II. Background

  1. First approved for use in U.S. in 1958
  2. Synthetic butylamino-benzoate derivative (related to tetracaine, procaine)
    1. Voltage-gated Sodium channel inhibitor
  3. Peripherally acting non-opioid Antitussive
  4. Decreases cough reflex by anesthetizing and suppressing stretch receptors receptors in the airways, lungs, and pleura

III. Dosing

  1. Adults: 100-200 mg orally every 8 hours as needed for cough
  2. Not approved for age under 10 years old

IV. Pharmacokinetics

  1. Onset: 15-20 minutes
  2. Duration: 3-8 hours

V. Adverse Effects

  1. Nausea
  2. Dizziness
  3. Headache
  4. Sedation or Somnolence
  5. Tongue numbness

VI. Precautions: Toxicology

  1. Tessalon Perles appear candy-like and could be ingested by young children
  2. Capsules are toxic if broken open (e.g. chewed, sucked) or taken in Overdose
    1. Single capsule may be lethal to child if the capsule leaks its liquid contents into the mouth
    2. McLawhorn (2013) Pharmacotherapy 33:38-43 +PMID:23307543 [PubMed]
  3. Narrow therapeutic range
    1. A small handful of capsules in Overdose could be lethal in adults
  4. Toxic Effects
    1. Muscle twitching or Tremors
    2. Generalized Tonic Clonic Seizures
    3. Laryngospasm or Bronchospasm
    4. Hypotension or cardiovascular collapse
    5. Cardiac Arrest
  5. Lethal effects of Benzonatate have likely been underestimated in past
    1. Benzonatate is rapidly metabolized and only recently have its metabolites been tested in autopsy cases

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Related Studies

Cost: Medications

Benzonatate (on 6/18/2017 at Walmart.com)
Benzonatate 100mg #14 capsules for $4.00 $0.29 each
Benzonatate 100mg #42 capsules for $10.00 $0.24 each
benzonatate (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
BENZONATATE 100 MG CAPSULE Generic $0.20 each
BENZONATATE 200 MG CAPSULE Generic $0.30 each

Ontology: benzonatate (C0053229)

Definition (NCI) A synthetic butylamino-benzoate derivative related to tetracaine and a peripherally acting antitussive, nonnarcotic Benzonatate reduces the cough reflex by anesthetizing and depressing mechanoreceptors in the respiratory passages, lungs, and pleura. It is recommended for cough relief in the common cold, bronchitis, pneumonia, and for chronic cough such as in asthma. (NCI04)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C029755
SnomedCT 31801005, 386030001
LNC LP18904-0, MTHU006813
English benzonatate, benzonatate (medication), BENZONATATE, benzonatate [Chemical/Ingredient], Benzonatate, Benzonatate (product), Benzonatate (substance)
Spanish benzonatato (producto), benzonatato (sustancia), benzonatato

Ontology: Tessalon Perles (C0723653)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Tessalon Perles, tessalon perle, tessalon perles

Ontology: Tessalon (C0740256)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C029755
English Tessalon, tessalon