Drug Database
CO

cocaine hydrochloride (Numbrino)

✓ Approved

Lannett · SCN5A · Small Molecule

What is cocaine hydrochloride?

cocaine hydrochloride is a small molecule developed by Lannett. It is approved for therapeutic indications via topical.

Drug Profile

Brand NamesNumbrino
CompanyLannett
Drug ClassSmall Molecule
Molecular TargetSCN5A
RouteTopical
StatusApproved
Sources: ClinicalTrials.gov, Lannett

Mechanism of Action

Molecular Targets

cocaine hydrochloride acts on 1 molecular target:

SCN5Asodium voltage-gated channel alpha subunit 5 (CMD1E, SSS1)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

cocaine hydrochloride is developed for 2 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Nervous system disordersAnaesthesia✓ Approved
Nervous system disordersSensory loss✓ Approved

Related Research Articles

PubMedEuropean journal of case reports in internal medicine2026-11-11

Pyoderma Gangrenosum and Haematochezia in A Patient with Previous Cocaine Abuse.

Hadjicharalambous Myrianthi M, Symeonidou Sofia S, Georgiou George G, Azina Chara C et al.

Pyoderma gangrenosum (PG) is an autoinflammatory neutrophilic dermatosis that may rarely occur in association with granulomatosis with polyangiitis (GPA). Management of refractory disease remains challenging. A 48-year-old man with a history of previous cocaine abuse was admitted due to impaired feeding in the context of a chronic hard palate perforation and a large oro-sinus fistula. During hospitalisation, he developed haematochezia and painful ulcerative skin lesions involving the right upper limb and lower extremities. Upper and lower gastrointestinal endoscopy revealed a Forrest IIc gastric lesion and a non-bleeding ileocecal ulcer. Histopathological examination of skin lesions demonstrated dense neutrophilic infiltration consistent with PG, while gastrointestinal biopsies excluded inflammatory bowel disease. An extensive evaluation excluded infection, antiphospholipid syndrome, cryoglobulinaemia, malignancy and vascular occlusive disease, all of which may mimic PG. Autoimmune screening workup yielded positive for anti-proteinase-3 antibodies (C-ANCA). The patient initially received high-dose methylprednisolone followed by mycophenolate mofetil and infliximab. Despite treatment, disease activity persisted with recurrent relapses, requiring hospitalisations. Upadacitinib was subsequently introduced, resulting in rapid clinical improvement, near-complete healing of skin lesions and successful glucocorticoid withdrawal. The coexistence of PG and GPA is rare and presents substantial diagnostic and therapeutic challenges. JAK inhibition with upadacitinib may represent a promising therapeutic option in refractory cases. Pyoderma gangrenosum may rarely coexist with granulomatosis with polyangiitis, creating significant diagnostic and therapeutic challenges.A history of cocaine abuse may complicate the diagnostic evaluation because cocaine-induced vasculitis can mimic ANCA-associated vasculitis.Upadacitinib may represent a promising steroid-sparing therapeutic option in refractory pyoderma gangrenosum associated with granulomatosis with polyangiitis.Pyoderma gangrenosum is a diagnosis of exclusion for which no confirmatory test exists; approximately 10% of patients given the diagnosis are subsequently found to have an alternative condition, so mimickers must be actively excluded before and during treatment.

PMID 43011654
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PubMedFrontiers in public health2026-11-11

Fifty years at the addiction bench and bedside: from withdrawal syndromes to adaptive brain states.

