Benzonatate

Cough Relief

Benzonatate is used to relieve a cough. It is a non-narcotic cough suppressant that helps reduce the urge to cough. It is typically prescribed for the symptomatic relief of coughs caused by various respiratory conditions, such as:

• The common cold
• Bronchitis
• Pneumonia
• Asthma
• Emphysema

It is important to note that this medication only treats the symptom of coughing and does not cure the underlying infection or condition causing the cough.

How It Is Used

This medication is intended for short-term use to manage a cough. It works by numbing the stretch sensors in the lungs and airways, which makes the cough reflex less active. Because it is not a narcotic, it may be used as an alternative to opioid-based cough medicines.

Mechanism of Action

Benzonatate belongs to a class of medications known as antitussives. Unlike some other cough suppressants that work on the cough center in the brain, benzonatate works peripherally in the body. It is chemically related to local anesthetics, such as procaine or tetracaine.

When taken, the medication works by:

• Numbing stretch receptors: It anesthetizes specialized sensors called stretch receptors located in the lungs, air passages, and the lining of the chest cavity.
• Reducing the cough reflex: By numbing these receptors, the medication dampens their activity. This makes the respiratory system less sensitive to the triggers that normally cause a person to cough.
• Providing localized relief: Because it targets the respiratory tract directly, it reduces the cough reflex at its source.

Onset and Duration

The effects of benzonatate typically begin within 15 to 20 minutes after the capsule is swallowed. The cough-suppressing effects generally last between 3 and 8 hours.

Common Side Effects

Benzonatate is generally well-tolerated, but some people may experience mild symptoms. Common side effects include:

• Drowsiness or dizziness
• Headache
• Nausea, constipation, or stomach upset
• Stuffy nose
• Itching or a mild skin rash
• A burning sensation in the eyes
• Feeling chilly

Serious Side Effects

Seek medical attention immediately if you experience any of the following serious symptoms:

• Allergic reactions: Signs may include hives, swelling of the face, lips, or tongue, and severe difficulty breathing or swallowing.
• Mouth and throat numbness: If the capsule is chewed, crushed, or dissolved in the mouth, it can cause a loss of feeling in the throat. This can lead to choking or the accidental inhalation of food or liquid into the lungs (aspiration). If numbness occurs, do not eat or drink until the feeling returns.
• Mental status changes: Confusion, hallucinations (seeing or hearing things that are not there), or extreme sedation.
• Chest symptoms: A feeling of numbness in the chest or tightness in the chest area.

Accidental Ingestion in Children

Benzonatate is extremely dangerous if accidentally swallowed by children. Ingestion of even one or two capsules by a child under 10 years of age can lead to death. Symptoms of overdose, such as seizures or heart rhythm problems, can appear within 15 to 20 minutes after ingestion.

Proper Administration

The capsules must be swallowed whole. Chewing, sucking, or crushing the medication can cause a local numbing effect in the mouth and throat. This loss of feeling can lead to choking or the accidental inhalation of food or liquid into the lungs. If numbness of the mouth, tongue, or throat occurs, individuals should avoid eating or drinking until the sensation returns.

Hypersensitivity and Allergic Reactions

Severe allergic reactions, including anaphylaxis, have been reported. These reactions may involve difficulty breathing, throat spasms, or a sudden drop in blood pressure. People with a known allergy to benzonatate or related local anesthetics, such as tetracaine or procaine, should not use this medication.

Psychiatric Effects

In some cases, benzonatate has been associated with unusual behavior or mental changes. These may include:

• Confusion
• Visual hallucinations
• Extreme restlessness
• Tremors

Pregnancy and Breastfeeding

It is not known whether benzonatate can cause fetal harm when administered to a pregnant woman or if it passes into human breast milk. The medication should be used during pregnancy only if clearly needed.

Pregnancy

There are no adequate and well-controlled studies regarding the use of benzonatate in pregnant women. Additionally, animal reproduction studies have not been conducted with this medication. It is currently unknown whether benzonatate can cause fetal harm or affect reproductive capacity when administered to a pregnant person.

Due to the lack of safety data, benzonatate should be used during pregnancy only if the potential benefit justifies the potential risk and if it is clearly needed. Individuals who are pregnant or planning to become pregnant should consult their healthcare provider to discuss the risks and benefits of using this cough suppressant.

Breastfeeding

It is not known whether benzonatate is excreted in human breast milk. Because many medications are passed through breast milk, healthcare providers typically advise caution when administering benzonatate to a person who is nursing. If you are breastfeeding, it is important to discuss the potential risks to the infant and the necessity of the medication with a healthcare professional before use.

Available Forms

Benzonatate is available as an oral capsule. These capsules are liquid-filled and are designed to be swallowed whole. They are sometimes described as perles due to their shape and appearance.

There are currently no other dosage forms available for this medication, such as oral liquids, tablets, or injectable versions.

FDA Approval and Indications

Benzonatate was first approved by the U.S. Food and Drug Administration (FDA) in 1958. It is indicated for the symptomatic relief of cough. It is available only by prescription and is not classified as a controlled substance.

Safety Communications

The FDA has issued safety alerts regarding the risk of accidental ingestion of benzonatate, especially by children. Because the medication is often dispensed in liquid-filled gelatin capsules that may look like candy, it poses a significant risk to young children.

• Age Restrictions: Benzonatate is not FDA-approved for use in children under the age of 10.
• Overdose Risk: Accidental ingestion of even a small number of capsules can be fatal for a child. Signs of overdose can occur within 15 to 20 minutes of ingestion.

Healthcare providers are advised to counsel patients on the importance of keeping this medication in a child-resistant container and stored out of reach of children to prevent accidental poisoning.

How Benzonatate Works

Benzonatate belongs to a class of medicines known as antitussives, or cough suppressants. It works differently than many other cough medicines because it acts as a local anesthetic. It numbs the stretch receptors in the lungs and airways, which helps to dampen the cough reflex and reduce the urge to cough.

Onset and Duration

This medication is intended for the symptomatic relief of a cough. It typically begins to work within 15 to 20 minutes after ingestion. The effects of a single dose generally last between 3 and 8 hours.

Important Safety Instructions for Cough Relief

To ensure the medication works safely and effectively for your cough, it is critical to follow these administration guidelines:

• Swallow capsules whole: You must swallow the capsule entire. Do not chew, crush, dissolve, or suck on the medication.
• Avoid throat numbness: If the capsule is broken or chewed in the mouth, it can cause immediate numbing of the mouth, tongue, and throat. This can lead to a loss of the gag reflex and potential choking.
• Eating and drinking: If you experience any numbness in your mouth or throat after taking benzonatate, do not eat or drink anything until the feeling has completely returned.