Tessalon Perles (Benzonatate) – Oral

What Is Tessalon?

Tessalon Perles is a prescription antitussive (cough medication) used to relieve coughing symptoms in adults and children over age 10. It is used to prevent coughing when you have a dry (nonproductive) cough

Tessalon Perles prevents coughing by reversibly anesthetizing (numbing) the stretch receptors of the respiratory passages, lungs, and pleura (membranes lining the lungs) to reduce the sensation that normally triggers a cough reflex.

This medication comes in 100 milligram liquid-filled perles (small, soft gelatin capsules) and 200 milligram capsules.

Drug Facts

Generic Name: Benzonatate

Brand Name(s): Tessalon Perles, Zonatuss

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Antitussive

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Benzonatate

Dosage Form(s): Liquid-filled perles, capsules

What Is Tessalon Used For?

The Food and Drug Administration (FDA) approved Tessalon Perles to prevent dry cough due to conditions that cause acute or recurrent coughing. A cough can interfere with your sleep and rest; cause chest discomfort; interfere with eating, drinking, and talking; or make it difficult to carry out your daily activities.

People use Tessalon Perles for a cough caused by: 

  • Allergies  
  • Infection
  • Bronchitis   
  • Inflammation 

This medication treats symptoms, not the underlying condition. It is often prescribed with other treatments, such as medications to relieve a sore throat or antibiotics to treat the infection.

Once you start taking Tessalon Perles, it won’t immediately stop your ongoing cough. Taking it as prescribed will help prevent the cough from recurring until the underlying condition (such as an infection) resolves.

People with a productive cough (cough with phlegm) should not take Tessalon Perles. Typically, it is good to cough up mucus and phlegm so they won’t block your airways. Suppressing this kind of cough can be harmful.

Tessalon (Benzonatate) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Tessalon

People usually take this medication on a schedule as prescribed by their healthcare provider and usually no more than three times per day. Taking it with or without food is fine.

Swallow the perles whole. Do not break, chew, dissolve, cut, or crush them. Doing so can cause numbness in your mouth and throat. If this accidentally happens, avoid eating or drinking until the numbness wears off—eating or drinking when you've lost sensation in your mouth and throat can cause you to choke. 

Storage

Be sure to store this medication away from the reach of pets or children. Perles are soft gelatin capsules that may look like candy to young children.

Keep the medication at room temperature, an average of 77 degrees Fahrenheit. You can briefly take it in temperatures between 59 degrees and 86 degrees.

Off-Label Uses

Tessalon Perles is a widely prescribed antitussive used for treating many types of cough. Healthcare providers may prescribe Tessalon for conditions not approved by the FDA. This is known as off-label use.

Some off-label uses of Tessalon include: 

  • Chronic cough 
  • Cough associated with COVID-19
  • Cough associated with cancer

Generally, Tessalon Perles works well at preventing cough. Within a few days after starting Tessalon, your healthcare provider will likely ask you about your progress.

How Long Does Tessalon Perles Take to Work?

Tessalon Perles begins to act within 15–20 minutes, and its effect lasts for three to eight hours.

What Are the Side Effects of Tessalon?

This medication is usually well tolerated. However, it can cause serious reactions or death, especially for children under 10.

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Tessalon Perles are:

  • Mouth, throat, or chest numbness
  • Constipation
  • Nausea
  • Stomach upset
  • Itchy skin
  • Rash
  • Congestion
  • Chilly sensation
  • Burning sensation of the eyes
  • Headaches
  • Dizziness
  • Tiredness

Talk to your healthcare provider if you have side effects so that you can both weigh the risks and benefits of this medication.

Severe Side Effects

Tessalon Perles can cause severe reactions. Chewing or sucking on the perles can numb your mouth and throat, causing you to choke or have difficulty breathing.

Additionally, you can have serious side effects even when you swallow the perles or capsules. These side effects are usually associated with high doses, but some people may experience a serious reaction when using the recommended dose.

Severe reactions can include:

  • Shortness of breath
  • Throat tightness
  • Severe dizziness
  • Sudden heart failure
  • Confusion
  • Hallucinations
  • Collapse

Get prompt medical attention if you experience any of these problems. You will need treatment for your symptoms. After you recover, discuss with your prescribe whether you should ever use this medication again for cough treatment. 

Long-Term Side Effects

Generally, the medication should not cause long-term side effects. The effects of Tessalon Perles should wear off within three to eight hours. However, serious side effects can result in lasting health problems, including injuries from a fall or brain damage due to lack of oxygen (from choking or inability to breathe).

Report Side Effects

Tessalon Perles may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Tessalon Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For cough:
      • Adults and children 10 years of age and older—100 milligrams (mg) three times a day. Do not take more than 200 mg at one time or more than 600 mg per day.
      • Children younger than 10 years of age—Use is not recommended.

