Cough is a physiological defense mechanism. However, excessive cough is known to have a great impact on quality of life. Cough is considered to be chronic when it lasts longer than 8 weeks. In the Netherlands, the prevalence is 10.9%. The concept as a whole is called 'cough hypersensitivity' in which there is a hypersensitivity of the cough reflex to aspecific stimuli. Specific treatment of the phenotype is important. If no specific phenotype is found it is called 'unexplained chronic cough' (UCC) and if symptoms persist despite treatment it is called 'chronic refractory cough' (CRC). Neuromodulating drugs are the main treatment in CRC. However, a suitable condition often cannot be achieved because of severe side effect and great interindividual variability in pharmacokinetics. New drugs, P2X3-antagonists, are being developed. These drugs mediate in a late phase of the cough reflex and are thereby considered to have fewer side effects.
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