Capval®

Names

Trade name: Capval® Non-proprietary name: Noscapine Other chemical names: Narcotin, Methoxyhydrastin (molecular formula of noscapine: C22H23NO7

Introduction

Capval® belongs to the group of antitussives, also called cough suppressants. Antitussives can act on the one hand by inhibiting the cough centre in the brain stem (= central effect) and on the other hand by inhibiting sensitive receptors in the lungs (= peripheral effect). It is important that this type of medication is only prescribed when the cough is dry (= without mucus).

Since the cough reflex is also inhibited when the coughing centre in the brain stem is inhibited, existing mucus cannot be coughed up as a result, which would possibly lead to an aggravation of the clinical picture. The active ingredient of Capval® is noscapine. Noscapine is a natural component of opium, which is extracted as an alkaloid from the plant opium poppy (Papaver somniferum).

As an antitussive, it has exclusively peripheral effects. This means that it acts directly on the bronchial tubes, where it has a bronchodilating (=dilating) and respiratory stimulating effect. Capval® does not relieve pain (analgesia) and is therefore not considered an opiate.

In contrast to opiates (e.g. codeine) it is much better tolerated and has no addictive potential, as it does not trigger euphoric effects. The fact that it acts exclusively in the periphery has another advantage: Capval® has no sedative effect and does not suppress breathing. Constipation, a common side effect of opiate use that is very stressful for those affected, does not occur when Capval® is taken. Moreover, according to recent studies, it is said to have an anti-tumour effect because it inhibits CYP2C9.

Pharmacokinetics

The plasma half-life of Capval® is between 2.6 and 4.5 hours. The molar mass is 413. Oral bioavailability, i.e. the percentage of the active ingredient that is still available at the site of action (in this case the bronchi), is around 30%.

Antitussives, such as Capval, are mainly used for symptomatic treatment of unproductive (= without mucus) nocturnal irritable cough. Since coughing is never an independent illness but only a symptom, the cause of the irritable cough must be examined by a doctor. A possible cause can be, for example, acute or chronic bronchitis.

Pertussis (whooping cough) can also be a reason for prescription as well as COPD (chronic obstructive pulmonary disease). A chesty cough can also be caused by a tumour or other anatomical changes. If the cough is too much cardiovascular stress, Capval is equally induced. This is the case, for example, if an aneurysm could burst due to the severe cough.

Side effects

Common side effects are headaches and dizziness. Occasionally nausea and vomiting occur after ingestion. Dizziness, skin and hypersensitivity reactions with itching are also side effects.

The development of Quinke’s edema (swelling of the face and neck) is occasional. Cramp-like pain in the upper abdomen with a feeling of tightness and shortness of breath have also been described, although rarely. Overdosage may cause seizures.