Benzonatate is a non-narcotic, prescription antitussive medication used to relieve a cough. It is available generically and under the brand name Tessalon, often in the form of soft gel capsules called perles. This medication suppresses the urge to cough and is reserved for persistent coughs that significantly impact comfort or ability to rest. It is approved for use in adults and children over the age of ten.
How Benzonatate Stops Coughing
Benzonatate’s action is primarily peripheral, meaning it works outside of the central nervous system, differentiating it from opioid-based cough suppressants like codeine. The drug functions as a local anesthetic, similar to compounds like procaine and tetracaine. It works by numbing or desensitizing specific sensory nerves involved in the cough reflex.
The main targets of benzonatate are the stretch receptors located throughout the respiratory passages, the lungs, and the pleura, which is the membrane surrounding the lungs. These receptors are sensory nerves that send an impulse to the cough center in the brain when they are irritated. Benzonatate dampens the activity of these receptors, reducing the signal that triggers the cough reflex.
By reducing the sensitivity of these pulmonary stretch receptors, the medication suppresses the involuntary urge to cough. This peripheral mechanism is the main way benzonatate controls the symptom of coughing. The drug’s effect begins quickly, often within 15 to 20 minutes after it is swallowed.
Medical Uses for Benzonatate
Benzonatate is indicated for the symptomatic relief of cough, addressing the symptom itself rather than the underlying cause. It is used for a non-productive cough (a dry cough that does not produce mucus or phlegm). The medication provides relief for coughs associated with acute respiratory conditions.
Common ailments for which benzonatate is prescribed include the common cold, influenza, bronchitis, and pneumonia. It may also suppress chronic coughs linked to conditions like emphysema or other respiratory irritation. The goal of treatment is to improve comfort, especially to allow for undisturbed sleep and rest.
The drug is often used when a cough is severe or persistent enough to interfere with daily life. It is considered an alternative for cough suppression when an opioid-based medication is not appropriate or desired. Benzonatate’s effectiveness in reducing the frequency of coughing has been noted in various respiratory conditions.
Proper Dosing and Administration
Benzonatate is available in liquid-filled capsules (perles) in strengths of 100 mg, 150 mg, and 200 mg. The standard dosage for adults and children over 10 is 100 mg to 200 mg taken three times a day, as needed for the cough. Patients must follow the specific instructions provided by the prescribing physician.
The maximum recommended daily dosage is 600 mg, and no single dose should exceed 200 mg. The capsules must be swallowed whole without alteration. The medication should never be crushed, cut, chewed, or dissolved in the mouth.
If a dose is missed, it should be taken as soon as it is remembered, unless it is nearly time for the next scheduled dose. Taking the medication as prescribed ensures the drug reaches the gastrointestinal tract and is absorbed properly. The antitussive effect generally lasts for three to eight hours following administration.
Serious Risks and Potential Side Effects
The most serious warnings involve the consequences of improper administration. Chewing, sucking, or dissolving the capsule releases the liquid contents into the mouth and throat, causing rapid, temporary numbness due to its local anesthetic properties. This localized numbing effect can lead to choking, oropharyngeal anesthesia, or severe reactions like laryngospasm, bronchospasm, and cardiovascular collapse.
Accidental ingestion by children under the age of ten poses a severe danger, with reports of rapid overdose and death. Ingestion of even one or two capsules can lead to severe toxicity, with symptoms such as restlessness, tremors, convulsions, coma, and cardiac arrest appearing quickly, often within 15 to 20 minutes. Because of this risk, the medication must be kept in a child-resistant container and stored out of the reach of children.
Beyond these serious warnings, benzonatate can cause a range of less severe adverse effects. Common side effects include drowsiness, dizziness, or headache. Patients may experience gastrointestinal upset, such as nausea, upset stomach, or constipation. Less frequent side effects include skin rash, burning sensation in the eyes, or a feeling of chilliness.