NHS-England Specialist Commissioning – Prescribing to remain with specialist centre
1.1 Mannitol dry powder for inhalation is recommended as an option for treating cystic fibrosis in adults:
who cannot use rhDNase because of ineligibility, intolerance or inadequate response to rhDNase
whose lung function is rapidly declining (forced expiratory volume in 1 second [FEV1] decline greater than 2% annually)
for whom other osmotic agents are not considered appropriate.
1.2 People currently receiving mannitol whose cystic fibrosis does not meet the criteria in 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.
NICE Guidance TA266 November 2012