A phase II study of hydrocodone for cough in advanced cancer.

Abstract

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 > or = 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.

• Authors: Jade Homsi, Declan Walsh, Kristine A Nelson, Nabeel Sarhill, Lisa Rybicki, Susan B Legrand, Mellar P Davis
• Journal: The American journal of hospice & palliative care (Am J Hosp Palliat Care) 2002 Jan-Feb Vol. 19 Issue 1 Pg. 49-56 ISSN: 1049-9091 [Print] United States
• PMID: 12171425 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)

Chemical References

• Antitussive Agents
• Hydrocodone

Topics

• Adult
• Aged
• Aged, 80 and over
• Antitussive Agents (therapeutic use)
• Cough (drug therapy, etiology)
• Drug Administration Schedule
• Female
• Humans
• Hydrocodone (therapeutic use)
• Lung Neoplasms (complications, drug therapy)
• Male
• Middle Aged
• Palliative Care
• Pleural Neoplasms (complications, drug therapy)
• Statistics, Nonparametric