What is the maximum recommended frequency for Benzonatate (Benzonatate) administration?

Maximum Recommended Frequency for Benzonatate Administration

The maximum recommended frequency for benzonatate is three times a day, with a maximum daily dose of 600 mg in three divided doses. 1

Dosing Guidelines

Benzonatate is available in two strengths:

• 100 mg capsules
• 200 mg capsules

Standard Dosing

• Adults and children over 10 years of age:
  • Usual dose: One 100 mg or 200 mg capsule three times a day as needed for cough
  • Maximum daily dose: 600 mg divided into three doses 1
  • Single dose should not exceed 200 mg 1

Administration Instructions

• Benzonatate capsules must be swallowed whole
• Capsules should never be broken, chewed, dissolved, cut, or crushed 1
• If a dose is missed, the patient should skip that dose and take the next dose at the scheduled time
• Patients should not take 2 doses at one time 1

Safety Considerations

Local Anesthetic Properties

• Benzonatate is chemically related to anesthetic agents of the para-amino-benzoic acid class (e.g., procaine, tetracaine) 1
• Release of benzonatate in the mouth can produce temporary local anesthesia of the oral mucosa, potentially causing choking 1

Potential Adverse Effects

• If numbness or tingling of the tongue, mouth, throat, or face occurs, patients should:
  • Refrain from oral ingestion of food or liquids until numbness resolves
  • Seek medical attention if symptoms worsen or persist 1

Overdose Risks

• Overdose can be life-threatening and has resulted in death in both children and adults 1, 2
• Signs and symptoms of overdose can appear within 15-20 minutes of ingestion 1
• Overdose manifestations include:
  • Restlessness
  • Tremors
  • Seizures 3
  • Cardiac arrhythmias, including torsades de pointes 4
  • Cardiac arrest 2
  • Coma
  • Death (reported within one hour of ingestion) 1

Pharmacokinetics

• Benzonatate is rapidly absorbed with a half-life of approximately 1.01 ± 0.41 hours 5
• It reaches maximum concentration (Cmax) relatively quickly 5

Special Populations

Pediatric Use

• Safety and effectiveness have not been established in children below 10 years of age 1
• Accidental ingestion resulting in death has been reported in children under 10 years 1
• Keep benzonatate out of reach of children

Pregnancy

• Pregnancy Category C
• Animal reproduction studies have not been conducted with benzonatate
• Should be given to pregnant women only if clearly needed 1

Nursing Mothers

• It is unknown whether benzonatate is excreted in human milk
• Caution should be exercised when administering to nursing women 1

Clinical Pearls and Pitfalls

Common Pitfalls

1. Exceeding recommended dosage: Never exceed a single dose of 200 mg or total daily dosage of 600 mg 1
2. Improper administration: Ensure patients understand the importance of swallowing capsules whole
3. Pediatric access: Keep medication secure and out of reach of children
4. Delayed recognition of toxicity: Be aware that symptoms of overdose can appear rapidly (within 15-20 minutes) 1

When to Seek Immediate Medical Attention

• Signs of overdose
• Persistent numbness or tingling of mouth or throat
• Difficulty breathing or swallowing

By adhering to the recommended maximum frequency of three times daily and not exceeding 600 mg per day, patients can safely use benzonatate for cough relief while minimizing the risk of adverse effects.