What is the recommended dosing for Tessalon Perles (benzonatate)?

Benzonatate (Tessalon Perles) Dosing Recommendations

The recommended dosage for benzonatate (Tessalon Perles) is one 100 mg or 200 mg capsule three times a day as needed for cough, with a maximum daily dose of 600 mg in three divided doses. 1

Standard Dosing

• For adults and children over 10 years of age: 100-200 mg three times daily as needed 1
• Maximum daily dose: 600 mg (divided into three doses) 1
• Benzonatate capsules should always be swallowed whole - never broken, chewed, dissolved, cut, or crushed 1

Important Administration Considerations

• Capsules must be swallowed intact to prevent local anesthesia of the oral mucosa which could lead to choking 1
• If numbness or tingling of the mouth, tongue, throat, or face occurs, patients should avoid eating or drinking until the sensation resolves 1
• Benzonatate is only approved for use in patients 10 years of age and older 1

Safety Considerations and Precautions

• Benzonatate is chemically related to local anesthetics (para-amino-benzoic acid class) and shares similar adverse effect profiles 1
• The medication works by inhibiting voltage-gated sodium channels, including Nav1.7, which is believed to be its mechanism for cough suppression 2
• Detectable effects occur at concentrations as low as 0.3 μM, which has been reported in humans 2
• Overdose can lead to serious consequences including cardiac arrest, with symptoms appearing within 15-20 minutes of ingestion 1, 3
• Deaths have been reported following overdose in both children and adults 3, 4

Clinical Efficacy

• Studies have shown that benzonatate can inhibit cough-reflex sensitivity in patients with acute viral cough 5
• The combination of benzonatate with guaifenesin has demonstrated enhanced antitussive effects compared to either agent alone 5

Special Populations

• Safety in pregnancy: Pregnancy Category C - should be given to pregnant women only if clearly needed 1
• Nursing mothers: Use with caution as it is unknown whether benzonatate is excreted in human milk 1
• Pediatric use: Not established for children under 10 years of age 1
• Fatal accidental ingestions have been reported in children under 10 years of age 1, 4

Monitoring

• No specific laboratory monitoring is required during benzonatate therapy 1
• Patients should be educated about proper storage to keep medication out of reach of children 1
• Patients should be instructed to never exceed the recommended dosage due to the risk of serious adverse effects 1