Modifications

Tell your healthcare provider if you become pregnant or plan to become pregnant while taking Tessalon Perles. You may also need to be cautious if you decide to breastfeed. Talk to your provider about your treatment options.

Missed Dose

If you miss a dose, skip the missed dose and take the next dose at the scheduled time. You should not take two doses at the same time.

Overdose: What Happens If I Take Too Much Tessalon?

Taking too much Tessalon is dangerous.

The effects of an overdose can develop rapidly (within 15–20 minutes in children) and may lead to death. Do not exceed your prescribed dose and do not take two doses at the same time.

Watch for these signs of an overdose:

  • Restlessness and tremors (involuntary, rhythmic shaking)
  • Convulsions (rapid, uncontrollable muscle spasms and shaking)
  • Coma (deep sleep from which you cannot be awakened)
  • Cerebral edema (swelling in the brain)
  • Cardiac arrest (sudden heart failure)

Get emergency medical help if you or someone else takes too much Tessalon Perles. If an overdose occurs, a healthcare provider may remove the medication with gastric lavage (a tube is placed into the mouth and advanced to the stomach to remove stomach contents) and/or activated charcoal.

Short-acting barbiturates can help treat convulsions that result from a Tessalon overdose. Further treatment can be given for heart, lung, and kidney dysfunction until the effects of the medication wear off.

Precautions

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It is very important that your doctor check your progress while you or your child are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

If your cough has not become better after 7 days or if you have a high fever, skin rash, or continuing headache with the cough, check with your doctor. These signs may mean that you have other medical problems.

Benzonatate overdose can occur in children (younger than 10 years of age) within 15 to 20 minutes after accidentally taking this medicine. In children under 2 years of age, ingestion of even 1 or 2 capsules has resulted in overdose. Signs and symptoms may include: convulsions (seizures), loss of consciousness, restlessness, or trembling or shakiness in the legs, arms, hands, or feet. If your child took this medicine by accident, call the poison control center (1-800-222-1222) and go to the hospital immediately.

What Are Reasons I Shouldn’t Take Tessalon?

You should not take Tessalon Perles if you have a hypersensitivity to benzonatate.

What Other Medications Interact With Tessalon?

Avoid other medications or substances that have the potential to cause sleepiness, as the additive effect can cause you to become very dizzy, drowsy, or lose consciousness. This includes alcohol or recreational drugs that cause drowsiness.

You should also avoid alcohol or recreational drugs that could cause you to become drowsy.

Tell your healthcare provider about all medications you are taking, including prescription and over-the-counter (nonprescription) medications and any vitamins and supplements you take.

Frequently Asked Questions

  • What is Tessalon Perles used for?

    Tessalon Perles is an antitussive medication used to relieve cough symptoms.

  • How does Tessalon Perles work?

    This medication prevents the airways from feeling the sensation that usually would stimulate the cough reflex.

  • What drugs should not be taken with Tessalon Perles?

    You should not take this medication with other drugs that have the potential to cause drowsiness.

  • How long does it take for Tessalon Perles to work?

    Tessalon Perles begins to act within 15 to 20 minutes, and its effect lasts for three to eight hours.

  • What are the side effects of Tessalon?

    This medication can cause several mild side effects, such as stomach upset and nausea. Additionally, it can cause severe, life-threatening complications, including heart failure, choking, inability to breathe, collapse, and hallucinations. The risk of side effects is higher if you take too much Tessalon Perles or chew or suck on the perles.

  • How do I stop taking Tessalon Perles?

    You can stop taking Tessalon Perles when your coughing stops or if you experience side effects.

How Can I Stay Healthy While Taking Tessalon Perles?

If your healthcare provider has prescribed Tessalon, it’s important that you do not chew, crush, dissolve, break, or suck on the perles or capsules. If you accidentally break the perle or capsule in your mouth, watch for signs of numbness in your mouth or throat. Wait until the numbness subsides before eating or drinking anything. 

You should only use Tessalon Perles for a dry (nonproductive) cough. A dry cough does not bring up phlegm or mucus. If your cough becomes productive, contact your healthcare provider to discuss your treatment options. 

Since Tessalon Perles won’t treat the underlying cause of your infection, make sure to take any other recommended or prescribed medication to treat the cause of your cough. 

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Evans MS, Maglinger GB, Fletcher AM, Johnson SR. Benzonatate inhibition of voltage-gated sodium currents. Neuropharmacology. 2016 Feb;101:179-87. doi:10.1016/j.neuropharm.2015.09.020

  2. Food and Drug Administration. Tessalon label.

  3. O'Keefe JB, Newsom LC, Taylor TH Jr. A survey of provider-reported use and perceived effectiveness of medications for symptom management in telemedicine and outpatient visits for mild COVID-19. Infect Dis Ther. 2021 Jun;10(2):839-851. doi:10.1007/s40121-021-00432-8

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.