hypertonic saline + ivacaftor

**Hypertonic saline + ivacaftor** is not a uniquely branded fixed-dose combination product, but rather describes the concomitant use of two separate pharmaceutical agents in patients with cystic fibrosis (CF). - **Hypertonic saline** is a sterile saline solution (usually 3%–7% sodium chloride) inhaled as a nebulized aerosol. It acts as a mucolytic agent by drawing water into the airway surfaces via osmosis, hydrating airway mucus, and improving mucociliary clearance. - **Ivacaftor** is a small molecule CFTR potentiator. It targets specific mutant forms of the cystic fibrosis transmembrane conductance regulator (CFTR) protein, increasing the probability that the defective CFTR chloride channel remains open, thereby improving chloride transport in epithelial cells. This drug combination is utilized as adjunctive therapy in CF to improve lung function and reduce exacerbations. Hypertonic saline is used to aid airway clearance, while ivacaftor corrects underlying CFTR dysfunction in eligible genotypes. This dual approach has been common in CF care, especially prior to widespread use of triple CFTR modulators. There is ongoing research to determine the clinical utility of continuing hypertonic saline in patients already on highly effective CFTR modulators like ivacaftor, since both impact lung function but by different mechanisms[1][3][4].