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Understanding Benzonatate Side Effects, Risks and more | A Comprehensive Guide

benoznatate

Clinically Reviewed by: Charee Marquez, LMFT

Benzonatate, commonly known under the brand name Tessalon Perles, is a popular cough medicine used to relieve coughs. Available as an oral capsule, specifically a liquid-filled capsule, it is often prescribed to manage persistent coughs. However, like any medication, Benzonatate can have a range of side effects. It’s essential to be aware of these potential unwanted effects, particularly if they are unusual or severe. Understanding how Benzonatate interacts with certain medicines, recognizing overdose symptoms, and knowing when to call your doctor for medical advice are crucial steps in ensuring safe usage. This blog will explore the various side effects of Benzonatate, what to do if you miss a dose, and how to handle an overdose. If any severe side effects occur, seek medical attention and contact your doctor immediately.

What is Benzonatate (Tessalon Perles)?

Benzonatate is a non-narcotic oral antitussive (cough suppressant) used to relieve coughing. It works by numbing the throat and lungs, making the cough reflex less active. Benzonatate is often prescribed for coughs caused by the common cold, bronchitis, pneumonia, or other respiratory conditions.

Key points about Benzonatate:

  1. Usage: It is typically used to suppress coughing. It should be taken exactly as prescribed by a healthcare provider.
  2. Dosage: The dosage is generally based on the individual’s medical condition and response to treatment. It usually comes in 100 mg or 200 mg capsules.
  3. Administration: Capsules should be swallowed whole, not chewed, to avoid numbing the mouth and throat, which can lead to choking.
  4. Side Effects: Common side effects may include drowsiness, dizziness, headache, nausea, or constipation. Serious side effects can include allergic reactions, mental/mood changes, and confusion.
  5. Precautions: It should not be used in children under 10 years old. Caution is advised for people with certain medical conditions, such as a history of severe allergic reactions. Consult a health care professional for more information about side effects.

 

Benzonatate Types and Dosages

Benzonatate is available in different forms and dosages, primarily as capsules and softgels. The specific types and dosages include:

Benzonatate Capsules (Perles):

  • 100 mg Capsules: These are small, pearl-like capsules, often referred to as “perles.”
  • 200 mg Capsules: These are larger capsules.

Benzonatate Softgels:

  • 100 mg Softgels: Similar in dosage to the capsules, these are available in a softgel form.
  • 150 mg Softgels: This is another dosage form available as a softgel, providing a middle ground between the 100 mg and 200 mg dosages.
  • 200 mg Softgels: These are larger softgels, providing the highest dosage form available.

Dosage Instructions:

  • Adults and Children over 10 Years: The typical dose is 100 mg to 200 mg, taken three times a day as needed for cough. The maximum recommended dose is 600 mg per day.
  • Children under 10 Years: Benzonatate is not recommended for children under 10 years due to the risk of serious side effects and potential choking hazard.
  • Missed Dose: If you miss a dose, skip the missed dose and take the next scheduled dose. Do not take a double dose to make up for the missed dose as this can lead to dangerous side effects.

Administration:

  • The capsules or softgels should be swallowed whole with water.
  • Do not chew, crush, or dissolve the capsules or softgels as this can cause numbing of the mouth and throat, which can lead to choking or severe allergic reactions.

Note: Always follow the prescribed dosage and instructions provided by your healthcare provider. Do not exceed the recommended dosage, and consult your healthcare provider if you have any questions or concerns regarding the medication.

 

Benzonatate Efficacy

Benzonatate is effective in reducing cough frequency and severity, particularly for non-productive (dry) coughs associated with conditions like the common cold, bronchitis, or pneumonia. It works by numbing the stretch receptors in the lungs and airways, which suppresses the cough reflex.

Key Points:

  1. Rapid Onset: Benzonatate begins to work within 15 to 20 minutes after ingestion, providing quick relief from coughing.
  2. Duration of Effect: The effects can last for up to 8 hours, allowing for less frequent dosing.
  3. Non-Narcotic: As a non-narcotic medication, Benzonatate does not have the addictive potential that some other cough suppressants (like codeine) possess.
  4. Symptom Relief: It is particularly effective for treating dry coughs and can help improve sleep by reducing nighttime coughing.

