All rights reserved. This information is not a substitute for medical advice. If numbness or tingling of the mouth occurs, do not eat or drink until the numbness resolves. Never suck or chew on a benzonatate capsule. To help prevent interactions, your doctor should manage all of your medications carefully. It works by reducing the cough reflex in the lungs and air passages. Copyright 2022 Scripps Media, Inc. All rights reserved. Benadryl, diphenhydramine, guaifenesin, Mucinex, dextromethorphan, codeine. They should not take 2 doses of benzonatate at one time. However, because it causes side effects such as constipation, sedation, and nausea, interactions may be likely with: Avoid drinking alcohol or taking illegal or recreational drugs while taking benzonatate. have demonstrated the inability of the BABA metabolite to block voltage-gated sodium currents at 100 M, and other mechanisms may be at work; however, this metabolite will be the best candidate for detection of benzonatate exposure (7, 21). This material may not be published, broadcast, rewritten, or redistributed. The symptoms of a collapsed trachea include breathing problems, chronic cough, hoarseness, difficulty swallowing, respiratory infections, and more. Expiration date on a bottle of Naproxen is: Feb 6, 2012. Generic drugs usually cost less. It comes with risks if you dont take it as prescribed. Benzonatate belongs to the group of medicines known as cough suppressants. The FDA warning focused on accidental overdose in children under 10. Benzonatate may cause various side . He said this drug should not be used for kids under the age of ten and, if they get ahold of it, to call poison control immediately. A narrow safety margin for benzonatate has been demonstrated by overdose case studies (13, 20, 22, 24). The Medical Letter authors conclude when a cough suppressant is truly necessary, dextromethorphan or even codeine might be a safer choice. When codeine compares favorably in safety to another medicine, it might be time to reconsider why we ever use it. Answered by Dr. JD in 9 mins 13 years ago Dr. JD 15+ years of experience 820 satisfied customers Revision date: May 25, 2022. LFTs require periodic surveillance. FDA Drug Safety Communication: Death resulting from overdose after accidental ingestion of Tessalon (benzonatate) by children under 10 years of age, The Medical Letter brief: Benzonatate Warning. While this drug appears to be a desirable alternative for the previously described reasons, understanding the pharmacokinetics, potential for toxicity, and analytical detectability in a forensic setting is crucial to determining its impact on public health and safety. Not a narcotic. Still looking for answers? An interaction is when a substance changes the way a drug works. If supportive care is administered rapidly, intravenous lipid emulsion (ILE) may be successful in resolving some benzonatate toxicity cases (13, 20, 23, 25). Taken in overdose, benzonatate can rapidly cause seizures, cardiac arrhythmias and death. We avoid using tertiary references. Data also suggests it may work centrally (i.e. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. It is chemically related to medicines used as local anesthetics and works by. Your risk may be higher if you chew or suck the capsule instead of swallowing it whole. Benzonatate (Tessalon Perles) was approved in 1958 as a peripherally-acting antitussive for its ability to inhibit cough before its mechanism of action was completely understood. The effects last for 3 to 8 hours. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. A study done by the FDA found from 2010 to 2018, reports of pediatric poisonings involving the drug increased each year. (. An RSV test is used to diagnose respiratory syncytial virus (RSV). Is it okay to take propranolol past the expiration date on the bottle. Is it still safe to take? This medication is sometimes used in dogs for chronic cough. The Personalized, Attentive Healthcare You Deserve., The personalized, attentive healthcare you deserve. yorkie or a 20 lb. U.S. Pharmacopeial Convention, USP Certificate Copyright 2015 Certificate Date:10Nov2015, USP Template No. Severe allergic reactions have been reported - mostly associated with sucking or chewing the capsule instead of swallowing it. It appeared as a late-eluting compound after trazodone in the base screen and was quantitated by a reference laboratory using traditional HPLC methodology. Benzonatate can cause a severe allergic reaction. include protected health information. Answer this question 3 Answers SD SDeering 5 Jan 2022 Is it still safe to take benzonatate 100 mg capsules purchased on 5/04/16 +0 CH chuck1957 27 Jan 2017 Sharon; Without a dought, it is as good as when you got