From the Guidelines
Benzonatate, also known as Tessalon, is a non-narcotic antitussive medication used to relieve cough symptoms, with a recommended adult dosage of 100-200 mg taken orally three to four times daily as needed, with a maximum daily dose of 600 mg, as indicated in the study by Molassiotis et al. 1.
Key Points
- Benzonatate works by numbing stretch receptors in the lungs, thereby reducing the cough reflex.
- The medication should be swallowed whole, never chewed or crushed, as this can release the medication too quickly and potentially cause serious side effects including numbness of the mouth, throat, and possible choking.
- Common side effects include drowsiness, headache, mild dizziness, and stomach upset.
- Benzonatate is particularly useful for dry, non-productive coughs and typically begins working within 15-20 minutes, with effects lasting for 3-8 hours.
- It should be used with caution in pregnant women and should not be combined with alcohol or other central nervous system depressants.
- If cough persists beyond one week of treatment, patients should consult their healthcare provider as this may indicate a more serious underlying condition.
Evidence
The study by Molassiotis et al. 1 provides evidence for the use of benzonatate in relieving cough symptoms, with a recommended dosage of 100-200 mg taken orally three to four times daily as needed. Another study by Irwin et al. 2 also supports the use of benzonatate as a peripherally acting antitussive in the setting of pulmonary malignancies.
Important Considerations
- Benzonatate should be used under the guidance of a healthcare provider, especially in patients with underlying medical conditions or taking other medications.
- Patients should be monitored for potential side effects and interactions with other medications.
- Benzonatate is not a substitute for other treatments for underlying conditions that may be causing the cough.
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) and has been associated with adverse CNS effects possibly related to a prior sensitivity to related agents or interaction with concomitant medication.
Benzonatate (Tessalon) is a non-narcotic oral antitussive agent used to relieve coughs [3][4]. It is chemically related to anesthetic agents and has a unique molecular structure. The main use of Benzonatate is as a cough suppressant.
From the Research
Overview of Benzonatate
- Benzonatate, also known by the brand name Tessalon, is a non-narcotic oral antitussive used to relieve cough symptoms 5, 6, 7.
- It is a peripherally acting antitussive that works by dampening the activity of cough stretch receptors 8.
Mechanism of Action and Efficacy
- Benzonatate has been shown to be effective in relieving cough symptoms in patients with advanced cancer 5 and in those with acute viral cough 7.
- The combination of benzonatate and guaifenesin has been found to be more effective than either agent alone in suppressing capsaicin-induced cough 7.
Safety and Toxicity
- Benzonatate overdose can pose a risk to patients due to the potential for rapid development of life-threatening adverse events, including cardiac arrest 6.
- Rodent carcinogenicity studies have found no evidence of benzonatate-related increase in any neoplasm, suggesting that it is not tumorigenic 8.
Pharmacokinetics
- Benzonatate is rapidly absorbed and metabolized to 4-(butylamino)benzoic acid (BBA), which can be used to extrapolate its concentration in plasma 9.
- The half-life of benzonatate and BBA has been found to be approximately 1 hour, with a maximum concentration reached within a short period after oral administration 9.