Tessalon Pearls (Benzonatate) Dosing
For adults and children over 10 years of age, the standard dose is 100-200 mg three times daily as needed for cough, with a maximum daily dose of 600 mg in three divided doses. 1
Standard Dosing Regimen
- Usual dose: One 100 mg or 200 mg capsule three times daily as needed
- Maximum dose: 600 mg daily in three divided doses (not to exceed 200 mg per single dose)
- Age restriction: Only approved for children 10 years and older 1
Critical Safety Warnings
Capsules must be swallowed whole—never broken, chewed, dissolved, cut, or crushed. 1 Release of benzonatate in the mouth causes temporary local anesthesia of oral mucosa and can lead to choking.
Pediatric Safety Concerns
- Contraindicated in children under 10 years old 1
- Accidental ingestion has resulted in death in young children, with symptoms appearing within 15-20 minutes and death occurring within one hour 1
- Recent surveillance data shows 83% of unintentional exposures occur in children 0-5 years old, though most cases do not result in serious adverse effects 2
Overdose Risk
Do not exceed 200 mg per single dose or 600 mg total daily. 1 Overdose can cause:
- Restlessness and tremors
- Seizures and coma
- Cardiac arrest and dysrhythmias (including torsades de pointes) 1, 3, 4
- Death in adults and children 1, 3
Dosing Considerations
If a dose is missed, skip it and take the next scheduled dose—never double up 1. The medication has rapid absorption with peak concentrations reached quickly and a half-life of approximately 1 hour 5.
Common Pitfalls to Avoid
- Storage: Keep out of reach of children due to high risk of fatal accidental ingestion 1
- Patient education: Emphasize the importance of swallowing capsules whole; if numbness of tongue, mouth, or throat occurs, refrain from eating or drinking until resolved 1
- Intentional exposures: Be aware of increasing patterns of intentional ingestion in adolescents 10-16 years old, which carry higher risk of serious toxicity 6, 2