carbocisteine / Generic mfg. - LARVOL DELTA

Effects of hypertonic saline and/or carbocisteine on sputum rheology in bronchiectasis: CLEAR-EME. (PubMed, ERJ Open Res) - "At baseline, viscoelasticity (crossover point σc) was positively correlated with interleukin-8 (r=0.49, p=0.012) and greater relative bacterial dominance (r=0.35, p=0.041). These data do not support the use of HTS or carbocisteine to alter sputum viscoelasticity, inflammatory marker levels or bacterial community composition in patients with bronchiectasis."

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Carbocisteine Reduces Airway Mucus Obstruction and Alters Inflammatory Cell Populations in a Model of Muco-Obstructive Lung Disease. (PubMed, Immunol Cell Biol) - "However, despite changes in immune cell populations, short-term administration failed to mitigate lung damage and inflammation associated with established muco-obstructive lung disease. These findings demonstrate the potent mucoactive effect of carbocisteine in established muco-obstructive lung disease, through a broader mechanism of action than previously understood, with the potential to modulate inflammatory responses for preventive or long-term treatment strategies."

Journal • Bronchiectasis • Chronic Obstructive Pulmonary Disease • Cystic Fibrosis • Genetic Disorders • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases • IL17A • ITGAM • MUC5AC • MUC5B

Phytochemical profile and in vitro antimicrobial, antiviral, and anticancer activities of Echium angustifolium ethanolic extract. (PubMed, Sci Rep) - "The ethanolic extract showed the highest yield (14.23%) among the tested solvents and richest phytochemical profile, with rutin as the predominant compound. LC-MS/MS identified 24 compounds including threonic acid, hypoxanthine, indole-3-carboxylic acid, N-methyllysine, 4-methyl-2-oxovaleric acid, 4-isopropylbenzoic acid, methionine, N-2-fluorenylacetamide, arachidic acid, N-methylanthranilic acid, carbocysteine, fructose-1,6-bisphosphate, lumazine, 5-aminoimidazole-4-carboxamide, and 3-isochromanone...The ethanolic extract of E. angustifolium exhibited multifunctional in vitro bioactivities, including antioxidant, antimicrobial, anti-inflammatory, anticancer, and antiviral effects. LC-MS/MS identified a diverse array of bioactive compounds, while mechanistic studies revealed apoptosis induction via the mitochondrial pathway (upregulation of Bax, Caspase-3, and Caspase-9; downregulation of Bcl-2) and direct antiviral activity through inhibition of..."

Journal • Preclinical • Hematological Disorders • Infectious Disease • Oncology • BAX • BCL2 • CASP3 • CASP9

Implementation and outcomes of drug response assessments for inhaled hypertonic saline in bronchiectasis: a post hoc analysis of the CLEAR trial. (PubMed, Thorax) - "DRA failure rate was low and did not identify medium-term/long-term tolerance to HTS, indicating that its utility as a screening tool for tolerability in this population is limited."

Journal • Retrospective data • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Unsupervised home spirometry versus supervised clinic spirometry: analysis of longitudinal participant-level data from the CLEAR trial in patients with bronchiectasis. (PubMed, Thorax) - "Home spirometry demonstrates good agreement with clinic spirometry, with variability between measurements decreasing over time. Home spirometry detected changes in lung function across exacerbations, although variability may limit interpretation at the individual patient level. With appropriate patient support to maintain adherence, home spirometry has potential as a tool for remote monitoring and decentralised clinical trials in bronchiectasis."

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

TAME-CLC: Muco-active Agent Use and Clinical Outcomes After Lung Cancer Diagnosis in Chronic Obstructive Pulmonary Disease (clinicaltrials.gov) - P=N/A | N=27000 | Active, not recruiting | Sponsor: Seoul National University

New trial • Chronic Obstructive Pulmonary Disease • Immunology • Lung Cancer • Oncology • Pulmonary Disease • Respiratory Diseases • Solid Tumor

Mucoactive agents in bronchiectasis: a systematic review and meta-analysis. (PubMed, Eur Respir Rev) - "Pooled evidence did not show a reduction in exacerbations and FEV1 % pred improvements were small. Evidence certainty was low/very low, meaning overall clinical benefit remains uncertain, highlighting the need for targeted trials of specific agents and subgroups."

