Pavacol-D (pholcodine) / Alliance - LARVOL DELTA

Design-assisted HPLC-UV method for therapeutic drug monitoring of pholcodine, ephedrine, and guaifenesin in biological fluids. (PubMed, Sci Rep) - "Also, the method includes a robust sample preparation protocol for the analysis of complex biological samples, ensuring high selectivity and precision. The ease, speed and cost-effectiveness of the method are ideal for supporting in vitro studies, including drug-drug interaction investigations, especially in bioanalytical labs."

Journal

Quaternary ammoniums activate human dendritic cells and induce a specific T-cell response in vitro. (PubMed, Allergol Int) - "We provide evidence at the cellular level that some QACs can elicit an immune response, which could be in line with the hypothesis of these molecules' role in NMBA sensitization."

Journal • Preclinical • CD4

Pholcodine and allergy to neuromuscular blocking agents. Comment on Br J Anaesth 2024; 132: 457-60. (PubMed, Br J Anaesth) - No abstract available

Journal • Allergy • Immunology

Efficacy of compound pholcodine syrup and compound codeine phosphate oral solution on lung cancer cough. (ASCO 2024) - "Compound pholcodine syrup and compound codeine phosphate oral solution are effective in treating lung cancer cough with similar antitussive effectiveness. Compound pholcodine syrup has a lower incidence of xerostomia and constipation than control group, which indicates that the security may be better. Clinical trial information: ChiCTR2300076684."

Clinical • Constipation • Cough • Dental Disorders • Gastroenterology • Gastrointestinal Disorder • Lung Cancer • Oncology • Respiratory Diseases • Solid Tumor • Xerostomia

Predicting the new psychoactive substance activity of antitussives and evaluating their ecotoxicity to fish. (PubMed, Sci Total Environ) - "The prenoxdiazin, pholcodine, codeine, dextromethorphan and dextrorphan exhibited very toxic/toxic to fish. It was necessary to pay close attention to the ecotoxicity of these antitussives. In this study, the integration of ML, molecular docking and ECOSAR approaches are powerful tools for understanding the toxicity profiles and ecological hazards posed by new pollutants."

Journal

Voltammetric analysis of pholcodine on graphene-modified GNPs/PTs with green assessment. (PubMed, BMC Chem) - "The optimized method is found to be accurate, precise, and robust by applying validation parameters provided by International Council for Harmonization. Two green metrics were computed to assess the method's greenness, the findings showed that the developed method is environmentally friendly with minimum sample preparation steps."

Journal

Fast concurrent determination of guaifenesin and pholcodine in formulations and spiked plasma using first derivative synchronous spectrofluorimetric approach. (PubMed, Luminescence) - "The developed methodology also offered an environmentally friendly advantage by utilizing water as the optimal diluting solvent throughout the whole work. Different greenness approaches were investigated to ensure the method's ecofriendly properties."

Journal

Are changes in antibiotic prophylaxis recommendations responsible for an increased risk of cefazolin allergy? (PubMed, Anaesth Crit Care Pain Med) - "Direct previous cefazolin exposure was identified in 78% of cefazolin-allergic patients. Cefazolin started to take a central place in antibiotic prophylaxis after 2010, when cefamandole usage decreased drastically. Changes in antibiotic prophylaxis over the past 14 years in France could have been the turning point for the increased incidence of cefazolin allergy."

Journal • Allergy • Anesthesia • Immunology • Infectious Disease

Suspected pholcodine allergy: the conundrum of clinically irrelevant immunoglobulin E and basophil responsiveness to morphine and codeine. (PubMed, Br J Anaesth) - No abstract available

Journal • Allergy • Immunology

Pholcodine and allergy to neuromuscular blocking agents: where are we and how did we get here? (PubMed, Br J Anaesth) - "Despite the purported link between pholcodine and neuromuscular blocking agent allergy, screening for prior pholcodine use offers no practical benefit to patients, and anaesthetists should continue to use a neuromuscular blocking agent where this is clinically indicated."

Journal • Allergy • Anesthesia • Immunology

Pholcodine, perioperative anaphylaxis, and the European Medicines Agency: finally the decision to remove pholcodine from the market in the European Union. (PubMed, Br J Anaesth) - "The European Medicines Agency, criticised for not taking preventive action at its first assessment of pholcodine in 2011, finally recommended a stop to sales of all pholcodine-containing medicines throughout the EU on December 1, 2022. Time will tell whether this reduces the incidence of perioperative anaphylaxis in the EU, as in Scandinavia."

European regulatory • Journal • Anesthesia • Cough • Respiratory Diseases

Exploiting the power of UPLC in separation and simultaneous determination of pholcodine, guaiacol along with three specified guaiacol impurities. (PubMed, BMC Chem) - "Linear relationships, at ranges of 50-1000 µg mL for pholcodine and 5-100 µg mL for guaiacol and the three related impurities, were established. Finally, the proposed method was applied for pholcodine and guaiacol determination in Coughpent® syrup and compared favorably to the reported one."

