Tessalon Perles dosage, forms, and strengths

Tessalon Perles (gel capsules) is a prescription brand-name drug that relieves symptomatic coughs, particularly chronic coughs. The active ingredient, benzonatate, is a non-opioid antitussive (cough suppressant) similar to topical anesthetics such as procaine and tetracaine. When taken orally, benzonatate desensitizes nerves in the lungs that initiate the cough reflex, preventing coughs at the source. Tessalon is taken as a gel capsule three times a day as long as coughing persists.

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Tessalon Perles forms and strengths

Tessalon gel capsules, or “Perles,” are taken as 100 mg capsules.

• Capsule: 100 milligrams (mg)

Tessalon Perles dosage for adults

Tessalon Perles dosage for symptomatic cough

Tessalon Perles is prescribed to relieve symptomatic cough in adults and children 10 years of age or older. Benzonatate’s mechanism of action is to anesthetize nerves, called stretch receptors, in the lungs and airway passages. Stretch receptors are nerves that sense when the lung is full of air and trigger the reflex to start breathing out. This reflex prevents us from overinflating the lungs, but these nerves are also responsible for initiating the cough reflex. By numbing these nerves, benzonatate stops the cough reflex at its very source.

• Standard dosage for symptomatic cough: 100–200 mg taken three times per day as needed

• Maximum dosage for symptomatic cough: 600 mg per day

Tessalon Perles dosage for children

Tessalon is FDA-approved to treat symptomatic cough in children 10 years of age and older. The children’s recommended and maximum dosage is identical to the adult dose. Children younger than the age of 10 should not be given Tessalon.

Tessalon should be administered to children over 10 under careful supervision. Children should not bite, chew, or suck on the capsule. If they do, the active ingredient, benzonatate, can numb the mouth, throat, and face, making swallowing difficult and possibly causing the child to choke if they eat or drink anything.

Tessalon has been known to cause death in young children, so keep the medication in a child-secure container out of the reach of children. Safely dispose of any unused Tessalon Perles.

Tessalon Perles dosage restrictions

Tessalon does not have dose restrictions for medical or other conditions. Pregnant or nursing women should use caution and only take Tessalon under the recommendation of a healthcare provider. Dosing for people with liver or kidney impairment has not been defined. 

Tessalon capsules must be swallowed whole without biting, chewing, or sucking on the capsule. For this reason, doctors will avoid prescribing Tessalon to people who cannot swallow the capsule

People who have had allergic reactions to benzonatate, topical anesthetics similar to benzonatate (such as tetracaine), or PABA will not be prescribed the drug. However, many benzonatate allergic reactions result from chewing or sucking on the capsule. Severe adverse reactions to benzonatate include tightening of the lung’s airways (bronchospasm), tightening of the larynx (laryngospasm), or circulatory collapse.

Tessalon Perles dosage for pets

Benzonatate, the active ingredient in Tessalon Perles, is not approved for use in animals, but veterinarians do prescribe it to pets to relieve symptomatic coughing. Veterinarians are cautioned, however, not to use the drug in animals with aggressive behaviors or seizure disorders. Dosages have not been standardized and so will depend on the veterinarian. 

Benzonatate capsules can be given to an animal with or without food. Try giving the capsule to the animal in a treat. As with humans, pets should not bite the capsule or the medication will numb the mouth and throat, making swallowing difficult and possibly causing choking if the animal drinks or eats something. A veterinarian or veterinary assistant can demonstrate the proper method for giving a pet this medication. 

How to take Tessalon Perles

Tessalon Perles is taken as a gel capsule three times a day as needed for cough. Because the drug can be fatal if too much is taken or it is taken incorrectly, the drug does require precautions when storing and taking the medicine.

• Follow all instructions from the doctor, pharmacist, or medication label when taking this medication.

• Do not exceed the prescribed dose. Never exceed two capsules in a single dose, or six capsules in a single day.

• Do not take two doses at one time.

• Swallow the capsules whole. Do not crush or chew the capsule. Chewing the capsule will quickly numb the mouth and throat and could 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 Tessalon Perles at room temperature (between 68˚and 77˚F) protected from light and moisture. Do not freeze this medication.

• 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 medicine should be removed from its container and mixed with an undesirable substance, such as cat litter, and then placed in a sealed container. It can then be discarded in the household trash.