Clinical • Journal • Retrospective data • Review • Bronchiectasis • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Inflammation • Pediatrics • Pulmonary Disease • Respiratory Diseases

Beyond its mucolytic mechanism, carbocisteine protects against cyclophosphamide-induced lung injury by modulating TLR-4/NF-κB signaling, oxidative stress, and PPARγ. (PubMed, Tissue Cell) - "In conclusion, SCMC markedly alleviates CP-induced lung injury by attenuating oxidative stress, inflammation, and apoptosis, and modulation of TLR-4/NF-κB pathway and PPARγ. These data support the potential application of SCMC as an adjuvant strategy to limit CP-associated pulmonary toxicity."

Journal • Acute Lung Injury • Inflammation • Oncology • Pneumonia • Respiratory Diseases • BCL2 • CASP3 • CAT • IL1B • PPARG • TLR4 • TNFA

Carbocisteine or Hypertonic Saline for Acute Respiratory Failure. (PubMed, N Engl J Med) - "Among critically ill patients with acute respiratory failure, neither carbocisteine nor HTS significantly reduced the duration of mechanical ventilation, and each was associated with harm. (Funded by the NIHR Health Technology Assessment Programme and the Belfast Health and Social Care Trust Charitable Trust Fund; MARCH ISRCTN Registry number, ISRCTN17683568.)."

Journal • Gastroenterology • Respiratory Diseases

Evaluating the Safety and Efficacy of Carbocisteine in the Treatment of Nonalcoholic Fatty Liver Disease Patients (clinicaltrials.gov) - P2 | N=46 | Recruiting | Sponsor: Tanta University | Trial completion date: Apr 2026 ➔ Apr 2027 | Trial primary completion date: Mar 2026 ➔ Mar 2027

Trial completion date • Trial primary completion date • Hepatology • Metabolic Dysfunction-Associated Steatotic Liver Disease

Airway Mucosal Defense: Mucins, Innate Immunity, and Contemporary Mucoactive Strategies. (PubMed, Biomedicines) - "Established drugs, including N-acetylcysteine, carbocysteine, dornase alfa, ambroxol, and hypertonic solutions, are considered alongside emerging molecular targets such as NF-κB-dependent regulation of mucin expression, calcium-activated chloride channels, MARCKS-mediated mucin exocytosis, purinergic signaling pathways, and NO/cGMP signaling. Non-pharmacological approaches, including airway clearance techniques and respiratory rehabilitation, are covered concisely. Overall, this review highlights mucins as dynamic regulators of innate immunity and underscores the need for mechanism-based, personalized mucoactive therapies to improve outcomes in chronic inflammatory airway diseases."

Journal • Review • Asthma • Chronic Obstructive Pulmonary Disease • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Inflammation • Pulmonary Disease • Respiratory Diseases • MARCKS • MUC5AC • MUC5B

Hypertonic Saline or Carbocisteine in Bronchiectasis. (PubMed, N Engl J Med) - No abstract available

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Hypertonic Saline or Carbocisteine in Bronchiectasis. Reply. (PubMed, N Engl J Med) - No abstract available

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Hypertonic Saline or Carbocisteine in Bronchiectasis. (PubMed, N Engl J Med) - No abstract available

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Hypertonic Saline or Carbocisteine in Bronchiectasis. (PubMed, N Engl J Med) - No abstract available

Journal • Bronchiectasis • Pulmonary Disease • Respiratory Diseases

Ulcerative colitis, pathophysiological mechanisms and drug repurposing: a new therapeutic dawn-narrative review. (PubMed, Inflammopharmacology) - "Several medications, including rosiglitazone, amlodipine, felodipine, atorvastatin, metformin, pentoxifylline, nitazoxanide, nifuroxazide, carbocisteine, levetiracetam, topiramate, nicodamid, and vildagliptin, have been shown to have positive effects on multiple organs through their anti-inflammatory properties. Using the findings of in vitro, in vivo, and clinical investigations, the positive effects of these medications on UC are thoroughly outlined and examined in the present research. Having a better knowledge of these protective benefits and the basic mechanisms may make it possible for UC patients to take these medications effectively."

Journal • Review • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis • AMPK • IL6 • mTOR • STAT3

Efficacy and safety of mucolytic agents in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis. (PubMed, BMC Pulm Med) - No abstract available

Journal • Retrospective data • Chronic Obstructive Pulmonary Disease • Immunology • Pulmonary Disease • Respiratory Diseases

Efficacy of Carbocisteine in Reducing Exacerbations in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, Adv Respir Med) - "Carbocisteine is associated with a significant reduction in COPD exacerbations and demonstrates a favorable safety profile. It may serve as an effective adjunctive therapy in patients with frequent exacerbations and mucus hypersecretion."

