Usage
- Levocloperastine is prescribed for the symptomatic treatment of dry cough. It is noteworthy that it does not treat productive coughs.
- Pharmacological classification: Antitussive (cough suppressant).
- Mechanism of Action: Levocloperastine acts primarily on the central nervous system by suppressing the cough center in the medulla oblongata. It also has peripheral effects in the lungs. It is a non-narcotic cough suppressant.
Alternate Names
- Levocloperastine Fendizoate
- Brand names vary depending on the region. Some examples include: Rapidkof, Levocip, and others.
How It Works
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Pharmacodynamics: Levocloperastine reduces the frequency and intensity of cough by decreasing the sensitivity of cough receptors and suppressing the cough center in the brain. It may also have some antihistaminic and anticholinergic properties.
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Pharmacokinetics: Levocloperastine is administered orally and is rapidly absorbed. The onset of action is typically within 20-30 minutes, and the duration of action is approximately 3-4 hours.
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Mode of Action: Levocloperastine primarily acts on the central nervous system by suppressing the cough center in the medulla oblongata.
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Receptor binding, enzyme inhibition, or neurotransmitter modulation: Primarily acts on the cough center but information about specific receptor binding or neurotransmitter modulation is limited based on the current sources.
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Elimination pathways: Information on this topic is limited but the liver and kidneys are known to be involved.
Dosage
Standard Dosage
Adults:
- 10 mg two to three times a day (up to 20mg three times daily, totaling 60mg/day). Oral administration is the typical route, and syrup and tablet forms are available.
Children:
- The dosage is adjusted based on the child’s age and weight:
- 2-6 years: Approximately 8.75 mg, three times a day.
- 6-12 years: Approximately 17.5 mg, three times a day.
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12 years: Adult dose.
- Pediatric safety considerations: Not recommended for children under 2 years of age due to lack of safety and efficacy data.
Special Cases:
- Elderly Patients: Use with caution due to increased risk of adverse effects. Dosage adjustments may be necessary.
- Patients with Renal Impairment: Limited information available. Use with caution and adjust dose based on creatinine clearance if needed.
- Patients with Hepatic Dysfunction: Contraindicated in severe hepatic impairment. Use with caution in mild to moderate hepatic dysfunction and consider dose reduction.
- Patients with Comorbid Conditions: Use with caution in patients with diabetes, cardiovascular disease, hyperthyroidism, or seizure disorders. Dose adjustments may be needed.
Clinical Use Cases
- The dosage recommendations in specific medical settings such as intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations are not readily available from the current sources. The drug is generally not used in these situations.
Dosage Adjustments
- Dosage adjustments may be required for patients with renal or hepatic impairment, diabetes, and cardiovascular disease.
Side Effects
Common Side Effects
- Drowsiness
- Dizziness
- Nausea
- Dry mouth
- Fatigue
- Headache
Rare but Serious Side Effects
- Allergic reactions (skin rash, itching, swelling, breathing difficulties)
- Fainting
- Severe drowsiness
Long-Term Effects
- Limited information on long-term effects is available.
Adverse Drug Reactions (ADR)
- Significant ADRs requiring immediate intervention include severe allergic reactions and severe drowsiness or respiratory depression (especially in case of overdose).
Contraindications
- Hypersensitivity to levocloperastine.
- Productive cough with excessive mucus secretion.
- Severe hepatic impairment.
- Children under 2 years of age.
Drug Interactions
- CNS depressants: Alcohol, benzodiazepines, opioids - may potentiate sedative effects.
- Anticholinergics: May increase anticholinergic effects.
- MAO inhibitors: Concomitant use may lead to serious interactions.
- Other antidepressants: Use with caution.
- Other medications: Always review patient medication list for potential interactions.
Pregnancy and Breastfeeding
- Pregnancy: Not recommended for use during pregnancy due to potential risk to the fetus.
- Breastfeeding: Not recommended during breastfeeding as it may be excreted in breast milk.
Drug Profile Summary
- Mechanism of Action: Centrally acting antitussive suppressing the cough center.
- Side Effects: Drowsiness, dizziness, nausea, dry mouth, fatigue, headache. Rarely, allergic reactions and fainting.
- Contraindications: Hypersensitivity, productive cough, severe hepatic impairment, children under 2.
- Drug Interactions: CNS depressants, anticholinergics, MAO inhibitors.
- Pregnancy & Breastfeeding: Not recommended.
- Dosage: Adults: 10 mg two or three times/day (up to 20mg three times daily). Children (2-6 years): approximately 8.75 mg three times/day; (6-12 years): approximately 17.5mg three times/day; (>12 yrs): Adult dose.
- Monitoring Parameters: Respiratory rate, cough frequency and intensity, alertness.
Popular Combinations
- Levocloperastine is sometimes combined with antihistamines like chlorpheniramine for synergistic effects in treating cough associated with allergies. Consult a physician to assess suitability for your patient.
Precautions
- General Precautions: Assess for allergies, renal/hepatic function, and other medical conditions before prescribing.
- Specific Populations: See dosage section for specific considerations.
- Lifestyle Considerations: Advise patients to avoid alcohol and activities requiring alertness while taking this medication. Driving or operating heavy machinery is contraindicated.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Levocloperastine?
A: Adults: 10 mg two to three times a day (up to 20 mg three times a day). Children’s dosages are weight and age dependent (See Dosage section).
Q2: Is Levocloperastine safe for pregnant or breastfeeding women?
A: No, it’s generally not recommended for pregnant or breastfeeding women due to potential risks to the fetus or neonate.
Q3: How does Levocloperastine work?
A: It primarily acts on the central nervous system by suppressing the cough center.
Q4: What are the common side effects of Levocloperastine?
A: Common side effects include drowsiness, dizziness, nausea, dry mouth, fatigue, and headache.
Q5: Can Levocloperastine be used for a productive cough?
A: No, it’s specifically indicated for dry cough. Using it for a productive cough could worsen the condition.
Q6: Are there any drug interactions I should be aware of?
A: Yes, it can interact with CNS depressants (alcohol, benzodiazepines, opioids), anticholinergics, and MAO inhibitors. Concomitant use should be carefully evaluated or avoided.
Q7: What should I do if a patient experiences an allergic reaction?
A: Discontinue the medication immediately and provide appropriate medical care for the allergic reaction.
Q8: Can Levocloperastine be used in children under 2 years of age?
A: No, its use is not recommended in children under 2 years of age.
Q9: How long should a patient take Levocloperastine?
A: Treatment should generally not exceed 7 days unless otherwise directed by a physician.
