Gefapixant

How it works

It blocks P2X3 receptors on airway sensory nerve fibres, attenuating ATP-mediated activation of the cough reflex arc and thereby reducing cough hypersensitivity.

Prescribing in practice

• Taste disturbance, including reduced or altered taste, is a very common and characteristic adverse effect that can lead to discontinuation.
• It is reserved for chronic cough that persists despite assessment and treatment of underlying causes.
• Dose considerations apply in renal impairment as elimination is predominantly renal.

Monitoring

Monitor cough response and tolerability, particularly taste-related adverse effects.

Counselling the patient

• An altered or reduced sense of taste is common and is usually reversible if the medicine is stopped.
• It is used when cough continues despite treating other possible causes.
• Discuss with your prescriber if taste changes become troublesome.

Evidence & guidelines

Gefapixant has been evaluated in randomised trials in refractory and unexplained chronic cough demonstrating reductions in cough frequency.