Seiko Kawai and Kenji Baba*
Division of Respiratory Medicine, Aichi Medical University School of Medicine, JapanFulltext PDF
A 61-year-old man visited our outpatient office with a 3-month history of refractory cough that had proven resistant to >1-month treatments with codeine phosphate, inhaled budesonide/formoterol combination, one of inhaled corticosteroid/long acting beta-agonist combinations (ICS/LABA combinations) and omeprazole. We attempted treatment with other ICS/LABA combinations (fluticasone/vilanterol combination), inhaled long-acting muscarinic agonists, proton pump inhibitors, macrolide antibiotics (roxithromycin) and codeine, but cough remained. Gabapentin was started at 200 mg, twice daily. Remission of cough began from day 10 of administration, and after 1 month, scores from all indices of cough Visual Analogue Scale (VAS) decreased to about onequarter of scores on presentation. The gabapentin regimen was maintained for 3 months, and then reduced to 200 mg/day. Five months after reducing the dose, no exacerbation of cough or cough VAS scores was seen. We reduced gabapentin further, completely ending treatment 10 months after beginning gabapentin. No recurrence of cough has been seen as of 6 months after ending gabapentin. The present clinical experience of complete remission of intractable cough by gabapentin implies that some cough mainly involves neural dysfunction. Further studies are required to determine suitable biomarkers, doses, and durations of pharmacotherapy.
Gabapentin; Chronic cough; Cough hypersensitivity syndrome
Kawai S, Baba K. A Case of Refractory Chronic Cough that Resolved Completely with Long-Term Low-Dose Gabapentin. J Respir Med Lung Dis. 2020; 5(1): 1052.