Tessalon Perles dosage FAQs

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

There is no extended-release version of Tessalon Perles or its active ingredient benzonatate. 

How long does it take Tessalon Perles to work?

Tessalon relieves coughing 15–20 minutes after swallowing a capsule.

How long does Tessalon Perles stay in your system?

With a half-life of 1.1 hours, a single dose of Tessalon relieves cough for three to eight hours. Tessalon doses are normally taken three times a day to maintain continuous cough control. Only take this medication while coughing persists. It should be immediately discontinued when coughing symptoms go away.

What happens if I miss a dose of Tessalon Perles?

Because of the risk of overdose, the FDA advises that a missed dose be skipped entirely. If a dose is missed, skip that dose and take the next dose on schedule. Never take extra Tessalon to make up for a missed dose.

How long can you take Tessalon Perles?

There is no limit on the length of time Tessalon Perles can be taken daily. The duration of benzonatate therapy will depend on the underlying condition causing the cough. In general, if coughing persists for longer than seven days, talk to a doctor or other healthcare professional. 

Benzonatate should only be taken while coughing persists. Doses can and should be skipped if coughing stops.

How do I stop taking Tessalon Perles?

Benzonatate does not cause dependency or withdrawal. The drug can be safely stopped at any point without problems. In fact, benzonatate should always be stopped as soon as coughing fades. If coughing stops completely, after a few days the medication should be safely disposed of.

The medication may need to be discontinued because of intolerable side effects including headache, sedation, nausea, constipation, nasal congestion, itching, numbness, or serious side effects such as confusion, visual hallucinations, or severe hypersensitivity reactions (such as bronchospasm or laryngospasm). The most serious hypersensitivity reaction can result in circulatory collapse and death. 

If adverse effects are experienced, alternative prescription drugs include cough suppressants containing opioids, such as codeine, or opioid-like antitussive agents, such as dextromethorphan. Lower-dose dextromethorphan can also be purchased in over-the-counter cough suppressants.

What is the maximum dosage for Tessalon Perles?

The normal dose of Tessalon for adults and children older than 10 years of age is 100 mg taken three times a day. This dose may double for problem coughing. The maximum dose is 200 mg (two 100 mg capsules) in a single dose. No more than 600 mg should be taken in a single day. 

Can you overdose on Tessalon Perles?

An overdose of benzonatate can be fatal and has been known to kill children younger than 10. If an overdose is suspected, immediately get emergency medical help. Symptoms of overdose will appear in 15 to 20 minutes and include tremor, restlessness, fainting, slow breathing, and, within an hour, convulsions, coma, and heart attack.

What interacts with Tessalon Perles?

According to the Food and Drug Administration (FDA), there are no significant drug interactions with benzonatate. However, the Prescriber’s Digital Reference (PDR) does caution doctors to avoid using Tessalon with other anesthetics and to use caution with some other classes of medications. Inform your doctor or other healthcare professional about all prescription and over-the-counter medications you are taking.

What happens when you mix Tessalon Perles and alcohol?

Benzonatate does not contain a narcotic. The manufacturer, Pfizer, does not caution against drinking alcohol when taking Tessalon. Some people, however, may experience drowsiness as a side effect of Tessalon. If so, alcohol will only increase the severity of this side effect. Rare side effects include mental confusion, hallucinations, and bizarre behaviors. In these cases, Tessalon should be discontinued.

Is it safe to take Tessalon Perles during pregnancy?

The active ingredient, benzonatate, is categorized as a category C risk for pregnancy. This means that the drug has shown some possible adverse effects when tested on animals, but has yet to be adequately tested in humans. Benzonatate is very similar to chloroprocaine, an anesthetic often used as an epidural nerve block during labor because of its low potential for harming the mother or baby. Inform your healthcare provider if you are pregnant or may be pregnant.

It is not known if benzonatate passes into breast milk or affects lactation in any way. Because of the lack of studies, the risks and benefits of taking Tessalon while breastfeeding should be discussed with a doctor or other healthcare provider.

Resources:

• Anatomy and neuro-pathology of the cough reflex arc

• Benzonatate

• Benzonatate compound summary

• Benzonatate drug summary

• Chloroprocaine

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

• Tessalon

• Tessalon prescribing information