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What is benzonatate?

Benzonatate is a cough suppressant, also called an antitussive drug. This medicine relieves coughs caused by influenza or colds. It’s not intended for relieving chronic coughs¹ that emerge with asthma, smoking, or emphysema.

This drug comes in two forms: Capsule and liquid-filled capsule (100mg, 150mg, and 200mg), and it’s only available on prescription.

What is benzonatate's brand name?

The brand name of benzonatate is Tessalon, manufactured by Pfizer. The FDA approved this drug in 1958, and doctors generally prescribe it to patients ten years old and above.

What is benzonatate used to treat?

Benzonatate cannot cure any conditions: It’s mainly used to relieve a dry cough in patients. Your doctor may prescribe it for a short period only. 

You should not take it when your cough generates a significant amount of phlegm or mucus. This medication relieves coughs by numbing specific nerves in your airways and lungs, reducing your urge to cough. Benzonatate may also work on the cough center in your brainstem.

How do you take benzonatate?

You take the capsule and liquid-filled capsule orally. Generally, you take this medication three times a day as per your doctor's advice, with food or on an empty stomach. Be sure to follow the instructions indicated on the product's label or by your doctor.

If you don't understand the instructions, ask your pharmacist or doctor to simplify them for you. It's essential to take this medication precisely as directed. Do not miss, reduce your dose, or overdose.

The dose of benzonatate is usually 100mg to 200mg orally, three times a day, or as needed for children over ten years old and adults. You must not exceed 600mg a day.

Don't cut, chew, break, crush, dissolve, or suck the benzonatate capsules. If you ingest the drug improperly, it may make your mouth or throat feel numb, increasing the risk of choking and a compromised airway.

Do not drink or eat anything if you encounter tingling or numbness in your face, mouth, throat, or tongue.

Get medical assistance immediately if:

  • The tingling and numbness persist or get worse

  • You have difficulty breathing

  • Or if you have other symptoms of an allergic reaction

Seeing results 

Benzonatate starts working within 15 to 20 minutes after swallowing the capsule.² Relief usually lasts for three to eight hours.

When this drug is used for local anesthesia, the anesthetic effect occurs within a minute.

Potential side effects of benzonatate

Your physician has prescribed this drug because they assessed that the advantage outweighs the risk of adverse effects. Most patients taking benzonatate do not have severe reactions, but they might suffer from some side effects.

Common side effects of benzonatate include:

  • Nausea

  • Dizziness

  • Constipation

  • Drowsiness

  • Stuffy nose

  • Upset stomach

  • Headache

Serious side effects are rare. The likelihood of side effects may intensify if you suck, chew, or dissolve benzonatate in your mouth. Some symptoms of severe side effects may include:

  • Allergic reaction

  • Skin rashes

  • Swelling or itching in the throat, face, or tongue

  • Difficulty breathing

  • Severe dizziness

  • Fainting

  • Burning eyes

  • Hallucinations

  • Confusion 

  • Numbness in the chest

Seek medical attention right away if these side effects occur.

Please note that these are not the complete list of the potential adverse effects of this drug. Speak to your doctor if you observe other side effects not indicated in this list.

Long-term use of benzonatate

In general, healthcare providers prescribe this medication to treat an acute cough for a limited period only. If you don’t see any improvement in your condition after seven days, consult your doctor for further evaluation.

Missed doses

If you miss a dose, skip the missed dose and continue taking the medication according to the schedule prescribed by your doctor.

Do not double the dosage to make up for a missed dose: Doubling up can cause complications.

Overdoses

An overdose of benzonatate can be life-threatening, particularly to children under ten years old. Accidental overdose symptoms may include:

  • Convulsions (seizures)

  • Tremors or shakiness in the legs, arms, hands, or feet

  • Loss of consciousness or coma

  • Restlessness

  • Breathing difficulty

  • No pulse

Seek emergency medical attention immediately.