Clinical Considerations:

  • While Benzonatate is effective for symptom relief, it does not treat the underlying cause of the cough.
  • Efficacy can vary among individuals, and it may not be as effective for productive (wet) coughs where mucus needs to be expelled.

 

Benzonatate Uses

Benzonatate is primarily used as a cough suppressant for the relief of:

  1. Cough associated with the common cold: Helps alleviate persistent dry cough.
  2. Bronchitis: Reduces coughing fits that can accompany this respiratory condition.
  3. Pneumonia: Provides relief from the cough that often accompanies pneumonia.
  4. Other respiratory conditions: Helps manage coughs related to various other respiratory illnesses.

Key Points:

  • Non-productive coughs: Especially effective for dry, irritating coughs.
  • Short-term relief: Used to reduce cough frequency and intensity, providing comfort and improving sleep quality.

Benzonatate is not an antibiotic or antiviral and does not treat the underlying cause of the cough. It is used symptomatically to make patients more comfortable while their body fights off the infection or irritation causing the cough. Always use Benzonatate as prescribed by a healthcare provider.

 

How Long Does Benzonatate Stay in Your System?

Benzonatate has a half-life of approximately 3.8 hours. This means that it takes about 3.8 hours for the concentration of the drug in the bloodstream to reduce by half.

Key Points:

  1. Onset of Action: Benzonatate begins to work within 15 to 20 minutes after ingestion.
  2. Duration of Effect: The effects can last for up to 8 hours.
  3. Elimination: Given the half-life of 3.8 hours, Benzonatate is typically eliminated from the system within about 19 hours (approximately five half-lives).

Considerations:

  • Individual factors such as metabolism, age, liver function, and kidney function can influence how long Benzonatate stays in the system.
  • Despite the relatively short half-life, effects are sustained for several hours due to the drug’s action on the cough reflex.

 

Benzonatate Onset and Duration

  • Onset: Benzonatate starts working within 15 to 20 minutes after ingestion.
  • Duration: The effects last for up to 8 hours, providing prolonged relief from coughing.

This rapid onset and extended duration make Benzonatate effective for managing persistent coughs throughout the day and night.

 

Benzonatate Storage and Disposal

  • Storage:
    • Keep at room temperature (20-25°C or 68-77°F).
    • Store in a tightly closed container, away from light and moisture.
    • Keep out of reach of children and pets.
  • Disposal:
    • Do not flush down the toilet or pour into drains.
    • Use a drug take-back program if available.
    • If no take-back program is available, mix the medication with an unappealing substance (like coffee grounds or cat litter), place in a sealed plastic bag, and dispose of in the household trash.

Always follow local regulations and guidelines for medication disposal.

 

How Does Benzonatate Work in the Brain and Body?

Mechanism of Action:

  • Peripheral Action: Benzonatate primarily works by numbing the stretch receptors located in the lungs and airways. These receptors are responsible for triggering the cough reflex when they detect irritation or mucus.
  • Numbing Effect: By anesthetizing these receptors, Benzonatate reduces the transmission of the cough signal to the brain, thereby decreasing the urge to cough.

Steps in the Body:

  1. Ingestion: After oral administration, Benzonatate is absorbed into the bloodstream.
  2. Receptor Binding: It binds to the stretch receptors in the respiratory tract, numbing them.
  3. Signal Suppression: The numbed receptors are less sensitive to irritants, leading to fewer signals being sent to the brain to initiate a cough.
  4. Cough Reflex Reduction: With fewer signals reaching the brain, the frequency and intensity of the cough reflex are significantly reduced.

Key Points:

  • Non-central Mechanism: Unlike some other cough suppressants, Benzonatate does not work directly on the central nervous system (CNS). It acts locally in the respiratory tract, making it non-narcotic and reducing the risk of CNS-related side effects.
  • Quick Action: The medication starts working within 15 to 20 minutes and provides relief for up to 8 hours.

Benzonatate effectively reduces coughing by targeting and desensitizing the peripheral receptors in the lungs and airways, rather than acting centrally in the brain.

