A phase II study of hydrocodone for cough in advanced cancer

Autor: Mellar P. Davis, Jade Homsi, Susan B. LeGrand, Declan Walsh, Nabeel Sarhill, Lisa Rybicki, Kristine A. Nelson
Rok vydání: 2002
Předmět:
Zdroj: American Journal of Hospice and Palliative Medicine®. 19:49-56
ISSN: 1938-2715
1049-9091
Popis: Purpose: Cough is a common symptom in advanced cancer. The use of hydrocodone as an antitussive has not been studied previously in this setting. This study evaluates hydrocodone for cough in advanced cancer. Methods: The results presented are from a phase II study with dose titration. Setting: Palliative medicine program in a tertiary referral center. Patients: 25 consecutive patients with cough from irreversible causes, on a stable opioid regimen for the prior 24 hours, and no previous or current use of hydrocodone for cough. Intervention: 5 mg hydrocodone was administered twice daily. The dose was then titrated daily (maximum: 60 mg/24 h), if needed, until a 3 50 percent improvement of the frequency of cough was achieved and then maintained for three consecutive days. Measurements: Cough severity, frequency, complications, and hydrocodone side effects. Results: 20 persons (10 women and 10 men) completed study evaluation. Median age was 63 years (range: 42-82). Nine patients had lung cancer and seven had lung or pleura metastases; 19 patients had at least 50 percent improvement of their cough frequency. The median best response was 70 percent improvement in the cough frequency (range: 50-90 percent). Median hydrocodone dose associated with the best response was 10 mg/day (range: 5-30 mg/day). Cough severity, frequency, associated symptoms and complications, and activities of daily living improved significantly. Side effects of hydrocodone (dry mouth, nausea, and drowsiness) were tolerable and rated as mild. Conclusions: Hydrocodone is effective and safe to treat cough in advanced cancer. A starting dose of 10 mg per day in divided doses seems effective. Dose escalation may be required. Most improved within one day.
Databáze: OpenAIRE