Gold Mark S MS

Over the past half-century, addiction medicine has moved from moral and symptom-based explanations toward a neuroscience of adaptation, learning, motivation, and recovery. This Perspective uses several linked translational programs-opioid withdrawal and the locus coeruleus, cocaine dependence and dopamine, environmental drug exposure, physician health, and food reward-to illustrate how observations at the bedside can generate mechanistic studies and how laboratory findings can, in turn, change treatment and public health. LC stimulation produced signs and symptoms that looked to me like opioid withdrawal. So, we thought that noradrenergic hyperactivity in opioid withdrawal caused symptoms, and while methadone or morphine could treat these, we could also treat them with a non-opioid, clonidine. Earlier noradrenergic interventions had been attempted with limited clinical success. Our work provided the first hypothesis-driven, double-blind, placebo-controlled demonstration that a non-opioid medication could suppress the acute human opioid withdrawal syndrome. This mechanism-based treatment was greeted with considerable interest because some clinicians had assumed that any medication capable of reversing opioid withdrawal distress must itself be an opioid. Clonidine and later lofexidine did just that and facilitated transition to naltrexone. Recognition that cocaine could produce compulsive use without a dramatic physical withdrawal syndrome helped shift the field toward reward circuitry, craving, pathological attraction, anhedonia, and relapse. Studies of tobacco, cannabis, and opioid smoke broadened prevention by showing that involuntary second- and third-hand exposure can be biologically detected and, most clearly for tobacco, can produce biologically meaningful effects. Third-hand exposure refers to residual drug-related contaminants that persist on indoor surfaces, dust, clothing, or other materials after active smoking has ended. Contemporary work on neuromodulation, exercise, psychedelics, and GLP-1 metabolic-reward pathways extends the same translational logic. Addiction is best understood as an acquired adaptive brain state supported by anti-survival or bad learning, development, and environment; recovery is active neurobehavioral relearning, not simply detoxification or drug clearance. Public health should therefore join brain sciences, work to delay initiation, identify emerging risk before a severe substance use disorder develops, prevent involuntary exposure, and provide rapid access to mechanism-based treatment, recovery-supportive environments, and outcomes measured over 5 years or longer.

PMID 43011373
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PubMedZhonghua nan ke xue = National journal of andrology2026-11-11

[Effect of esketamine on anesthesia and postoperative analgesia in patients with prostate resection: Based on oxidative stress response].

Liu Dapeng D, Feng Lingling L, Yao Qun Q, Li Jianwei J et al.

Objective To investigate the effects of esketamine on postoperative analgesia, cognitive function, oxidative stress and safety in patients with electroprostatectomy. Methods One hundred and twenty patients who underwent electroprostatectomy in Zaozhuang Municipal Hospital from October 2021 to May 2022 were selected and divided into experimental group and control group according to the different treatment, with 60 cases in each group. The patients in control group were treated with routine sufentanil during the operation. And esketamine hydrochloride was used in the experimental group at the dosage of 0.2 mg/kg 10 minutes before the end of the operation. VAS score and MMSE score were recorded at 0.5, 2, 4 and 12 h after surgery. The levels of oxidative stress indexes including NE and GSH-Px were compared between the two groups, and the postoperative urinary tract irritation and adverse reactions were analyzed. Results There was significant difference in VAS score between the two groups at 0.5 h and 2 h after surgery (P<0.05), but no significant difference at 4 h and 12 h (P>0.05). There was significant difference in MMSE score at 0.5 h after operation (P<0.05). The scores of urethral irritation in the experimental group were significantly lower than those in the control group at 0.5 h and 2 h after operation (P<0.05), and the inhibition effect on urethral irritation was significant. After anesthesia, the levels of NE and GSH-Px in experimental group showed a more dramatic improvement compared to control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Esketamine has good postoperative analgesic effect in elderly patients undergoing transurethral resection of prostate with a temporary effect on early postoperative cognitive function, which alleviates symptoms of urinary duct irritation and oxidative stress caused by surgery.

PMID 43012260
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PubMedZhonghua nan ke xue = National journal of andrology2026-11-11

[Clinical efficacy and mechanism of Liniao Tonglin decoction in treating UU-infected oligoasthenospermia with dampness-heat pouring down syndrome].

Zhu Fanyu F, Li Ninghua N, Yang Wentao W

Objective To explore the clinical effect and mechanism of Liniao Tonglin decoction on oligoasthenospermia caused by Ureaplasma urealyticum (UU) infection with dampness-heat pouring down syndrome. Methods Eighty-eight patients were randomly divided into control group and observation group, with 44 cases in each group. The patients in control group were treated with doxycycline hydrochloride enteric-coated capsules and doxycycline tablets. While the patients in observation group were treated with Liniao Tonglin decoction on the basis of the treatment given to the control group. Both groups were treated for 14 days. Sperm concentration, total sperm count, progressive motility sperm rate(PR%), sperm motility rate（［PR+NP］%）, seminal plasmic elastase, interleukin-6(IL-6), interleukin-17(IL-17) levels TCM syndrome score and negative conversion rate of UU were compared between the two groups before and after the treatment. Results The overall efficacy rate of the observation group was significantly higher than that in the control group (86.05% vs 66.67% , χ2=4.435, P<0.05). UU negative conversion rate was also superior in the observation group (95.35% vs 88.10%，P>0.05). The increases in sperm concentration, total count, PR%, and （PR+NP）% (P<0.05) exhibited in both of two groups after the treatment, with significantly greater improvements in the observation group (P<0.05). The levels of seminal elastase, IL-6, IL-17 and TCM syndrome scores declined in both groups (P<0.05), with greater improvements in the observation group as well (P<0.05). Conclusion Liniao Tonglin decoction combined with antibiotics improves the count and motility of sperm and TCM syndrome score of oligoasthenospermia induced by UU infection with dampness-heat pouring down syndrome, increases the negative rate of UU, inhibits the expression of inflammatory factors, and changes the patency of reproductive tract and the living environment of sperm.