 

Effects of Benzonatate on the Body

Effects of Benzonatate on the Body:

  • Cough Suppression: Numbs stretch receptors in the lungs and airways, reducing the cough reflex.
  • Onset: Begins to work within 15-20 minutes.
  • Duration: Provides relief for up to 8 hours.

Side Effects:

  • Common: Drowsiness, dizziness, headache, nausea, constipation.
  • Serious: Allergic reactions, mental/mood changes, confusion.

Always follow prescribed guidelines and consult with a healthcare provider for any concerns.

 

Benzonatate Side Effects, Risks, and Unusual or Allergic Reactions

Common Side Effects:

  • Drowsiness
  • Dizziness
  • Headache
  • Nausea
  • Constipation
  • Nasal congestion

Less Common but Serious Side Effects:

  • Allergic reactions (e.g., rash, itching, swelling, severe dizziness, trouble breathing)
  • Mental/mood changes (e.g., confusion, hallucinations)
  • Numbness in the mouth, throat, or chest (if the capsule is chewed or dissolved)
  • Difficult breathing difficulty
  • Unusual or allergic reaction

Rare but Severe Risks:

  • Severe allergic reactions: Anaphylaxis can occur, requiring immediate medical attention.
  • Accidental overdose: Can cause restlessness, tremors, seizures, and cardiac arrest. This is especially risky in children under 10 years.
  • Choking hazard: If the capsule is chewed, it can cause numbing of the mouth and throat, leading to a choking risk.
  • If an overdose occurs, contact a poison control center at 800-222-1222 or seek emergency medical assistance immediately.

Precautions:

  • Children: Not recommended for children under 10 years due to the risk of severe side effects.
  • Swallowing: Always swallow capsules whole to avoid numbing of the mouth and throat.
  • Medical Conditions: Inform your healthcare provider if you have a history of allergic reactions or other medical conditions.

Always follow the prescribed dosage and consult your healthcare provider for any concerns regarding side effects or risks associated with Benzonatate.

 

Is Benzonatate Addictive?

Benzonatate is non-narcotic and not addictive. It does not work on the central nervous system like opioid-based cough suppressants, so it does not have the potential for abuse or dependence.

 

Can You Overdose on Benzonatate?

Yes, an overdose on Benzonatate is possible and can be serious. Symptoms of overdose may include:

  • Restlessness
  • Tremors
  • Seizures
  • Cardiac arrest
  • Severe dizziness or fainting

Key Points:

  • Children: Particularly at risk; even a small amount can be dangerous.
  • Immediate Medical Attention: Required if overdose is suspected.

Always follow the prescribed dosage and keep the medication out of reach of children.

 

Prevalence of Benzonatate Side Effects

The prevalence of side effects for Benzonatate can vary, but generally, they are considered uncommon. Here’s a brief overview:

Common Side Effects (less frequent):

  • Drowsiness: Occurs in a small percentage of users.
  • Dizziness: Experienced by some individuals but not widespread.
  • Headache: Reported by a minority of patients.
  • Nausea: May affect a few users.
  • Constipation: Less commonly reported.

Serious Side Effects (rare):

  • Allergic Reactions: Such as rash, itching, swelling, severe dizziness, and trouble breathing. These are rare but require immediate medical attention.
  • Mental/Mood Changes: Confusion and hallucinations are very rare.
  • Numbness in Mouth/Throat: Occurs if the capsule is chewed, posing a choking hazard.
  • Rare Confusion: Although uncommon, confusion may occur and requires medical attention.

Overdose Risks:

  • Rare but serious, especially in children, with symptoms like restlessness, tremors, seizures, and cardiac arrest.

Key Points:

  • Side effects are generally rare and usually mild.
  • Serious side effects and overdose risks, although rare, necessitate caution and adherence to prescribed dosages.

Consult with a healthcare provider for personalized information and guidance regarding Benzonatate use.

 

What are the most common side effects of Benzonatate?

Drowsiness, dizziness, headache, nausea, and constipation.

 

What should I do if I experience severe side effects?

