Tessalon Perles Do Not Lower Blood Pressure
Tessalon (benzonatate) is a non-narcotic antitussive medication used to suppress cough and has no blood pressure-lowering properties. This medication works as a local anesthetic on stretch receptors in the respiratory passages and is not indicated for, nor effective in, treating hypertension.
Mechanism and Clinical Use
- Benzonatate functions as a topical anesthetic agent that acts on pulmonary stretch receptors to suppress the cough reflex 1
- The drug provides rapid oral anesthesia (within approximately 55 seconds) when used topically, demonstrating its local anesthetic properties rather than systemic cardiovascular effects 1
- In clinical studies evaluating benzonatate for airway anesthesia, no significant changes in mean arterial pressure or heart rate (beyond 20% from baseline) were observed, indicating cardiovascular neutrality 1
Evidence from Hypertension Guidelines
- The 2024 ESC Guidelines for hypertension recommend ACE inhibitors, ARBs, dihydropyridine calcium channel blockers, and thiazide/thiazide-like diuretics as first-line blood pressure-lowering medications 2
- Beta-blockers are recommended only when there are compelling indications such as angina, post-myocardial infarction, heart failure, or heart rate control—not as primary antihypertensive agents 2
- Benzonatate is not mentioned in any major hypertension guidelines as a therapeutic option for blood pressure management 2
Safety Considerations
- Benzonatate has been associated with serious toxicity in overdose situations, including fatalities, but these cases do not involve blood pressure effects as a mechanism of toxicity 3
- The medication should be used strictly for its approved indication (cough suppression) and not considered for cardiovascular indications 3, 1
Clinical Bottom Line
If you are seeking blood pressure reduction, you should use evidence-based antihypertensive medications such as ACE inhibitors, ARBs, calcium channel blockers, or diuretics as recommended by current guidelines 2. Tessalon perles have no role in blood pressure management and should only be used for their intended purpose of cough suppression 1.