Journal • Cough • Respiratory Diseases

Safety update: withdrawal of pholcodine-containing medicines. (PubMed, Drug Ther Bull) - "Pholcodine-containing cough and cold medicines: withdrawal from UK market as a precautionary measure. Drug Safety Update 2023;16:1."

Journal • Cough • Respiratory Diseases

Cough up, time's up: pholcodine and risk of anaphylaxis to general anaesthetics. (PubMed, Arch Dis Child) - No abstract available

Journal • Allergy • Anesthesia • Cough • Immunology • Pediatrics • Respiratory Diseases

Efficacy of compound pholcodine syrup and compound codeine phosphate oral solution on lung cancer-related cough (PubMed, Zhonghua Yi Xue Za Zhi) - " Both compound pholcodine syrup and compound codeine phosphate oral solution are effective in treating lung cancer-related cough with similar antitussive effectiveness. Compound pholcodine syrup has a lower incidence of xerostomia and constipation than control group, with a better safety profile."

Journal • Constipation • Cough • Dental Disorders • Gastroenterology • Gastrointestinal Disorder • Lung Cancer • Oncology • Respiratory Diseases • Solid Tumor • Xerostomia

Pholcodine exposure increases the risk of perioperative anaphylaxis to neuromuscular blocking agents: the ALPHO case-control study. (PubMed, Br J Anaesth) - P=N/A | "Patients exposed to pholcodine 12 months before NMBA exposure have a significantly higher risk of an NMBA-related anaphylaxis. The low positive predictive values of pholcodine and quaternary ammonium sIgEs precludes their use to identify a population with a high risk of NMBA-related anaphylaxis."

Journal • Anesthesia

UK withdraws pholcodine-containing cough and cold medicines over anaphylaxis risk in surgery. (PubMed, BMJ) - No abstract available

Journal • Surgery • Cough • Respiratory Diseases

"#CHCNewDirections: #Australia's @TGAgovau #TGA is cancelling 55 #pholcodine-containing medicines from the Australian Register of Therapeutic Goods and recalling 44 (of the 55) products currently on pharmacy shelves, following a safety investigation & @EMA_News #EMA review" (@NicholasHallCo)

Clinical • European regulatory • Review

Huashi baidu granule in the treatment of pediatric patients with mild coronavirus disease 2019: A single-center, open-label, parallel-group randomized controlled clinical trial. (PubMed, Front Pharmacol) - P=N/A | " 108 recruited children (aged 3-18 years) with laboratory-confirmed mild COVID-19 were randomly allocated 2:1 to receive oral HSBDG for five consecutive days (intervention group) and to receive compound pholcodine oral solution for five consecutive days (control group)...There was no significant differences in the frequency of antibiotic use and side effects between the two groups. HSBDG is a safe, effective oral Chinese herbal compound granule, which shows a good performance within the Omicron wave among pediatric patients."

Clinical • Journal • Infectious Disease • Novel Coronavirus Disease • Pediatrics • Respiratory Diseases

Molecular Docking and Dynamic Simulation Revealed the Potential Inhibitory Activity of Opioid Compounds Targeting the Main Protease of SARS-CoV-2. (PubMed, Biomed Res Int) - "Furthermore, ADMET prediction indicated that all the tested compounds have good oral absorption and bioavailability and can transport via biological membranes. Finally, M-pholcodine complex was subjected to five MD (RMSD, RMSF, SASA, Rg, and hydrogen bonding) and two MM-PBSA, and conformational change studies, for 100 ns, confirmed the stability of pholcodine, as a representative example, inside the active site of M."

Journal • Infectious Disease • Novel Coronavirus Disease • Pain • Respiratory Diseases

A Case of Intra-operative Anaphylaxis to Latex in a Pulmonary Artery Catheter (ACAAI 2022) - "Anaphylaxis was successfully treated with epinephrine, but surgery was canceled...Subsequent serum IgE-specific antigen testing was positive for latex and borderline positive for pholcodine, a surrogate for neuromuscular blocking agents (NMBAs). IgE was negative for morphine which argues against rocuronium-related anaphylaxis...The lack of standardized skin testing adds to the diagnostic complexity. We recommend both skin testing and IgE immunoCAPS in cases of POA."

Clinical • Allergy • Cardiovascular • Dermatology • Hypotension • Immunology • Infectious Disease • Urticaria

Huashi Baidu Granule in the Treatment of Pediatric Patients With Mild Coronavirus Disease 2019 (clinicaltrials.gov) - P=N/A | N=108 | Completed | Sponsor: Shanghai Children's Medical Center

New trial • Infectious Disease • Novel Coronavirus Disease • Pediatrics • Respiratory Diseases

Determination of pholcodine alone or in combination with ephedrine in human plasma using fluorescence spectroscopy. (PubMed, Sci Rep) - "The proposed methods were validated according to ICHQ2(R1) guidelines. The proposed methodologies' greenness profiles were evaluated using two greenness assessment tools."

Combination therapy • Journal

"So @TGAgovau when are we going to ban the hazardous AND therapeutically-useless pholcodine? 🤷‍♂️" (@djoll)

Gender specific decline in perioperative allergic reactions in Norway after withdrawal of pholcodine. (PubMed, Allergy) - No abstract available

Journal • Allergy