What is the recommended dosage for Tessalon (benzocaine) pearls?

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Tessalon Pearls (Benzonatate) Prescription Dosing

Critical Safety Warning

Tessalon (benzonatate) is NOT benzocaine—these are completely different medications, and confusion between them can be fatal. Benzonatate is an oral non-narcotic antitussive (cough suppressant), while benzocaine is a topical anesthetic. The evidence provided contains no FDA labeling or guideline information specifically for Tessalon/benzonatate dosing.

Standard Adult Dosing (Based on General Medical Knowledge)

For adults and children over 10 years of age, the standard prescription is 100-200 mg orally three times daily as needed for cough, with a maximum daily dose of 600 mg.

Key Prescribing Points:

  • Capsules must be swallowed whole—never chewed, dissolved, or broken open, as release of benzonatate in the mouth can cause severe local anesthesia of the oral mucosa and choking risk 1

  • Contraindicated in children under 10 years of age due to risk of fatal overdose from accidental ingestion or intentional misuse 1

  • Typical prescription format:

    • Benzonatate 100 mg or 200 mg capsules
    • Take one capsule by mouth three times daily as needed for cough
    • Maximum 600 mg per day
    • Swallow whole—do not chew or dissolve

Critical Safety Considerations:

  • Fatal overdoses have been reported, particularly in children who accidentally ingested the medication or when capsules were chewed 1

  • Death can occur within 1 hour of overdose ingestion 1

  • The soft gelatin capsules ("perles") are attractive to children and pose a significant poisoning risk if accessible 1

  • Patients must be counseled explicitly about the choking hazard if capsules are chewed or sucked 1

Storage and Dispensing:

  • Dispense in child-resistant containers with clear warnings about keeping away from children

  • Counsel patients to store securely out of reach of children due to documented pediatric fatalities 1

References

Research

Two fatalities resulting from Tessalon (benzonatate).

Veterinary and human toxicology, 1986

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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