Hi there. My daughter is only 5 with CF and started Hypersal(or 7% hypertonic saline) almost a year ago. Side effects are coughing, some people can wheeze , like a reactive airway. Our CF doc, made us do the first Hypertonic saline in his office with the RT, to make sure my daughter could tolerate that. He said that was the CFF recommendation. She did cough like crazy when she started it. It is recommended to do albuterol first, wait 15 minutes(in an ideal world) the do the Hypersal. For the pulmozyme, our doc I don't think was sure when that fits in. We do it after the hypersal, then VEST. My daughter has done the VEST and Hypersal at the same time, which is ideal cause it REALLY loosens stuff up, BUT Maggie doesn't like to do it that way, so I don't make her. I feel that the Hypersal has been a very important thing in her care, she gained weight when she started it and has gotten through some colds without antibiotics.