Table 2.
Pharmacological treatment for post-COVID cough
| Drug Class | Examples | Citing studies | Sample size | Dose and Duration | Remarks |
|---|---|---|---|---|---|
| Antihistaminics | Levocetirizine Dextromethorphan | Sepiashvili R et al. (2021)[45] | 56 | 80% of patients had sooth in cough as a symptom. | |
| Centrally acting antitussive drugs/Neuro-modulating drugs | Gabapentin | Ryan et al. (2012)[41] | 32 | 1800 mg od | Improved cough specific QoL |
| Soltani Rasool et al. (2022)[51] | 76 | 300 mg tds ×5 days | Improved cough frequency and severity | ||
| Pregabalin | Vertigan AE et al. (2016)[50] | 40 | 300 mg od ×4 weeks along with SPT$ | Reduces cough symptoms and improves QOL | |
| Leukotriene receptor antagonist (LTRA) | Monteleukast | Mohamed Hussein A.A.R. et al. (2022)[46] | 32 | 10 mg/day ×14 days | Decrease number of cough paroxysm/day, cough severity index, cough QoL, cough duration |
| P2X3 Antagonist | Gefapixant (AF-219/MK-7264) | McGarvey L P et al (2022)[52] | 244 | 45 mg bid ×12 wks (COUGH 1) | Reduction in 24 hour cough frequency and Improvement in cough questionnaire score |
| 440 | 45 mg bid ×24 wks (COUGH 2) | ||||
| Charged sodium channel blocker | NTX-1175 (Nebulised) | Ongoing trial (EuraCT 2020-004715-27)[56] | |||
| NK#-1 Receptor antagonist | Aprepitant Orvepitant | Smith J et al.[54] | 13 | 30 mg od ×4 weeks (VOLCANO 1) | Improvement in objective daytime cough frequency, cough VAS and QoL. |
| Muscarinic antagonist | Inhaled Tiotropium | Dicpinigaitis PV et al. (2008)[44] | 11 | 18 mcg od ×7 days | Inhibits cough reflex sensitivity to capsaicin |
| Inhaled steroids | Glycopyrronium/Formoterol/Budesonide | Yamaya M et al. (2020)[48] | Inhibit CoV replication partly and modulate infection-induced inflammation in the airway. | ||
| TRPV 1 antagonist* | SB-705498 | Khalid S et al. (2014)[55] | 21 | 600 mg single dose | Improvement in cough reflex sensitivity to capsaicin |
| Immunomodulatory drugs | Thalidomide | ClinicalTrials.gov Identifier: NCT04273529[57] | 100 mg od× 14 days (results not posted yet) | ||
| Mast cell stabilizer | Inhaled Sodium Cromoglycate | ClinicalTrials.gov Identifier: NCT05077917[58] | 2 ml of 1% cromolyn sodium solution delivered via nebulizer 4 times a day for 4 days followed by 4% cromolyn solution administered intranasally 4 times per day for 14 days | ||
*TRPV 1 - Transient receptor potential vanilloid 1. #NK-1 - Neurokinin-1