What to Know About Benzonatate

A Cough Suppressant Used to Treat the Common Cold, Pneumonia and Influenza

Benzonatate is a prescription non-narcotic antitussive used to relieve a cough. It works by relaxing the cough reflex in your airways. It can be used to treat a new-onset cough from viruses like the flu or the common cold.

Benzonatate comes in a capsule and a liquid-filled capsule. Common brand names include Tessalon and Zonatuss. Generic benzonatate is also available.

woman with cough might be prescribed benzonatate
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Uses

Benzonatate is used to temporarily relieve a cough but cannot cure the respiratory illness. Your doctor may prescribe it for a limited amount of time. Benzonatate is not meant to be used for a chronic cough from asthma or smoking.  

Benzonatate works by relaxing the cough reflex in your lungs and airways. This is especially helpful for a cough that keeps you up at night. 

Before Taking

Before this drug is prescribed for a cough, your doctor will determine if the possible benefits outweigh the risks. Your doctor will probably ask if your cough is productive, which means that when you cough into a tissue, mucus or phlegm come out.

Benzonatate makes you cough less and should not be used for a cough that produces a large amount of mucus or phlegm. That is because reducing your cough could cause mucus to build up in your lungs, putting you at risk for serious respiratory illnesses and trouble breathing. 

Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case. 

Precautions and Contraindications

Benzonatate should not be used in children under ten years old. If this medication is being prescribed for your child, ask your doctor about safer options. 

Your doctor will ask what medications and supplements you are currently taking. Benzonatate can interact with a long list of medications, including psychiatric medications. A small number of patients have reported confusion and visual hallucinations while taking Benzonatate with their other prescribed drugs. 

Benzonatate should not be used in patients with allergies to Novocaine or tetracaine, because those are included in the capsule. 

If you are pregnant, breastfeeding, or have surgery coming up, your doctor may look into an alternate option to help control your cough.  

Other Cough Suppressants

In addition to benzonatate, the most common prescription antitussives include:

  • Codeine
  • Hydrocodone 

There are also over-the-counter (OTC) cough suppressants, including:

Dosage

Benzonatate comes in liquid-filled capsules and can be taken up to three times per day. The capsules should always be swallowed whole and never crushed or chewed. According to the manufacturer, dosing should be as follows:

Your doctor will most likely start you at a dose of a 100 milligram (mg) capsule up to three times per day as needed for a cough. Your doctor may increase your dose to a 200 mg capsule up to three times per day as needed for a total of 600 mg per day.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

How to Take and Store

Because benzonatate capsules contain Novocaine, they should never be cut open or chewed. Novocaine is the numbing agent you have probably had at the dentist. It can quickly numb your mouth, and this could put you at risk for choking or trouble breathing.

If you notice a numbing sensation in your mouth or throat after taking benzonatate, let your doctor know right away and don’t attempt to eat or drink anything until you feel back to normal.  

Benzonatate can be taken with food or on an empty stomach. If you miss a dose, skip the missed dose and wait until your next scheduled time. Never double up on dosages.

The capsules should be kept in a cool dry room, avoiding humid rooms like the bathroom.

Benzonatate can be deadly in children under 10 years old, so it is critical that you keep the prescription bottle sealed and on a high shelf out of their reach. Keep the bottle out of sight, as children may be curious about the liquid-filled capsules.

The best way to dispose of extra medication once you no longer need it is with a prescription take-back program at your local pharmacy or health department. Avoid placing unused capsules in the garbage or flushing them down the toilet. 

Side Effects

Common

Most side effects of Benzonatate are mild and uncommon. Possible side effects include:

  • Constipation
  • Dizziness
  • Drowsiness
  • Headache 
  • Nausea
  • Stuffy nose 

Severe

Severe side effects are possible from hypersensitivity reactions, drug interactions or a damaged capsule. Call your doctor right away if you experience any of the following side effects:

  • Confusion
  • Hallucination 
  • Itchy rash or hives
  • Numbness in the mouth, throat, or chest
  • Tightening of the throat 
  • Trouble breathing or swallowing

Overdose Warning

A benzonatate overdose can happen quickly. Symptoms can appear within 15 minutes, and death has been reported within an hour. Symptoms of an overdose may include:

  • Restlessness 
  • Tremors
  • Seizures
  • Loss of consciousness 

If you or your child experience any of these overdose symptoms, call 911 immediately. 

Warnings and Interactions

Benzonatate should be used with caution in patients who:

  • Are pregnant or breastfeeding 
  • Have a chronic cough
  • Have a productive cough 
  • Have a history of hallucinations
  • Are current smokers 

Warnings 

Benzonatate can be taken up to three times per day as needed for a cough. Do not take your next dose if your cough is controlled. If after taking Benzonatate for seven days you still experience a cough, talk with your doctor.

This medication should be used to treat an acute cough for a limited amount of time. If your cough is not improving after one week, your doctor may need to examine you again. 

If you develop a fever, rash, or new-onset headache while taking benzonatate, stop the medication, and call your doctor. This could be a sign that you have other medical conditions that need to be addressed. 

Benzonatate can cause overdose and death in children under 10 years old with only one or two doses. Keep the medication out of reach of children and never give your child a capsule of Benzonatate. 

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Article Sources
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  2. MedlinePlus. Benzonatate. Updated August 15, 2017.

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