PMID 43012219
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PubMedZhonghua zhong liu za zhi [Chinese journal of oncology]2026-11-11

[Mitoxantrone hydrochloride liposomes combined with R-GDP regimen in the treatment of relapsed/refractory diffuse large B-cell lymphoma: a single-arm, multicenter, exploratory clinical study].

Ma L L, Zhao J J, Wang J R JR, Zheng M J MJ et al.

Objective: To evaluate the efficacy and safety of the mitoxantrone liposome combined with R-GDP regimen (R-GDP-Mito regimen) in the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Methods: From May 2023 to September 2025, a total of 33 patients with relapsed/refractory DLBCL(R/R DLBCL) were enrolled from multiple centers, including Shanxi Provincial Cancer Hospital, Jincheng People's Hospital of Shanxi Province, Heping Hospital Affiliated to Changzhi Medical College, and Datong Second People's Hospital of Shanxi Province. All patients received 2 to 6 cycles of the R-GDP-Mito regimen. The short-term and long-term efficacy as well as adverse events were analyzed. Results: Among the 33 patients, 16 achieved complete remission (CR), 11 achieved partial remission (PR), 3 had stable disease (SD), and 3 experienced disease progression (PD). The objective response rate (ORR) was 81.8% (27/33), with a 95% CI of 61.4% to 92.3%. The median time to best response was 1.9 months. With a median follow-up of 4.8 months, disease progression was observed in 4 patients, and 5 patient deaths were recorded, attributed to disease progression and severe pulmonary infection, respectively. The median progression-free survival (PFS) was not reached, while the median overall survival (OS) was 16.1 months. The 1-year PFS and OS rates were 56.6% and 90.5%, respectively. All 33 patients experienced adverse events (AEs). Hematological AEs occurred in 60.6% (20/33) of patients, and non-hematological AEs occurred in 81.8% (27/33) of them. Conclusion: The R-GDP-Mitoregimen demonstrates high antitumor activity and well-controlled safety profile in R/R-DLBCL patients, offering a promising new therapeutic option, particularly for those unable to immediately access or tolerate novel targeted or immunotherapy regimens.

PMID 43010748
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PubMedPsychopharmacology2026-11-10

Substitutability of cocaine and social interaction in male and female rats before and after intermittent access cocaine self-administration.

Brooks Eliza M EM, Bird Toni T, Rego Felipe Pazos FP, Olivero-Gamez Claudia G CG et al.

Previous studies have found that cocaine and social interaction act as substitutes in male rats, but it is unknown whether they are also substitutes in female rats. The two purposes of the present study were to compare male and female rats on the way cocaine and social reinforcement economically interact and to determine whether exposure to intermittent access (IntA) cocaine self-administration changes the interaction. In a first phase, male (n = 16) and female (n = 17) rats were allowed to choose between cocaine and social reinforcement available at varying prices to determine how these reinforcers economically interact. Then, half of the rats of each sex received 12 sessions of IntA cocaine self-administration while the other half served as no-cocaine homecage controls. In a final phase, the way that cocaine and social reinforcement interacted was redetermined. Cocaine and social reinforcement were partial substitutes in male rats, replicating previous findings. In contrast, these reinforcers were not substitutes in females, but instead were independent economic goods. During IntA cocaine self-administration, female rats escalated their intake over sessions, but males did not. IntA cocaine exposure had no impact on reinforcer interactions. The sex difference in the way that cocaine and social reinforcement interacted suggests that one or both of these reinforcers may serve different functions in male and female rats. The results of this study contribute to growing research on the way that the broader behavioral economic context contributes to choice between drug and non-drug alternatives.

PMID 43003978
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