From the Guidelines
Cough suppressants are medications used to reduce coughing symptoms, with opioids being the most effective option for patients with lung cancer, as suggested by the most recent and highest quality study 1.
Overview of Cough Suppressants
Cough suppressants can be categorized into two main types: centrally acting and peripherally acting. Centrally acting cough suppressants, such as opioids, work by acting on the cough center in the brain to reduce the cough reflex. Peripherally acting cough suppressants, on the other hand, work by reducing the sensitivity of the nerves in the throat and lungs.
Recommended Treatment Options
For patients with lung cancer, the following treatment options are recommended:
- Demulcents such as butamirate linctus (syrup) or simple linctus (syrup) or glycerin-based linctus (syrup) as an initial trial 1
- Opiate-derivative titrated to an acceptable side-effect profile for patients who do not respond to demulcents 1
- Peripherally-acting antitussive such as levodropropizine, moguisteine, levocloperastine or sodium cromoglycate for opioid-resistant cough 1
- Local anesthetics, including nebulized lidocaine/bupivacaine or benzonatate, for opioid-resistant cough that does not respond to peripheral antitussives 1
Important Considerations
- Cough suppressants should generally not be used for productive coughs with phlegm, as coughing helps clear mucus from the lungs.
- Patients with lung cancer should be assessed for any co-existing causes of cough and treated accordingly.
- Cough suppression exercises and endobronchial brachytherapy may be considered as alternative or additional treatments for patients with lung cancer.
- Staying hydrated, using honey (for adults and children over 1 year), and using humidifiers can also help manage cough symptoms alongside medication.
From the FDA Drug Label
Purpose Cough suppressant Package/Label Principal Display Panel ... Cough Suppressant Uses temporarily relieves: cough due to minor throat and bronchial irritation Cough suppressants are medications that help relieve coughing.
- Examples of cough suppressants include:
From the Research
Definition of Cough Suppressants
- Cough suppressants, also known as antitussives, are medications used to relieve coughing 4, 5, 6, 7, 8
- They work by suppressing the cough reflex, which can be caused by a variety of factors, including respiratory tract infections, allergies, and gastroesophageal reflux disease
Types of Cough Suppressants
- Centrally acting opioids, such as codeine, morphine, and dextromethorphan, which work by binding to opioid receptors in the brain and spinal cord 4, 6, 7, 8
- Peripherally acting antitussives, such as moguisteine and levodropropizine, which work by blocking the cough reflex at the level of the lungs and airways 8
- Non-opioid antitussives, such as bilastine, which is a non-sedating antihistamine that can be used in combination with other medications to relieve coughing 5
Mechanism of Action
- Cough suppressants can work by reducing the sensitivity of the cough reflex, making it less likely to be triggered by irritants such as dust, smoke, and cold air 4, 7
- They can also work by reducing the frequency and severity of coughing fits, making it easier for patients to manage their symptoms and get a good night's sleep 5, 6
Examples of Cough Suppressants
- Codeine, which is a centrally acting opioid that is commonly used to relieve coughing 4, 6, 8
- Dextromethorphan, which is a centrally acting opioid that is commonly used in over-the-counter cough medications 5, 8
- Bilastine, which is a non-sedating antihistamine that can be used in combination with other medications to relieve coughing 5