What is Benzocaine (Benzontate)?

From the Guidelines

Benzonatate is a non-narcotic prescription cough suppressant that works by numbing stretch receptors in the lungs to reduce the cough reflex, with a standard adult dosage of 100-200 mg taken orally three to four times daily as needed, as indicated in the study by Molassiotis et al. 1.

Key Characteristics of Benzonatate

• It is a peripherally acting antitussive, meaning it works locally in the lungs rather than centrally in the brain, which distinguishes it from opioid-based cough suppressants.
• The medication comes as liquid-filled capsules (Tessalon Perles) that should be swallowed whole to avoid temporary numbness of the mouth and throat or serious adverse reactions.
• Common side effects include drowsiness, headache, dizziness, and mild stomach upset.
• Benzonatate is not habit-forming and does not cause respiratory depression, making it a safer option for many patients with persistent cough compared to codeine-containing cough suppressants.

Clinical Use and Safety

• Patients should be aware that benzonatate can cause serious harm or death if accidentally chewed or allowed to dissolve in the mouth, and it should be kept away from children.
• The medication typically begins working within 15-20 minutes, and its effects last for 3-8 hours.
• In the context of lung cancer, benzonatate has been shown to effectively control cough in some patients, including those unresponsive to opioid treatment, as noted in studies such as the one by Moroni et al. 1, although the evidence base is limited and variable.

Considerations for Prescribing Benzonatate

• Given its safety profile and efficacy, benzonatate can be considered for the symptomatic relief of cough in patients with lung cancer or other conditions, especially when other treatments have failed or are not tolerated.
• However, the decision to prescribe benzonatate should be made on a case-by-case basis, taking into account the patient's overall health status, potential side effects, and the availability of other treatment options.
• It is crucial for healthcare providers to educate patients on the proper use of benzonatate and the potential risks associated with its misuse.

From the FDA Drug Label

DESCRIPTION Benzonatate, a non-narcotic oral antitussive agent, is 2,5,8,11,14,17,20,23,26-nonaoxaoctacosan-28-yl p(butylamino) benzoate; with a molecular weight of 603.7. PRECAUTIONS Benzonatate is chemically related to anesthetic agents of the para-amino-benzoic acid class (e. g. procaine; tetracaine)

Benzonatate is a non-narcotic oral antitussive agent. It is chemically related to anesthetic agents of the para-amino-benzoic acid class, such as procaine and tetracaine. There is no information about Benzocaine (Benzontate), the question seems to be referring to Benzonatate. 2 2

From the Research

Definition and Uses of Benzocaine (Benzonatate)

• Benzonatate is a non-narcotic antitussive used to relieve cough symptoms 3, 4, 5, 6.
• It is a peripherally acting antitussive, meaning it works locally in the respiratory tract to suppress coughing 3.
• Benzonatate is used to treat coughs in various conditions, including advanced cancer, acute viral cough, and upper respiratory tract infections 3, 5, 6.

Mechanism of Action and Efficacy

• The exact mechanism of action of benzonatate is not fully understood, but it is thought to work by inhibiting the cough reflex sensitivity 5.
• Studies have shown that benzonatate is effective in relieving cough symptoms in patients with advanced cancer, acute viral cough, and upper respiratory tract infections 3, 5, 6.
• Benzonatate has been shown to be effective in combination with other medications, such as guaifenesin, in relieving cough symptoms 5.

Safety and Side Effects

• Benzonatate can cause serious side effects, including cardiac arrest, if taken in overdose 4.
• The risk of overdose and cardiac arrest is higher when benzonatate is taken with other medications or substances, such as alcohol 4.
• Benzonatate has a relatively safe profile when used as directed, but patients should be educated on the risks of overdose and the importance of following dosage instructions 4.