Benzonatate dosage, forms, and strengths

Benzonatate is a generic prescription drug used for the symptomatic relief of cough. Also sold under the brand name Tessalon, benzonatate is a non-opioid cough suppressant that is chemically similar to topical anesthetics, such as procaine and tetracaine. Benzonatate works by numbing nerve endings in the lungs and airways to help dampen, or reduce, the cough reflex. Benzonatate is taken by mouth as a gel capsule three times a day until coughing subsides.

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Benzonatate forms and strengths

Both benzonatate and brand-name Tessalon Perles are taken orally as gel capsules.

• Capsule: 100 milligrams (mg), 150 mg, 200 mg

Benzonatate dosage for adults

Benzonatate is typically used to treat a cough caused by a respiratory infection, such as a cold or the flu. It is usually only prescribed for the short-term treatment of cough; it is not recommended to treat a chronic cough caused by a condition like emphysema or asthma. Most people will be prescribed a 100 mg dose taken three times daily, although doses up to 200 mg can be taken three times per day as needed.

Benzonatate desensitizes nerves in the lungs and airway passages. More specifically, benzonatate dampens the activity of stretch receptors, which play a role in triggering the cough reflex. Stretch receptors are involved in the first step of the cough reflex, so numbing these nerves helps shut down coughing.  

• Standard benzonatate dosage for adults: 100–200 mg taken orally three times per day

• Maximum benzonatate dosage for adults: 600 mg per day

Benzonatate dosage for children

The U.S. Food and Drug Administration (FDA) has approved benzonatate to treat symptomatic cough in children 10 years of age and older. Children younger than 10 years should not be given benzonatate.

• Standard benzonatate dosage for children 10 years of age and older: 100–200 mg taken orally three times per day

• Maximum benzonatate dosage for children 10 years of age and older: 600 mg per day

Children will require adult supervision when taking benzonatate. Biting, chewing, or sucking on the benzonatate capsule can release the drug into the mouth, numbing the mouth, throat, and face. Swallowing can become difficult, which could lead to choking if a child eats or drinks after chewing benzonatate.

In addition, incidents of death have been reported after the accidental ingestion of benzonatate in children. Keep the medication out of the reach of children and store it securely with a child-proof cap. Safely dispose of any extra medicine when finished with treatment. It is important to seek medical attention immediately if benzonatate is ingested by a child younger than 10 years old.

Benzonatate dosage restrictions

There are no benzonatate dosing restrictions for medical, physical, or other conditions. However, benzonatate is not recommended for people who are allergic to benzonatate or similar topical anesthetics, such as procaine or tetracaine. Hypersensitivity reactions to benzonatate can be severe and include symptoms such as tightening of the lung’s airways (bronchospasm), tightening of the larynx (laryngospasm), and sudden loss of blood flow to the brain and other organs.

Benzonatate is a chemical variation of para-amino-benzoic acid, or PABA, so anyone with PABA allergies should avoid taking this drug. PABA is commonly found in cosmetics, skincare products, and hair care products, so many people first experience a PABA allergy due to skin reactions from skincare or beauty products. A healthcare provider may ask about cosmetics or skincare product allergies before prescribing this drug.

People with difficulty swallowing may need to avoid taking benzonatate. Healthcare providers do not recommend benzonatate for people with difficulty swallowing because accidentally biting, chewing, or sucking on the benzonatate capsule can numb the mouth and throat, making swallowing even more difficult. 

People with liver or kidney problems may be prescribed benzonatate at normal doses. Women who are pregnant or breastfeeding may also be prescribed benzonatate if the benefits outweigh the risks of potential harm to the baby.

Benzonatate dosage for pets

Although not FDA approved for use in animals, benzonatate is sometimes prescribed off-label to relieve coughing in pets. Dosages have not been standardized and will be determined by the veterinarian. Because of the risk of the animal biting the benzonatate capsule, veterinarians may not use the drug in animals with aggressive behaviors or seizure disorders.

As with humans, pets must swallow benzonatate capsules whole without biting or chewing the capsule. Chewing or biting the drug may numb the animal’s mouth and throat. The animal will then have trouble swallowing, which could lead to choking or aspiration of food or water. A veterinarian or veterinary assistant can demonstrate the proper procedure for administering benzonatate capsules to an animal. 

How to take benzonatate

Benzonatate is taken as a gel capsule three times a day with or without food. 

• Follow all instructions from the healthcare provider, pharmacist, or medication label when taking benzonatate.

• Do not exceed the prescribed dose. Never take more than 200 mg in a single dose or 600 mg in a single day.

• Swallow the capsules whole. Do not crush, chew, bite, or suck on the capsule. Doing so can quickly numb the mouth and throat, cause difficulty swallowing, and create a choking hazard.

• If tingling or numbness is felt in the mouth, throat, or face, do not eat or drink until the numbness stops. If the numbness doesn’t go away, get emergency medical attention.

• Store benzonatate at room temperature (68°–77°F) protected from moisture in a tight, light-resistant container. Do not freeze this medication.

• Always store this medication in a child-resistant container out of the reach of children at all times.

