Benzonatate: Uses, Side Effects, and What You Should Know

If you’ve ever dealt with a relentless cough that keeps you up at night, you’ve probably looked for fast relief. One medication that may have come up in your search is Benzonatate. Often prescribed for short-term relief from coughing, Benzonatate is a non-narcotic antitussive (cough suppressant) that can be highly effective—but it’s also a medication that should be used with care.

In this post, we’ll explore what Benzonatate is, how it works, its uses, possible side effects, safety concerns, and more. Whether you’re a patient considering this medication or a caregiver wanting to understand it better, this guide has you covered.

What is Benzonatate?

Benzonatate (brand name: Tessalon Perles, Zonatuss) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of cough. It is commonly prescribed to reduce coughing caused by respiratory conditions such as the common cold, bronchitis, pneumonia, or other illnesses involving the throat and lungs.

Classification:

  • Drug Class: Antitussive (cough suppressant)

  • Type: Non-narcotic

  • Form: Soft gelatin capsules, typically 100 mg or 200 mg

  • Prescription status: Rx only (not available over-the-counter)

How Does Benzonatate Work?

Benzonatate works by numbing (anesthetizing) certain nerves in the respiratory system. More specifically, it acts on:

  • The stretch receptors in the lungs

  • The vagal afferent nerves in the airways and pleura

These nerves are responsible for triggering the cough reflex. By numbing them, Benzonatate reduces the urge to cough.

Unlike opioid-based cough suppressants like codeine, Benzonatate does not act on the brain. This is one of its major advantages, as it avoids the risk of dependency and central nervous system side effects associated with narcotics.

What Is Benzonatate Used For?

Benzonatate is used primarily for symptomatic relief of cough. It’s not a cure for the underlying illness but can help manage the disruptive and sometimes painful symptom of coughing.

Conditions commonly treated with Benzonatate include:

  • Acute bronchitis

  • Pneumonia

  • Chronic obstructive pulmonary disease (COPD) (in some cases)

  • Post-viral cough

  • Upper respiratory tract infections

  • Throat irritation after surgery or procedures

Dosage and Administration

Standard Dosage:

  • Adults and children 10 years and older: Typically 100 mg to 200 mg up to three times daily as needed.

  • Maximum daily dose: Do not exceed 600 mg per day.

Important Administration Notes:

  • Swallow the capsules whole with water.

  • Do not chew or dissolve the capsules in the mouth.

  • Taking Benzonatate incorrectly can result in serious side effects, including numbness of the mouth and throat.

Side Effects of Benzonatate

Like any medication, Benzonatate has potential side effects. Most are mild and go away on their own, but some can be serious and require immediate medical attention.

Common Side Effects:

  • Drowsiness

  • Dizziness

  • Headache

  • Nausea

  • Constipation

  • Nasal congestion

  • Chilly sensation

Serious Side Effects:

  • Numbness in the mouth or throat (especially if capsules are chewed)

  • Confusion or hallucinations

  • Tremors

  • Seizures

  • Allergic reactions (rash, itching, swelling)

  • Difficulty breathing

Black Box Warning and Safety Concerns

While Benzonatate is generally safe when used correctly, there are important warnings to be aware of.

Chewing Capsules Can Be Dangerous

One of the most significant dangers associated with Benzonatate is chewing or sucking on the capsule. This can cause immediate:

  • Numbness of the mouth and throat

  • Choking

  • Hypersensitivity reactions

  • Seizures

  • Death (in extreme cases)

This risk is especially high in young children who might accidentally ingest the capsules. Even one capsule can be fatal for a child under 10 years old.

Always keep Benzonatate out of reach of children.

Benzonatate for Children: Is It Safe?

The FDA has approved Benzonatate for use in children 10 years and older. It should never be given to younger children due to the high risk of severe adverse effects or death.

Important Guidelines:

  • Do not assume lower doses are safe for younger kids.

  • If a child ingests Benzonatate accidentally, seek emergency medical attention immediately—even if there are no symptoms right away.

Benzonatate vs. Other Cough Medications

There are several types of cough suppressants available. Here’s how Benzonatate compares:

Medication Type Narcotic Acts on Brain? Risk of Dependence
Benzonatate Antitussive No No Low
Dextromethorphan Antitussive No Yes Low
Codeine Opioid Yes Yes High

Key Differences:

  • Benzonatate works peripherally (outside the brain), so there’s less risk of sedation or addiction.

  • Dextromethorphan is found in many OTC cough syrups and also acts on the brain but with minimal abuse potential.

  • Codeine is effective but carries a high risk of dependency and is not recommended for children.

Can You Take Benzonatate With Other Medications?

Generally, Benzonatate can be used alongside other medications like antibiotics or decongestants. However, be cautious when combining it with:

  • Other sedatives

  • Alcohol

  • Antidepressants

  • Anti-anxiety drugs

These combinations may increase the risk of drowsiness, confusion, or respiratory depression in some cases.

Always consult your healthcare provider or pharmacist before combining medications.

Overdose Risk

Overdose on Benzonatate can be life-threatening and may occur rapidly—within 15 minutes of ingestion.

Symptoms of Overdose:

  • Restlessness

  • Tremors

  • Seizures

  • Coma

  • Cardiac arrest

  • Death

If you suspect an overdose, call 911 or poison control immediately.

Who Should Avoid Benzonatate?

You should avoid Benzonatate if you:

  • Are allergic to PABA-based anesthetics (e.g., procaine, tetracaine)

  • Have difficulty swallowing capsules

  • Are under 10 years of age

  • Have had previous reactions to Benzonatate

Pregnant or breastfeeding individuals should use Benzonatate only if clearly needed, as there’s limited data on its safety in pregnancy and lactation.

Patient Tips for Safe Use

  1. Swallow whole — never chew or suck the capsule.

  2. Store safely — keep in a child-proof container, out of reach.

  3. Watch for drowsiness — avoid driving if you feel sleepy.

  4. Don’t exceed dosage — stick to prescribed limits.

  5. Follow up — if symptoms persist for more than 7 days, consult your doctor.

Final Thoughts

Benzonatate can be an effective and non-addictive option for managing cough when used correctly. Its ability to numb the nerves that trigger the cough reflex makes it especially useful in cases where coughing is painful or disruptive to sleep.

However, it’s not without risks. The danger of accidental ingestion—especially in children—cannot be overstated. Proper storage, dosage adherence, and understanding how the medication works are essential to using Benzonatate safely.

If you’ve been prescribed Benzonatate or are considering asking your healthcare provider about it, weigh the benefits against the risks and ensure you follow all instructions closely.

FAQs About Benzonatate

1. Can I take Benzonatate with cold medicine?

Yes, but check for interactions—especially with other sedating medications.

2. Is Benzonatate addictive?

No, it is not a narcotic and does not carry an addiction risk.

3. How long does Benzonatate take to work?

Usually within 15–30 minutes, with effects lasting up to 8 hours.

4. Can I drink alcohol while taking Benzonatate?

It’s best to avoid alcohol, as it can increase drowsiness and other side effects.

5. What should I do if I miss a dose?

Take it when you remember unless it’s almost time for your next dose. Never double up.

References:

  • U.S. Food and Drug Administration (FDA)

  • National Institutes of Health (NIH)

  • American Academy of Pediatrics (AAP)

  • MedlinePlus Drug Database