clearing and lung clearing that I can barely cope with it. Does anyone else get the sinus clearing via nose and throat effect also? Knock on wood, I have not had a sinus headache since I started the 3%.

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@liz440

Ditto my pulmo 3% for pseudomonas and won't give 7%. Not sure I could handle it anyway and the 3% causes so much coughing, nose blowing, sinus clearing and lung clearing that I can barely cope with it. Does anyone else get the sinus clearing via nose and throat effect also? Knock on wood, I have not had a sinus headache since I started the 3%.

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My nose runs a lot and there is an amazing amount post-nasal drips in what I collect while I am nebulizing the PulmoSal. That is one reason I am concerned about changing to the generic 7%.

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@liz440

What is the difference between pulmosal and generic sodium chloride? Thanks

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The generic is just hypertonic saline. PulmoSal has a buffering agent to change the PH to better match the PH in the lung. Or at least that is what the manufacturer claims.

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@bklynprof

My nose runs a lot and there is an amazing amount post-nasal drips in what I collect while I am nebulizing the PulmoSal. That is one reason I am concerned about changing to the generic 7%.

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I use generic 3% and get amazing post nasal drips so I don't think it will be a problem for you.

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