What is the recommended dosage of Benzonatate for adults and children?

Benzonatate Dosage Recommendations for Adults and Children

For adults and children over 10 years of age, the recommended dosage of benzonatate is one 100 mg or 200 mg capsule three times daily as needed for cough, with a maximum daily dose of 600 mg divided into three doses. 1

Adult Dosing

• Standard dose: 100-200 mg three times daily
• Maximum daily dose: 600 mg (divided into three doses)
• Administration: Capsules must be swallowed whole, never chewed, crushed, dissolved, or broken

Pediatric Dosing

• Children over 10 years: Same as adult dosing (100-200 mg three times daily)
• Children under 10 years: Benzonatate is not approved for use in children younger than 10 years of age 1

Important Administration Guidelines

Safety Considerations

• Benzonatate capsules must always be swallowed whole
• The medication should never be chewed, dissolved, cut, or crushed as this can lead to rapid release of the medication and potential toxicity 2
• Store medication out of reach of children, as accidental ingestion can lead to severe toxicity

Duration of Treatment

• For cough management in lung cancer patients, benzonatate may be used when other approaches have failed 3
• In general practice, limit treatment duration and reassess if cough persists

Monitoring and Precautions

Potential Adverse Effects

• Benzonatate has local anesthetic properties similar to tetracaine and procaine
• Serious adverse effects from overdose can include:
  • Seizures
  • Cardiac dysrhythmias (including torsades de pointes)
  • Central nervous system depression
  • In severe cases, cardiac arrest 2, 4

Special Populations

• Elderly patients may require more careful monitoring but no specific dosage adjustment is indicated
• Pregnant women: Use with caution as safety data is limited

Clinical Pearls

• Intentional overdoses have much higher rates of serious toxicity than unintentional exposures 5
• While benzonatate can be effective for cough suppression, it should be used judiciously and at appropriate doses
• The combination of benzonatate with guaifenesin may provide enhanced antitussive effects compared to either agent alone 6

Common Pitfalls to Avoid

• Prescribing for children under 10 years of age
• Allowing patients to chew or break capsules
• Failure to educate patients about the importance of swallowing capsules whole
• Exceeding the maximum recommended daily dose of 600 mg

Remember that benzonatate is just one option for cough management, and appropriate patient selection and education are essential for safe use of this medication.