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Palliative cancer care - cough - Management
What dose regimen should I use?
- Carbocisteine and mecysteine hydrochloride are options to reduce the viscosity of the secretions.
- If a palliative care patient does not demonstrate any convincing benefit after a week or two of using a mucolytic, then use of a mucolytic should be discontinued.
- For carbocisteine:
- A starting dose of carbocisteine 750 mg three times a day is recommended.
- Once a satisfactory improvement in sputum viscosity has been achieved, the dose should be reduced to carbocisteine 750 mg twice a day.
- For mecysteine hydrochloride:
- Start with mecysteine 200 mg, four times a day, for 2 days; then 200 mg, three times a day (for up to 6 weeks).
- After 6 weeks use, the dose should be reduced to mecysteine 200 mg twice a day.
[Twycross et al, 2002; ABPI Medicines Compendium, 2006; BNF 53, 2007]
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