Benzonatate

Benzonatate is a peripherally acting antitussive, structurally a polyglycol ester related to the local anesthetic tetracaine. It suppresses cough by anesthetizing stretch receptors in the airways, alveoli, and pleura, dampening the afferent arc of the cough reflex. A central component has been proposed but is not well characterized. The capsules must be swallowed whole, never chewed or sucked; the released local anesthetic produces rapid oropharyngeal numbness, choking, and in pediatric ingestions, cardiac arrhythmia and death.

Antitussive

Benzonatate

Tessalon, Zonatuss

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Summary

Classes

Antitussive

Common uses

Symptomatic relief of cough▲0▼

Pharmacy

Starting dose

100-200 mg PO TID (max 600 mg/d)

Preparations

100, 150, 200 mg liquid-filled capsules ("perles")

US FDA Max

600 mg/d

Pharmacology

Routes

Oral (swallow whole)

Onset

15-20 minutes

Duration

3-8 hours

Half-life

Not well characterized

Bioavailability

Not well characterized

Pregnancy

Limited human data; animal reproductive studies not conducted^{[citation needed]}

Legal status

Rx-only in US

Purported mechanism

Benzonatate anesthetizes pulmonary and pleural stretch receptors, blocking the afferent arc of the cough reflex; a central antitussive component has been proposed but is not well characterized.▲0▼ Pediatric ingestion (capsule chewed or punctured) releases the free local anesthetic and causes seizures, cardiac arrhythmia, and death.