New capsaicin formulations for nebulisation as a substitution to Nasotracheal suction

Nasotracheal suction (NTS) is a procedure used to remove sputum in people who have difficulty with expelling sputum and coughing. NTS is an invasive method which requires inserting a catheter into person’s airways and applying a negative pressure in order to remove sputum. It may be quite unpleasant or traumatic experience for the patient, it may cause adverse events, and it necessitates qualified healthcare staff.

The project is introducing a novel method by utilising nebulised capsaicin to avoid use the invasive NTS. Inhaled capsaicin is an irritant for cough reflex and it has been used for cough challenge testing but not as a therapeutic intervention. Capsaicin tablets will be formulated by direct compression. The physical properties of the prepared tablets will be assessed in order to guarantee suitable mechanical characteristics and pharmaceutical performance. The tablet will be designed to dissolve rapidly to prepare a nebuliser solution and release capsaicin to stimulate cough reflex which will lead to the expelling of sputum.

The designed tablets will undergo testing by healthcare staff in a case series with healthy volunteers, to determine usability and acceptability of the formulation and its application to healthcare staff.

Finally, a thorough Patient and Public Involvement (PPI) activity will investigate the views and experiences of patients who need NTS as wells as their family members and carers, through interviews and focus groups. The PPI activity will investigate the use of nebulised capsaicin as an alternative to NTS, and aspects of design and conduct of a clinical follow-on study.