Seek immediate medical attention if you experience symptoms of a severe allergic reaction or other serious side effects.

 

Can Benzonatate affect my ability to drive?

Yes, because it can cause drowsiness and dizziness, it may impair your ability to drive or operate heavy machinery.

 

Can children take Benzonatate?

Benzonatate is not recommended for children under 10 years due to the risk of serious side effects.

 

What should I do if I accidentally chew a Benzonatate capsule?

If you chew or dissolve a Benzonatate capsule, it can numb your mouth and throat, leading to a choking hazard. Seek medical advice immediately if this occurs.

 

How Does Benzonatate Affect Your Mood?

  • Rare Side Effects: May cause confusion or hallucinations in rare cases.
  • Monitor: Watch for unusual mood changes.
  • Consult: Seek medical advice if significant mood changes occur.

Mood changes are uncommon but possible. Always report any concerning symptoms to your healthcare provider.

 

Does Benzonatate Make You Dizzy?

Yes, dizziness is a known side effect of Benzonatate.

Key Points:

  • Common Side Effect: Dizziness can occur in some users.
  • Monitor: Be aware of how you feel, especially when starting the medication.
  • Safety: Avoid driving or operating heavy machinery if you experience dizziness.

If dizziness persists or is severe, consult your healthcare provider.

 

Can Benzonatate Affect Your Pregnancy?

The effects of Benzonatate on pregnancy are not well-studied, and it is classified as a Category C drug by the FDA. This means that there are no well-controlled studies in pregnant women, and Benzonatate should only be used during pregnancy if clearly needed and prescribed by a healthcare provider.

Key Points:

  • Limited Data: There is a lack of extensive research on the safety of Benzonatate in pregnant women.
  • Category C: Potential risks should be weighed against the benefits.
  • Consult Healthcare Provider: Always consult your healthcare provider before using Benzonatate if you are pregnant or planning to become pregnant.

Your healthcare provider can help determine whether the benefits of taking Benzonatate outweigh the potential risks to your pregnancy.

 

Alcohol Use and Benzonatate

Combining alcohol with Benzonatate is not recommended due to potential additive effects.

Key Points:

  • Increased Drowsiness: Both alcohol and Benzonatate can cause drowsiness. Using them together can enhance this effect, leading to excessive sleepiness or sedation.
  • Increased Dizziness: The combination can also increase the likelihood of dizziness, impairing coordination and reaction time.
  • Safety Concerns: Avoid activities that require alertness, such as driving or operating heavy machinery, if consuming alcohol while taking Benzonatate.

Recommendation:

  • Avoid Alcohol: It is best to avoid alcohol while taking Benzonatate to prevent these potential side effects and ensure safety.

 

Benzonatate Drug Interactions with Other Medications

Benzonatate is generally considered to have a low potential for drug interactions, but there are some considerations to keep in mind.

Key Interactions:

  1. CNS Depressants:
    • Examples: Sedatives, tranquilizers, and alcohol.
    • Effect: Enhanced sedative effects, increased risk of drowsiness, dizziness, and impaired coordination.
  2. Other Cough Suppressants:
    • Examples: Codeine, dextromethorphan.
    • Effect: Potential for additive effects leading to excessive suppression of the cough reflex.
  3. Medications that cause drowsiness:
    • Examples: Antihistamines (e.g., diphenhydramine), muscle relaxants, certain antidepressants, antipsychotics.
    • Effect: Increased drowsiness and sedation.

General Recommendations:

  • Consult Healthcare Provider: Always inform your healthcare provider of all the medications you are taking, including over-the-counter drugs and supplements, to avoid potential interactions.
  • Monitor Side Effects: Be cautious of increased drowsiness or dizziness if taking other medications that have sedative effects.

 

Is Benzonatate Right for You?

  • Effective for Cough Relief: Especially for dry, non-productive coughs.
  • Non-Narcotic: No risk of addiction.
  • Consider Side Effects: Possible drowsiness, dizziness, allergic reactions.
  • Consult Healthcare Provider: Essential if pregnant, breastfeeding, or taking other medications.

