9. Ask About Medications
No medications have been approved specifically to treat cough in IPF, but your doctor can suggest some options. “A multifaceted approach using a combination of over-the-counter and prescription cough suppressants, neuromodulatory agents, and narcotic agents may provide some relief,” says Dr. Kershaw.
Kulkarni says cough suppressants containing dextromethorphan can help reduce the urge to cough in some people, but evidence of their effectiveness for IPF is limited. While they aren’t routinely prescribed, she says these medications may help manage your cough:
- Inhalers or nebulizers may be prescribed if there is evidence for coexisting airway conditions, such as asthma.
- Low-dose corticosteroids like prednisone may be considered for a short time in selected patients with a severe cough that doesn’t respond to other treatments.
- Benzonatate (Tessalon Perles, Zonatuss) is a nonnarcotic cough suppressant that works by numbing the sensory receptors in the lungs, which then reduces the nerve signals sent to the brain’s cough center.
- Low-dose opioids such as morphine or hydrocodone may reduce a severe cough that doesn’t respond to other treatments in certain patients under close medical supervision.
Gabapentin, a neuromodulator, is another option. “This drug is better known for its role in treating neuropathic pain and it works in a similar way in chronic cough to dampen the hypersensitive neuropathic cough reflex,” says Garfield.
Kershaw encourages people to look into clinical trials that are investigating new treatments for IPF-related cough. “One promising agent, nalbuphine, showed a reduction in cough secondary to IPF in an early phase trial,” he says.
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