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Carcainium chloride (VRP700) is a small molecule drug developed as an inhaled treatment for chronic cough and other respiratory conditions such as idiopathic pulmonary fibrosis (IPF) and idiopathic interstitial pneumonia (IIP). It is a quaternary derivative of the local anesthetic lidocaine. The mechanism of action is presumed to involve inhibition of sensory receptors in the lungs—specifically by suppressing cough-initiating signals at sensory nerve endings via a novel pathway distinct from morphine-based antitussives. Early clinical studies suggested that nebulized VRP700 could reduce cough frequency and improve quality of life in patients with IIP without significant side effects. However, subsequent Phase IIa trials in IPF did not meet primary efficacy endpoints, leading to discontinuation of further development by Verona Pharma[2][4][5][6][7].
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