What are the age limits for Tessalon Perles (Benzonatate)?

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Last updated: March 18, 2025View editorial policy

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From the Research

Tessalon Perles (benzonatate) should not be given to children under 10 years of age due to safety concerns, and its use is generally recommended for patients aged 10 years and older for the symptomatic relief of cough. The primary concern with benzonatate in young children is the risk of accidental ingestion, which can lead to severe choking hazards or fatal overdose, as highlighted in a case involving an infant found choking with Tessalon perles 1. For adults and children 10 years and older, the typical dosage is 100-200 mg three times daily as needed for cough, not exceeding 600 mg in 24 hours. It's crucial to note that there is no specific upper age limit for elderly patients, though as with many medications, older adults may require dose adjustments based on their kidney or liver function. The medication works by numbing stretch receptors in the lungs that trigger coughing, providing relief without the sedative or addictive properties of narcotic cough suppressants.

Key Considerations

  • The medication should be swallowed whole, not chewed or dissolved in the mouth, as this can cause temporary numbness of the mouth and throat, potentially increasing choking risk.
  • Overdose of Tessalon perles can lead to severe and life-threatening adverse events, including cardiac arrest and residual blindness, as reported in a case of a 17-year-old woman who ingested at least 10 200-mg Tessalon capsules 2.
  • Rational prescribing and patient education are necessary to minimize the risks associated with benzonatate use.

Safety and Efficacy

The safety and efficacy of benzonatate have been established for patients aged 10 years and older, but its use in younger children is not recommended due to the potential for severe adverse effects. While there are reports of methemoglobinemia associated with other medications, such as benzocaine 3, 4, 5, these are not directly relevant to the use of benzonatate. However, they do highlight the importance of careful consideration and monitoring when prescribing any medication, especially in vulnerable populations.

References

Research

Two fatalities resulting from Tessalon (benzonatate).

Veterinary and human toxicology, 1986

Research

Systematic Review of Methemoglobinemia in Acetaminophen Poisoning.

QJM : monthly journal of the Association of Physicians, 2020

Research

Severe methemoglobinemia on reexposure to benzocaine.

Journal of clinical anesthesia, 2001

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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