From the Guidelines
Levocloperastine is a peripherally-acting antitussive medication that can be used to treat opioid-resistant cough in adult patients with lung cancer, as suggested by the Chest guideline and expert panel report 1.
Mechanism of Action and Usage
Levocloperastine works by suppressing the cough reflex, and its usage is recommended when demulcents and opioid-derivative treatments are ineffective. The medication is typically considered for patients with lung cancer experiencing cough that does not respond to first-line treatments, such as demulcents or opioid-derivatives 1.
Dosage and Administration
Although the provided evidence does not specify the dosage of levocloperastine, it is essential to follow the recommended dosage and administration guidelines to minimize side effects and maximize efficacy.
Side Effects and Precautions
Common side effects of antitussive medications include mild drowsiness, dizziness, and gastrointestinal disturbances. However, the specific side effect profile of levocloperastine may vary, and patients should be monitored closely for any adverse reactions.
Clinical Considerations
When prescribing levocloperastine, clinicians should exercise caution in patients with respiratory conditions where cough suppression might be harmful, such as chronic bronchitis or asthma. Additionally, patients should avoid alcohol and other CNS depressants while taking this medication to prevent excessive sedation.
Quality of Life and Symptom Management
Cough is a significant predictor of quality of life in patients with lung cancer, and effective management of this symptom is crucial to improve patient outcomes 1. Levocloperastine, as a peripherally-acting antitussive, may be a valuable treatment option for patients with opioid-resistant cough, helping to alleviate this debilitating symptom and improve overall quality of life.
From the Research
Overview of Levocloperastine
- Levocloperastine, also known as Levocloperpine, is an antitussive (cough suppressant) medication 2, 3.
- It acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree to treat chronic cough 2.
Efficacy of Levocloperastine
- Studies have shown that Levocloperastine significantly improves cough symptoms, including intensity and frequency of cough, in patients of all ages 2, 3.
- It has a more rapid onset of action compared to standard antitussive agents, such as codeine, and is effective in treating cough induced by angiotensin-converting enzyme inhibitors 2.
- Levocloperastine has been found to reduce nighttime awakenings and irritability in children, and improve quality of life in adults 2, 3.
Safety and Tolerability of Levocloperastine
- Unlike standard antitussive agents, Levocloperastine does not cause central adverse events, such as drowsiness, and has a better tolerability profile 2, 3.
- No adverse drug reactions, sedation, or other central nervous system side effects were reported in a prospective observational study of Levocloperastine in adult patients with dry cough 3.
Comparison with Other Antitussive Agents
- Levocloperastine has been compared to other antitussive agents, such as codeine, levodropropizine, and DL-cloperastine, and has been found to have improved or comparable efficacy with a more rapid onset of action 2.
- Other antitussive agents, such as opioids and non-opioids, have been found to have limitations, including side effects and physical dependence 4, 5.