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Pronunciation
(ben ZOE na tate)
Generic Available (U.S.)
Yes: Capsule (softgel)
Index Terms
Brand Names: U.S.
Pharmacologic Category
Use: Labeled Indications
Symptomatic relief of nonproductive cough
Pregnancy Risk Factor
C
Pregnancy Considerations
Animal reproduction studies have not been conducted.
Lactation
Excretion in breast milk unknown/use caution
Contraindications
Hypersensitivity to benzonatate, related compounds (such as tetracaine), or any component of the formulation
Warnings/Precautions
Concerns related to adverse effects:
• Hypersensitivity reactions: Severe reactions, including bronchospasm, cardiovascular collapse and laryngospasm have been reported. May be related to localized anesthetic effects due to sucking or chewing the capsule.
• Psychiatric effects: Isolated cases of abnormal behavior including mental confusion and visual hallucinations have been reported; may be related to prior sensitivity to related agents (eg, tetracaine, procaine) or interaction with concurrent medications.
Special populations:
• Pediatrics: Accidental ingestion and potentially fatal overdose of benzonatate has been reported in children <10 years of age. Signs and symptoms of overdose (restlessness, tremors, convulsion, coma, cardiac arrest) may occur within 15-20 minutes after ingestion. Death has been reported within 1 hour. Not approved for use in children <10 years of age.
Adverse Reactions
Frequency not defined.
Central nervous system: Confusion, dizziness, hallucinations, headache, sedation
Dermatologic: Pruritus, skin eruptions
Gastrointestinal: Constipation, GI upset, nausea
Neuromuscular & skeletal: Chest numbness
Ocular: Burning sensation in eyes
Respiratory: Nasal congestion
Miscellaneous: Chill sensation, hypersensitivity reactions (bronchospasm, laryngospasm, cardiovascular collapse)
Metabolism/Transport Effects
None known.
Drug Interactions
There are no known significant interactions.
Storage
Store at room temperature of 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).
Mechanism of Action
Tetracaine congener with antitussive properties; suppresses cough by topical anesthetic action on the respiratory stretch receptors
Pharmacodynamics/Kinetics
Onset of action: Therapeutic: 15-20 minutes
Duration: 3-8 hours
Dosage
Children >10 years and Adults: Oral: 100-200 mg 3 times/day as needed for cough; maximum dose: 600 mg/day
Administration: Oral
Swallow capsule whole (do not break. chew, dissolve, cut, or crush).
Monitoring Parameters
Monitor patient's chest sounds and respiratory pattern
Patient Education
Do not break or chew capsule. Maintain adequate hydration, unless instructed to restrict fluid intake. You may experience drowsiness, impaired coordination, blurred vision, increased anxiety, upset stomach, or nausea. Report persistent CNS changes (dizziness, sedation, tremor, or agitation), numbness in chest or feeling of chill, visual changes or burning in eyes, numbness of mouth or difficulty swallowing, or lack of improvement or worsening or condition.
Geriatric Considerations
No specific geriatric information is available about benzonatate. Avoid use in patients with impaired gag reflex or who cannot swallow the capsule whole.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause drowsiness
Mental Health: Effects on Psychiatric Treatment
May potentiate sedative effects of sedating psychotropics
Nursing: Physical Assessment/Monitoring
Assess effectiveness of therapy (relief of cough, lung sounds, and respiratory pattern). Monitor for CNS changes at beginning of therapy and periodically throughout.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Capsule, oral:
Zonatuss™: 150 mg
Capsule, softgel, oral: 100 mg, 200 mg
Tessalon®: 100 mg, 200 mg
Pricing: U.S. (www.drugstore.com)
Capsules (Benzonatate)
100 mg (30): $20.99
200 mg (30): $33.99
Capsules (Tessalon Perles)
100 mg (30): $49.99
References
Mongan PD and Culling RD, “Rapid Oral Anesthesia for Awake Intubation,” J Clin Anesth, 1992, 4(2):101-5.
International Brand Names
Lexi-Comp.com
Last full review/revision January 2012
Content last modified January 2012
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