What to discuss with your doctor before you start taking benzonatate

Before starting taking this drug, it's crucial to inform your doctor about the following:

  • Any prescription, non-prescription drugs, supplements, vitamins, and herbal products you're taking or planning to take. Your doctor may need to adjust the doses of your medications or monitor you regularly for adverse reactions.

  • If you are allergic to procaine (Novocain), benzonatate, tetracaine (Synera), and other drugs or other contents found in benzonatate capsules. Ask your doctor about the ingredients in benzonatate.

  • Tell your doctor or dentist that you're currently taking benzonatate if you have an upcoming surgery, such as dental surgery.

  • If you're pregnant, planning to get pregnant, or breastfeeding. Contact your doctor immediately if you become pregnant while taking benzonatate.

Stopping benzonatate

Stop taking this medication and contact your doctor if you have an allergic reaction, notice skin rashes, develop a fever, encounter any serious side effects, and suffer from a new-onset headache.

These symptoms may indicate that you have other medical conditions that your healthcare provider needs to examine.

Benzonatate and pregnancy

Benzonatate is under Pregnancy Category C.³ Animal studies have shown that the drug can cause harm to the fetus, but there are inadequate human studies. It's not known whether this drug can impair reproduction capacity or cause harm to the fetus when taken by a pregnant woman.

In the same way, there is no extensive research on women to determine infant risk when using benzonatate during breastfeeding. Your doctor must weigh the advantages against the risks before prescribing benzonatate if you’re nursing.

This drug is generally not prescribed during pregnancy unless the potential benefit outweighs the potential risk to the fetus.

Interactions with other drugs

Drug interactions may occur with specific supplements or medications that cause drowsiness, including:

  • Cough and cold remedies

  • Anxiety or sleep medications

  • Anti-seizure drugs

  • Antihistamines

  • Muscle relaxants

  • Psychiatric medicines

Tell your doctor about all over-the-counter (OTC) and prescribed medications, herbal or dietary supplements, and vitamins you are taking. Avoid taking recreational drugs and drinking alcohol while taking benzonatate.

It's helpful to review the patient information leaflet (PIL) for a comprehensive list of interactions.

Allergy information

Tell your doctor about your allergies and if you have had allergic reactions to this drug or other medications.

It's also critical to inform your doctor if you are allergic to dyes, certain foods, and preservatives.

Clinical trial history

Coughing caused by a viral upper respiratory infection (URI) is the most common type of cough. It accounts for enormous spending on prescription and non-pharmaceutical cough remedies. However, researchers have done very few studies to show if any of these medications are effective for URI-induced coughs.

One study⁴ investigated the effects of benzonatate, guaifenesin, their combination, and placebo on capsaicin-induced cough in 30 adults with acute URIs.

Over seven days, participants did an inhaled capsaicin cough challenge test, which involved inhaling increasing concentrations of capsaicin to induce five or more coughs. The study discovered that a combination of benzonatate and guaifenesin creates a stronger cough suppressant effect than using them alone or a placebo. However, this was a very small-scale study, so further research is necessary.

Tips and advice for taking benzonatate

  • Benzonatate is pregnancy category C, meaning that animal studies have shown adverse effects on the fetus. As such, it’s not recommended during pregnancy or breastfeeding unless the potential benefits outweigh the risks. If your doctor recommends it, take it exactly as instructed and stay vigilant for any side effects.

  • It's also important to talk to your healthcare provider first if you are a smoker or have a history of hallucinations before taking this medication.

  • Children under ten should not take benzonatate. Your physician can prescribe safer options.

  • Take this drug precisely as directed by your healthcare provider. Do not take less or more of it, and don't take it longer than prescribed. Taking benzonatate incorrectly may increase the occurrence of side effects.

Typically, the information indicated on the product's label is the average dose of this drug. If you notice that your dose differs, do not adjust it unless your healthcare provider advises you to.

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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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