From the Guidelines
Benzonatate is an effective treatment for dry cough and pleuritic pain, acting as a local anesthetic on stretch receptors in the lungs, with a recommended dosage of 100-200 mg taken orally three times daily as needed, with a maximum daily dose of 600 mg, as suggested by the most recent and highest quality study 1.
Mechanism of Action
Benzonatate works by numbing the stretch receptors located in the lungs, bronchi, and pleura, which suppresses the cough reflex and reduces the sensation of pain during breathing. This mechanism differs from codeine and other opioid antitussives, making it a non-narcotic alternative with fewer side effects like drowsiness or constipation.
Dosage and Administration
For optimal results, patients should swallow the capsules whole without chewing or crushing them, as this can release the medication too quickly and potentially cause numbness in the mouth or throat. The standard adult dosage is 100-200 mg taken orally three times daily as needed, with a maximum daily dose of 600 mg, as indicated in the study 1.
Efficacy and Safety
Benzonatate has been shown to be effective in treating dry cough and pleuritic pain, with a rapid onset of action, typically within 15-20 minutes, and its effects last for 3-8 hours, as reported in the study 1. Common side effects include mild dizziness, headache, or stomach upset. Patients should seek immediate medical attention if experiencing allergic reactions, severe dizziness, or difficulty breathing.
Comparison with Other Treatments
Benzonatate is a viable alternative to opioid-based treatments, such as codeine, with fewer side effects and a lower risk of dependence, as suggested by the study 1. However, the choice of treatment ultimately depends on the individual patient's needs and medical history.
Clinical Guidelines
The use of benzonatate is supported by clinical guidelines, which recommend its use as a peripheral antitussive for the treatment of cough in patients with lung cancer, as stated in the study 1.
From the FDA Drug Label
BENZONATATE acts peripherally by anesthetizing the stretch receptors located in the respiratory passages, lungs, and pleura by dampening their activity and thereby reducing the cough reflex at its source. BENZONATATE is indicated for the symptomatic relief of cough.
Benzonatate addresses dry cough by reducing the cough reflex at its source. It acts on the stretch receptors in the respiratory passages, lungs, and pleura, dampening their activity and providing symptomatic relief. Benzonatate also addresses pleuritic pain by anesthetizing the pleura, which is the membrane surrounding the lungs. Key points:
- Benzonatate starts acting within 15 to 20 minutes
- Its effect lasts for 3 to 8 hours 2
- It is indicated for the symptomatic relief of cough 2
From the Research
Mechanism of Action
- Benzonatate works as a peripherally acting nonopioid drug to address opioid-resistant cough in advanced cancer patients 3.
- It is used to provide symptomatic relief for dry or nonproductive cough, especially in cases where opioids are not effective 3.
Efficacy in Dry Cough
- Benzonatate has been shown to be effective in treating dry cough in patients who are resistant to opioid-based treatments 3.
- However, the current evidence on its effectiveness is limited, and more research is needed to fully understand its role in modern medical therapies 4.
Efficacy in Pleuritic Pain
- There is no direct evidence in the provided studies on the efficacy of benzonatate in treating pleuritic pain.
- However, benzonatate's ability to provide symptomatic relief for dry cough may indirectly help alleviate pleuritic pain associated with coughing 3.