Levodropropizine Dosing
The recommended dose of levodropropizine is 75 mg three times daily (total 225 mg/day) for adults, based on evidence from randomized controlled trials in patients with cough. 1, 2
Standard Adult Dosing
Levodropropizine 75 mg orally three times daily is the established dosing regimen demonstrated in a double-blind randomized trial of 140 patients with lung cancer, where this dose showed equivalent antitussive efficacy to dihydrocodeine 10 mg three times daily 1, 2
This dosing schedule (75 mg TID) significantly reduced subjective cough severity and nocturnal awakenings with similar duration of cough suppression compared to opioid antitussives 1, 2
Pediatric Dosing
For children, the recommended dose is 2 mg/kg orally three times daily, based on clinical trials in pediatric respiratory diseases 3, 4
This pediatric dosing (2 mg/kg TID for 3 days) produced statistically significant decreases in coughing frequency and nocturnal awakenings (P < 0.001) 4
Formulation Considerations
Levodropropizine is available in multiple formulations including oral drops, syrup, immediate-release tablets (60 mg), and controlled-release tablets (90 mg) 5, 6
For controlled-release formulations, the dose is 90 mg twice daily (total 180 mg/day), which provides similar total systemic exposure to the immediate-release formulation given three times daily 6
Food delays absorption of controlled-release tablets but does not significantly affect total systemic exposure, allowing flexible administration with or without meals 6
Clinical Advantages Over Opioid Antitussives
The key advantage of levodropropizine at this dosing is markedly reduced somnolence: 8% versus 22% with dihydrocodeine, making it preferable when sedation is problematic 1, 2
Levodropropizine at 60 mg doses does not affect respiratory responses to hypercapnia, unlike the opioid dihydrocodeine 15 mg, confirming its peripheral mechanism of action without central respiratory depression 7
Important Geographic Limitation
Levodropropizine is not available in the United States, which significantly limits its use depending on practice location 1, 2
In regions where levodropropizine is unavailable, centrally acting opioid antitussives (hydrocodone, dihydrocodeine) remain the recommended alternatives for cancer-related cough 1