Nalbuphine ER Shows Success in Chronic Cough Trial

The drug significantly reduced cough frequency in patients with idiopathic pulmonary fibrosis during a phase 2b study.

Updated on Oct. 29, 2026 in Asthma

Isometric editorial illustration of a glass laboratory nebulizer, representing medical research into cough management for pulmonary disease. — A phase 2b clinical trial presented at CHEST 2026 found that nalbuphine ER significantly reduced chronic cough frequency in patients with idiopathic pulmonary fibrosis. AI Illustration. Upload story photo >

Live Poll

Should the government prioritize fast-track approval for new treatments of chronic, currently untreatable conditions?

The CORAL phase 2b trial found that nalbuphine ER effectively decreased cough frequency and severity in patients with idiopathic pulmonary fibrosis. Results from the study were presented in October 2026 at the CHEST 2026 meeting in Phoenix, Arizona.

Why it matters

Chronic cough remains a major burden for patients with idiopathic pulmonary fibrosis, yet there are currently no treatments approved in the United States for this specific condition. Improving cough management could significantly enhance the daily quality of life for those living with the disease.

The CORAL trial enrolled 165 patients, with the 108-mg dose achieving a 60.2% decrease in objective 24-hour cough frequency at week 6. Serious adverse events occurred in 1.6% of nalbuphine ER patients, compared to 10% in the placebo group.

The players

CHEST

The American College of Chest Physicians is a global professional organization that promotes the prevention, diagnosis, and treatment of chest diseases.

The details

Nalbuphine ER functions by acting as a mixed kappa opioid receptor agonist and mu opioid receptor antagonist on the cough reflex arc. Researchers have selected the 54-mg dose for further study in the upcoming phase 3 program.

Week 1 saw improvements in patient-reported cough severity versus placebo.
Week 2 showed relative improvement on the E-RS:IPF cough subscale.
Week 6 served as the primary analysis point for objective cough frequency.
October 18-21, 2026, was the window for the presentation at CHEST 2026.
Week 24 will serve as the primary endpoint for the phase 3 trial.

The Big Picture

This development represents a departure from the current clinical landscape where there is an absence of FDA-approved therapies for IPF-related chronic cough. The trial results move the scientific community closer to establishing an effective standard of care for this population.

The transition to a phase 3 trial indicates that patients may eventually gain access to a specialized treatment for chronic cough associated with pulmonary fibrosis. Until approval is granted, patients should consult with their pulmonologists regarding existing symptom management strategies.

The takeaway

Nalbuphine ER shows promise in managing a previously untreatable symptom that affects the daily lives of many patients with idiopathic pulmonary fibrosis. Those currently struggling with chronic cough should continue to monitor updates from their healthcare providers regarding the progress of phase 3 clinical trials.