 

Addiction and Mental Health Treatment

Addiction and Mental Health Treatment Options

  1. Inpatient Rehabilitation:
    • Inpatient rehabilitation, also known as residential treatment, involves individuals residing within a treatment facility for a specified duration. This structured environment provides intensive care and support.
  2. Outpatient Programs:
    • Outpatient programs offer flexibility, allowing individuals to receive treatment while continuing their daily lives. They attend therapy sessions, counseling, and other interventions on a scheduled basis.
  3. Detoxification (Detox):
    • Detox is the initial phase of treatment, focusing on safely and systematically removing substances from the body. It is often conducted under medical supervision to manage withdrawal symptoms.
  4. Therapy and Counseling:
    • Various therapeutic modalities, including individual counseling, group therapy, and family therapy, are crucial components of addiction and mental health treatment. These sessions help individuals explore and address underlying issues.
  5. Medication-Assisted Treatment (MAT):
    • MAT involves the use of medications, in conjunction with counseling and behavioral therapies, to address substance use disorders. It is particularly effective for opioid and alcohol addictions.
  6. Dual Diagnosis Treatment:
    • Dual Diagnosis Treatment addresses co-occurring mental health disorders alongside substance use disorders. It involves integrated interventions to holistically address both aspects of an individual’s well-being.
  7. Holistic Therapies:
    • Holistic approaches incorporate alternative therapies such as yoga, meditation, art therapy, and mindfulness. These practices aim to promote overall well-being and support recovery.
  8. Support Groups:
    • Support groups, like those following the 12-step model (e.g., Alcoholics Anonymous, Narcotics Anonymous), provide a community for individuals to share experiences, seek guidance, and foster mutual support.
  9. Sober Living Homes:
    • Sober living homes offer a transitional and supportive environment for individuals in recovery. They provide a structured living arrangement to reinforce sobriety.
  10. Mental Health Treatment:
    • Mental health treatment specifically addresses psychiatric conditions. It may involve therapy, medication management, and other interventions to enhance emotional well-being.
  11. Cognitive-Behavioral Therapy (CBT):
    • CBT is a goal-oriented therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors. It is effective for both addiction and mental health concerns.
  12. Dialectical Behavior Therapy (DBT):
    • DBT combines cognitive-behavioral techniques with concepts of acceptance and mindfulness. It is particularly beneficial for individuals with emotional dysregulation.
  13. Motivational Interviewing (MI):
    • MI is a client-centered counseling style aimed at eliciting behavior change by helping individuals explore and resolve ambivalence. It is effective in the early stages of recovery.
  14. Residential Treatment Centers:
    • Residential facilities provide immersive and structured treatment experiences for individuals requiring a more extended and intensive intervention.
  15. Community-Based Programs:
    • Programs within the community offer accessible and community-centered support for individuals with mental health concerns.
  16. Inpatient Mental Health Treatment:
    • Inpatient mental health treatment involves individuals residing within a treatment facility designed to provide a controlled and supportive environment for managing mental health conditions.

 

Does Insurance Cover Addiction and Mental Health Treatment?

Typically, yes. The coverage of addiction treatment by insurance can vary depending on the type of insurance plan, specific policy details, and the individual’s needs and circumstances. Here are key points to consider regarding insurance coverage for addiction treatment:

