Related Experiment Videos
Dose finding of tocainide in the treatment of tinnitus
Abstract:
A dose finding study was performed for the use of oral tocainide in the treatment of tinnitus. In a single-blind study, increasing doses of tocainide hydrochloride ranging from 0 to 1800 mg and back to 0 mg were administered to 19 patients. Each dose was given for 4 days and the effects as well as the serum concentrations were recorded on the 4th day. In 8 patients the symptoms regressed to a non-troublesome level. In most instances this effect was seen at doses of 900 and 1800 mg, respectively. Side effects were frequent. The most important side effect, which was an absolute indication for termination of the study, was an exanthema that developed in 7 of the patients (37%). Taking into account all side effects observed, it was concluded that no justification exists for doses over 900 mg daily for the treatment of tinnitus. However, in comparison with lidocaine, which can only be given intravenously, the therapeutic score of tocainide is low and in fact tocainide is no satisfactory alternative to lidocaine.
Insights
Oral tocainide showed symptom regression in some tinnitus patients at higher doses. However, frequent side effects, including rash, limit its use and it is not a satisfactory alternative to intravenous lidocaine.
Area of Science:
- Pharmacology
- Otolaryngology
Background:
- Tinnitus is a common auditory condition affecting millions.
- Limited effective oral treatments for tinnitus exist, necessitating research into novel therapeutic agents.
Purpose of the Study:
- To determine the optimal and safe dosage of oral tocainide for tinnitus management.
- To evaluate the efficacy and tolerability of tocainide in a dose-finding study for tinnitus.
Main Methods:
- A single-blind, dose-escalation study involving 19 tinnitus patients.
- Administration of oral tocainide hydrochloride in doses from 0 to 1800 mg, with effects and serum concentrations monitored.
- Each dose was administered for four days.
Main Results:
- Symptom reduction to a non-troublesome level was observed in 8 out of 19 patients, primarily at 900 mg and 1800 mg doses.
- Frequent side effects were noted, with a significant incidence of exanthema (37% of patients).
- The therapeutic benefit of tocainide was deemed low compared to intravenous lidocaine.
Conclusions:
- A daily dose of oral tocainide exceeding 900 mg is not justified for tinnitus treatment due to side effect profile.
- Tocainide is not considered a satisfactory alternative to intravenous lidocaine for tinnitus management.