What is the recommended dosing for Pulmozyme (dornase alfa)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: November 22, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Pulmozyme (Dornase Alfa) Dosing

The recommended dose of Pulmozyme is 2.5 mg (one single-dose ampule) inhaled once daily via nebulizer for all patients with cystic fibrosis aged 5 years and older. 1

Standard Dosing Regimen

  • Adults and children ≥5 years: 2.5 mg inhaled once daily 1
  • Some patients may benefit from twice daily administration (2.5 mg twice daily), particularly:
    • Patients older than 21 years 1
    • Patients with baseline FVC >85% of predicted 1

Pediatric Considerations

  • Children 5-17 years: Use is supported by randomized controlled trial evidence demonstrating efficacy and safety 1
  • Children <5 years (as young as 3 months): Use is supported by extrapolation of efficacy data from older children, with safety data from 65 pediatric patients aged 3 months to <5 years who received 2.5 mg daily for 2 weeks 1
  • The same 2.5 mg once daily dose applies across all pediatric age groups 1

Administration Details

  • Administer via compressed air-driven nebulizer or recommended nebulizer system 1
  • Each ampule delivers 2.5 mL of solution containing 1 mg/mL dornase alfa 1
  • The solution contains no preservative and should be used immediately after opening 1

Clinical Evidence Supporting Dosing

The 2.5 mg once daily dose demonstrated:

  • 9.4% improvement in FEV1 compared to 2.1% for placebo (p<0.001) in patients with advanced lung disease 2
  • 27% reduction in relative risk of respiratory tract infections requiring parenteral antibiotics 1
  • Improved lung function and reduced exacerbations in patients with moderate to severe disease 3

The 2.5 mg twice daily dose showed:

  • 29% reduction in relative risk of respiratory tract infections 1
  • May be more beneficial in older patients (>21 years) and those with higher baseline lung function 1

Important Compatibility Warning

Do not mix Pulmozyme with Atrovent LS or Sultanol Inhalationslösung due to physicochemical incompatibility caused by benzalkonium chloride and disodium edetate excipients, which reduce dornase alfa activity 4. Pulmozyme can be mixed with preservative-free unit dose formulations of ipratropium or albuterol for a limited time 4.

Monitoring and Duration

  • Daily administration is essential to maintain efficacy; intermittent dosing reduces effectiveness 5
  • Long-term use (up to 24 weeks and beyond) has been demonstrated to be safe and well-tolerated 2, 5
  • Routine use is associated with improved survival in CF patients 6

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.