Is Tessalon (Benzonatate) an expectorant?

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Last updated: May 22, 2025View editorial policy

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From the Guidelines

Tessalon pearls (benzonatate) are not an expectorant, but rather a non-narcotic antitussive medication that works to suppress coughs.

Mechanism of Action

Tessalon pearls function by numbing stretch receptors in the lungs, which reduces the cough reflex. This is different from expectorants like guaifenesin, which thin mucus secretions to help clear them from the respiratory tract.

Dosage and Administration

Tessalon pearls are typically prescribed at a dose of 100-200 mg three times daily for cough suppression, with a maximum daily dose of 600 mg, as indicated in the study by 1.

Side Effects and Precautions

The medication should be swallowed whole, as breaking or chewing the capsules can release the medication too quickly and potentially cause numbness in the mouth or throat, which could lead to choking. Side effects may include drowsiness, headache, dizziness, or stomach upset.

Appropriate Use

Tessalon pearls are most appropriate for dry, non-productive coughs where suppression is the goal, rather than for wet, productive coughs where bringing up mucus would be beneficial. According to the study by 1, benzonatate is a peripherally acting antitussive that can be effective in managing cough in patients with lung cancer. Some key points to consider when using Tessalon pearls include:

  • They are not suitable for everyone, especially those with a history of bronchospasm or other respiratory conditions.
  • They can interact with other medications, such as sedatives and antidepressants.
  • They should be used with caution in patients with liver or kidney disease.
  • They can cause dependence and withdrawal symptoms if used for an extended period. It is essential to consult a healthcare professional before using Tessalon pearls, especially if you have any underlying medical conditions or are taking other medications.

From the Research

Tessalon Pearls as an Expectorant

  • Tessalon pearls, which contain benzonatate, are primarily used as an antitussive to suppress cough 2.
  • There is no direct evidence in the provided studies to suggest that Tessalon pearls are used as an expectorant 3, 4, 5, 2, 6.
  • Expectorants, such as guaifenesin, are used to thin and loosen mucus, making it easier to cough up 3.
  • The mechanism of action of benzonatate is thought to be anesthesia of vagal sensory nerve fibers that mediate cough, rather than thinning or loosening mucus 4.
  • While Tessalon pearls may be used to relieve cough symptoms, they are not typically classified as an expectorant 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Pharyngitis: Approach to diagnosis and treatment.

Canadian family physician Medecin de famille canadien, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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