This is data that I received from the medical website UpToDate, possibly explaining why some sites are hesitant to use Mucomyst:
"N-acetylcysteine (Mucomyst)... can liquefy CF sputum in vitro (meaning in the petri dish!). However, there are no well-designed studies that demonstrate its clinical utility (meaning in people). Furthermore, its potential to induce airway inflammation in a subgroup of patients and to inhibit ciliary function has led to reductions in its use.
More recently, inhalation of hypertonic saline (7 percent solution) has been tested because of its proposed ability to promote secretion clearance and/or improve airway lining fluid properties in cystic fibrosis. Preliminary results from an Australian clinical trial presented at the North American CF Meeting (St. Louis, MO 2004) showed improvement in FEV1 and frequency of pulmonary exacerbations. At present, a convenient means to prepare and dispense the solution is not available."
... So, I guess some docs are hesitant to prescribe meds that don't have a lot of clinical data... practicing evidence-based medicine gives docs a comfort zone and is relatively free of liability issues... it's considered good medicine. Also, if docs aren't used to presribing it, then sometimes they get a little iffy about starting. It seems that the MNP clinic has a lot of experience with the medication, it seems to work for their patients, and they feel really comfortable with it. They should look at the data in their patients who are on Mucomyst and those who are on Pulmozyme & see if there are any differences... However, I think the bottom line is... if it makes you feel better and you notice a difference when you're taking it, then it works for you! If you want to try it, your doctor shouldn't hold you back, but instead give you their professional opinion & let you decide... that's the whole basis behind an "informed decision" and docs should respect your judgement and feelings
~L~