The Food and Drug Administration (FDA) cautions that unused benzonatate must be disposed of safely to prevent accidental ingestion by children or animals. The safest way to dispose of unused benzonatate is to return it to the pharmacist for disposal. If that is not possible, remove the medicine from the container and mix it with an undesirable substance, such as cat litter. Place the mixture in a tightly sealed container. The sealed container can then be discarded in the household trash.

Benzonatate dosage FAQs

Benzonatate vs. benzonatate XR/ER: What’s the difference in doses?

There is currently no extended-release version of benzonatate available. 

How long does it take for benzonatate to work?

Relief from coughing can usually be felt within 15–20 minutes after swallowing a benzonatate capsule. 

How long does benzonatate stay in your system?

Benzonatate provides cough relief for three to eight hours after swallowing a capsule. The half-life, or the amount of time it takes for half the drug amount to be eliminated from the body, is around 1 hour. 

What happens if I miss a dose of benzonatate?

If you miss a dose of benzonatate, skip that dose and take the next dose on schedule. Never take extra benzonatate or a double dose to make up for a missed dose. Taking extra doses may result in an overdose, which can lead to severe complications including death, especially in children. 

How long can you take benzonatate?

While there is no official limit to how long benzonatate can be taken, the drug should only be taken as long as coughing persists. The duration, of course, will depend on the underlying condition causing the cough. No matter what the cause, it is important to see a doctor or other healthcare professional if coughing persists for longer than a week or two. A persistent cough may be a sign of a serious condition that requires more than symptomatic relief. 

Coughing may stop before the prescription runs out. If coughing stops completely for several days, the medication should be safely disposed of. Benzonatate is not entirely safe to keep around, so don’t save it for later. Talk to a pharmacist about the safest way to dispose of the medicine.

How do I stop taking benzonatate?

Benzonatate can be safely stopped at any time and for any reason without causing problems. Benzonatate does not cause dependency or withdrawal. 

Most people stop taking benzonatate because the coughing goes away. Some people, however, may not be able to tolerate some of the unpleasant side effects of benzonatate, such as headache, drowsiness, nausea, constipation, stuffy nose, or itching. Other people may need to stop taking benzonatate because of serious adverse reactions, such as mental confusion, visual hallucinations, or severe allergic reactions. 

If it’s necessary to stop taking benzonatate because of adverse effects, alternative antitussive agents include prescription cough suppressants containing opioids (codeine) or opioid-like cough suppressants (dextromethorphan). Over-the-counter dextromethorphan is also widely available.

What is the maximum dosage for benzonatate?

The maximum benzonatate dose is 200 mg taken every eight hours. No more than 600 mg should be taken in a single day. 

Can you overdose on benzonatate?

An overdose of benzonatate can be fatal and has been known to result in death in children younger than 10. Symptoms of overdose can appear within 15 to 20 minutes. Get emergency medical help at any sign of a benzonatate overdose including:

• Tremor

• Restlessness

• Fainting

• Slow or stopped breathing

• Slow heartbeat

• Weak pulse

• Convulsions

• Coma

• Heart attack

What interacts with benzonatate?

There are no significant drug interactions with benzonatate identified by the FDA. The Prescriber’s Digital Reference (PDR), on the other hand, warns prescribers to avoid combining benzonatate with topical anesthetics or MAO inhibitors, a small class of drugs that includes antidepressants and certain antibiotics. Topical anesthetics can increase the toxic effects of benzonatate, and MAO inhibitors can increase the risk of low blood pressure or central nervous system (CNS) problems. If there’s any uncertainty about whether a prescription drug might be an anesthetic or MAO inhibitor, a healthcare professional or pharmacist can help identify that drug. Tell your doctor if you are taking opioids, sleeping pills, muscle relaxers, or seizure or anxiety medicines before taking benzonatate.

What happens when you mix benzonatate and alcohol?

Alcohol does not interact with benzonatate. However, some side effects of benzonatate, such as drowsiness, sedation, or dizziness, may be amplified when benzonatate and alcohol are taken together.

Is it safe to take benzonatate during pregnancy?

Pregnant women may be given benzonatate for symptomatic cough if the benefits outweigh the potential risks. The safety of benzonatate in unborn babies has not been adequately studied. It’s best to consult a healthcare provider before taking benzonatate while pregnant. 

The American Academy of Pediatrics (AAP) has no recommendation on the safety and use of benzonatate in nursing women. However, healthcare professionals do not know if benzonatate passes into breast milk or affects lactation. For this reason, healthcare providers are cautious about prescribing benzonatate when a woman is breastfeeding. 

Any woman who is pregnant or nursing should get medical advice from a healthcare professional about the pros and cons of taking benzonatate while pregnant or nursing.

Related resources for benzonatate dosages:

• Anatomy and neuro-pathology of the cough reflex arc, Multidisciplinary Respiratory Medicine

• Benzonatate, Epocrates

• Benzonatate, Plumb’s Veterinary Medication Guides

• Benzonatate compound summary, U.S. National Library of Medicine

• Benzonatate drug summary, Prescribers Digital Reference (PDR)

• Benzonatate prescribing information, U.S. National Library of Medicine

• FDA Drug Safety Communication: Death resulting from overdose after accidental ingestion of Tessalon (benzonatate) by children under 10 years of age, Food and Drug Administration (FDA)

• Tessalon prescribing information, U.S. National Library of Medicine