Clinical • Journal • Retrospective data • Review • Chronic Obstructive Pulmonary Disease • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases

What is the clinical effectiveness and cost-effectiveness of nebulised 7% saline in patients with chronic obstructive pulmonary disease (COPD)- (MucAct COPD Trial) (BTS WM 2025) - "There was a prolonged time to first exacerbation requiring antibiotic therapy and/or systemic steroids (p=0.044) in the intervention arm. Conclusion Although hypertonic saline compared with carbocisteine treatment led to no significant difference in the CAT questionnaire, there was a prolonged time to first exacerbation and reduced exacerbations."

Clinical • Cost effectiveness • HEOR • Bronchiectasis • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Novel Coronavirus Disease • Pulmonary Disease • Respiratory Diseases

Famotidine-Induced Rash and Eosinophilia: A Case Report. (PubMed, Cureus) - "He initially received intravenous gentamicin followed by oral amoxicillin-clavulanic acid for the urinary tract infection. Oseltamivir and carbocisteine were prescribed for the flu...Considering the timing of the rash and the patient's lack of prior adverse reactions to penicillin, famotidine was identified as the most probable causative agent for the rash. The rash improved following discontinuation of famotidine, supporting the diagnosis of famotidine-induced hypersensitivity reaction."

Journal • Allergy • Cardiovascular • Eosinophilia • Heart Failure • Immunology • Infectious Disease • Influenza • Nephrology • Respiratory Diseases

Unmasking disease in ulcerative colitis-associated bronchiectasis after treatment with vedolizumab (WBC 2025) - "Her bowel disease was in remission after treatment with infliximab and tofacitinib...Sputum cultures grew Serratia marcescens but despite numerous antibiotic courses, inhaled corticosteroids and bronchodilators, low dose azithromycin and carbocisteine, he continued to wheeze and produce mucopurulent sputum...He was maintained on low dose prednisone while he was transitioned to Ustekinumab for his UC... These cases highlight the potential for vedolizumab to unmask bronchiectasis symptoms in people with UC, possibly due to its gut-selective immune mechanism. Pulmonologists and gastroenterologists should be aware of this issue and should have a high index of suspicion for bronchiectasis in people with worsening airway symptoms on vedolizumab, particularly when repeat antibiotic courses are ineffective. Adjustments to UC therapy, aimed at broader systemic immunomodulation, may be necessary to address both intestinal and pulmonary disease effectively."

Bronchiectasis • Cough • Dermatology • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Mucositis • Pulmonary Disease • Respiratory Diseases • Ulcerative Colitis

PHARMACOLOGIC VS NONPHARMACOLOGIC INTERVENTION IN THE MANAGEMENT OF EXCESSIVE DAYTIME SLEEPINESS IN OBSTRUCTIVE SLEEP APNEA (CHEST 2025) - "Other pharmacologic treatments, including armodafinil, pitolisant, and solriamfetol, have demonstrated efficacy in improving wakefulness, particularly in patients with residual sleepiness. Excessive daytime sleepiness (EDS) is a major concern in obstructive sleep apnea (OSA), especially for those with persistent symptoms despite CPAP therapy. While CPAP remains the gold standard, other interventions offer potential benefits. Treatment options like carbocysteine and herbal remedies have shown promise in reducing EDS, though more research is needed."

Excessive Daytime Sleepiness • Obstructive Sleep Apnea • Respiratory Diseases • Sleep Disorder

Association between early administration of mucoactive agents and in-hospital mortality in patients with pneumonia requiring mechanical ventilation: a nationwide cohort study. (PubMed, J Intensive Care) - "In patients with ventilated pneumonia, early administration of mucoactive agents was associated with lower in-hospital mortality."

Journal • Infectious Disease • Pneumonia • Respiratory Diseases

Hypertonic Saline or Carbocisteine in Bronchiectasis. (PubMed, N Engl J Med) - "In participants with bronchiectasis, neither hypertonic saline nor carbocisteine significantly reduced the mean incidence of pulmonary exacerbations over a period of 52 weeks. (Funded by the National Institute for Health and Care Research Health Technology Assessment Programme and others; ISRCTN Registry number, ISRCTN89040295.)."

Journal • Bronchiectasis • Genetic Disorders • Immunology • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

RCT Abstract - Effectiveness of hypertonic saline (HTS 6%) and carbocisteine in reducing bronchiectasis exacerbations (Results of the CLEAR randomised trial) (ERS 2025) - No abstract available

Clinical • Bronchiectasis • Pulmonary Disease • Respiratory Diseases