  1. Type of Insurance Plan:
    • Different types of insurance plans, such as private insurance, Medicaid, or Medicare, may have varying levels of coverage for addiction treatment.
  2. In-Network vs. Out-of-Network Providers:
    • Insurance plans often have a network of preferred providers. In-network addiction treatment facilities are generally covered at a higher rate than out-of-network providers. Checking if the facility is in-network can impact coverage.
  3. Verification of Benefits:
    • It is crucial to contact the insurance provider and verify the specific terms of coverage for addiction treatment. This includes checking details such as copayments, deductibles, and any out-of-pocket expenses.
  4. Medical Necessity and Preauthorization:
    • Insurance coverage for addiction treatment may be contingent on a determination of medical necessity. Preauthorization or approval from the insurance company may be required before entering a treatment program.
  5. Level of Care:
    • Different levels of addiction treatment, such as inpatient, outpatient, or intensive outpatient programs, may have different coverage considerations. Some insurance plans may cover certain levels of care more comprehensively.
  6. Length of Treatment:
    • Insurance coverage may be influenced by the length of the treatment program. Some plans may have limitations on the number of days covered, while others may provide more extensive coverage for longer durations.
  7. Parity Laws:
    • Mental Health Parity and Addiction Equity Act (MHPAEA) in the United States requires insurance plans to offer coverage for addiction services at levels comparable to medical and surgical coverage.
  8. Crisis or Emergency Situations:
    • In cases of immediate need or crisis, insurance plans may cover addiction treatment as part of emergency services. However, it is essential to follow up with the insurance provider for ongoing coverage considerations.
  9. Appeals Process:
    • If an insurance claim for addiction treatment is denied, individuals have the right to appeal the decision. The appeals process allows for a review of the denial, and successful appeals can result in coverage being granted.
  10. Out-of-Pocket Expenses:
    • Even with insurance coverage, individuals may still have out-of-pocket expenses, such as copayments or coinsurance. Understanding these costs is essential for financial planning.

 

Common Insurance Plans Used for Addiction and Mental Health Treatment

Common types of insurance plans used for addiction and mental health treatment include:

  1. Preferred Provider Organization (PPO):
    • PPO plans offer flexibility in choosing healthcare providers, allowing individuals to visit both in-network and out-of-network providers without a referral. PPO plans typically cover a portion of the cost for addiction and mental health rehab services, but out-of-pocket expenses may be higher when using out-of-network providers.
  2. Health Maintenance Organization (HMO):
    • HMO plans require individuals to choose a primary care physician (PCP) who coordinates their care and provides referrals to specialists, including addiction and mental health treatment providers. HMO plans often have lower out-of-pocket costs but may limit coverage to in-network providers, except in emergencies.
  3. Exclusive Provider Organization (EPO):
    • EPO plans combine aspects of both PPO and HMO plans, offering a network of preferred providers for individuals to choose from. While EPO plans do not require a PCP or referrals for specialists, coverage is typically limited to in-network providers, except in emergencies.
  4. Point of Service (POS):
    • POS plans offer individuals the option to receive care from both in-network and out-of-network providers. However, using out-of-network providers may result in higher out-of-pocket costs, and individuals may need a referral from their PCP to see specialists, including addiction and mental health treatment providers.

These insurance plans may vary in terms of coverage, network providers, cost-sharing requirements (e.g., copayments, coinsurance, deductibles), and authorization requirements for addiction and mental health rehab services. It’s essential for individuals to review their insurance plan documents, understand their coverage details, and verify network providers before seeking treatment. Additionally, individuals may need to obtain preauthorization or prior approval for certain rehab services to ensure coverage and minimize out-of-pocket expenses.

 

Conclusion

In conclusion, while Benzonatate (Tessalon Perles) can be effective in relieving coughs, it’s important to be aware of its potential side effects and interactions with other medicines. If you experience any unusual or allergic reactions, such as skin rash, difficult breathing, or a rare burning sensation, seek medical help immediately. Be particularly cautious of overdose symptoms, which can include restlessness, shakiness, changes in blood pressure, and more severe reactions like visual hallucinations or convulsions. Always store Benzonatate safely, avoid drinking alcohol while taking it, and follow your doctor’s dosing instructions closely. If you miss a dose, take the next dose at the regular time without doubling up. For any concerns or questions about Benzonatate, including its effects on children younger than 10 years or interactions with other prescription medicines, check with your healthcare professional. Your health and safety should always come first when managing your cough with any medication.

 

Seeking Treatment? We Can Help!

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

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FAQs

Yes, although rare, it can cause severe allergic reactions, including rash, itching, swelling, severe dizziness, and trouble breathing.
Yes, drowsiness is a common side effect.
Yes, dizziness is a reported side effect and can impair coordination and alertness.
Serious side effects include mental/mood changes, confusion, hallucinations, and severe allergic reactions.
You should consult your healthcare provider as Benzonatate can interact with other CNS depressants and medications that cause drowsiness.

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