Starting Dose for Tessalon Pearls (Benzonatate)
The recommended starting dose for Tessalon pearls (benzonatate) is 100 mg three times daily, with a maximum daily dose of 600 mg.
Dosage Information
- Tessalon pearls (benzonatate) are typically prescribed at a starting dose of 100 mg three times daily 1
- The medication is available in capsule form (pearls) with a standard strength of 100 mg or 200 mg 1
- Maximum daily dose should not exceed 600 mg per day 1
- Dosing frequency is typically three times daily, but can be adjusted based on clinical response 1
Clinical Considerations
- Benzonatate is a non-narcotic antitussive that works by anesthetizing stretch receptors in the lungs, thereby reducing the cough reflex 2
- The medication begins working within 15-20 minutes of oral administration 2
- Duration of effect is typically 3-8 hours, which supports the three times daily dosing schedule 2
- Tessalon pearls should be swallowed whole, not chewed or crushed, as this can lead to rapid release of medication and potential toxicity 2
Safety Concerns
- Overdose can lead to serious adverse effects including cardiac arrest, seizures, and even death 2
- Cases of fatal overdose have been reported, particularly in pediatric patients who may mistake the pearls for candy 3
- Symptoms of toxicity can develop rapidly (within 15-20 minutes of ingestion) and may include confusion, restlessness, convulsions, and cardiovascular collapse 2
- Caution is advised when prescribing to patients with a history of drug abuse or suicidal ideation, as intentional overdose has been reported 2
Special Populations
- In elderly patients, consider starting at the lower end of the dosing range due to potential for increased sensitivity to adverse effects 1
- Use with caution in patients with significant hepatic impairment as metabolism may be affected 1
- The medication should be used during pregnancy only if clearly needed, as safety during pregnancy has not been well established 1
Monitoring
- Monitor for clinical response, typically within the first few days of treatment 2
- Assess for adverse effects including hypersensitivity reactions, dizziness, headache, or gastrointestinal disturbances 2
- If no improvement in symptoms is observed after a reasonable trial period (approximately one week), consider alternative treatments 1