it as long as you kept in a dry place like the cupboard. Do not give this medication to a child younger than 10 years old without medical advice. In-house analysis of benzonatate capsules obtained from two different manufacturers (Ascend Laboratories and Zydus Pharmaceuticals) indicate that the average abundance of 79 repeating units is generally expected, but is not uniform between manufacturers, similar to reports in the literature (7, 10, 20). They're fast, easy-to-use and free! Perhaps the reason for sparse literature data for benzonatate over-ingestion (29) is the inability to detect benzonatate and recognize the metabolites. Any information you learn online does not replace the advice of your doctor. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. 2. Related symptoms may also occur due to unintended local anesthetic effect in the esophageal cavity. Benzonatate relieves cough by acting directly on the lungs and the breathing passages. Benzonatate is used to relieve coughing. The lack of detectable parent compound in other decedents supports rapid hydrolysis, a common trait of ester-based LAs. ongoing numbness or tingling in your mouth, throat, or face; numbness in your chest; a choking feeling; chills; or burning in your eyes. Benzonatate is used to relieve cough. Can be taken up to three times daily. Benzonatate works by numbing the throat and lungs, making the cough reflex less active. If a child accidentally ingests benzonatate, seek medical attention immediately. Benzonatate may be used to relieve the symptoms of a dry cough. This site complies with the HONcode standard for trustworthy health information: verify here. This drug is used to relieve coughing. Take benzonatate exactly as prescribed by your doctor. Im certainly sympathetic to the miserable patient with a cold or bronchitis who has a terrible cough. A study done by the FDA. Popular cough relief medicine benzonatate for children 10 and older. How Does Respiratory Syncytial Virus (RSV) Spread? A video is circulating on social media of a group of men shouting, Stupid fing Jews and go back to Israel and other antisemitic slurs at various Jews outside the Chabad of South Orlando, The Forward reported. Numbs the throat to make the cough less active. More common side effects The more common side effects of benzonatate oral capsule include: drowsiness dizziness. The maximum dosage is 600 mg per day. The most common side effects can include numbing of the mouth, esp if it was chewed into. Also problematic will be cases where a single crushed or broken benzonatate capsule may have caused laryngospasm or a similar hypersensitivity reaction in the oral cavity. Purchased benzonatate 2/27/16. People in these age groups should not take more than 200 mg at one time. In some cases, they may not be available in every strength or form as the brand-name version. No, benzonatate (Tessalon) is not known to be habit-forming. You should always consult your doctor or other healthcare professional before taking any medication. Tell your doctor if your condition lasts or gets worse. Good luck. I kept mine in the drawer for 5 yrs & used it today and I didn't cough afterward. Use: Symptomatic relief of cough. This can be harmful or prevent the drug from working well. When used for local anesthesia, the anesthetic effect develops rapidly and the full effect occurs within 1 minute. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. et al. Take each dose with a full glass of water. You may need to decide whether to stop breastfeeding or stop taking this medication. Death can occur from the misuse of cough and cold medicines in very young children. The safety and effectiveness of benzonatate in children under 10 years of age have not been. Never suck or chew on a benzonatate capsule. Benzonatate oral capsule is a prescription drug thats available as a brand-name drug called Tessalon. Benzonatate [Package Insert]. Details obtained through investigation by the medical examiner helped to support the possibility of benzonatate over-ingestion in some of our in-house cases. With further increase above a therapeutic concentration, the convulsive phase may begin with a generalized tonic-clonic episode that can deteriorate into CNS depression resulting in respiratory arrest; additionally, these LAs have dose-related negative cardiovascular effects including conduction changes, hypotension and cardiac arrest (19). The old adage, when in doubt, throw it out, really applies here! information submitted for this request. It should be. Symptomatically, the distinction is purely argumentative, since some of the life-threatening symptoms of a type 1 allergic reaction versus anesthetic toxicity are the same, such as bronchospasm, hypotension and cardiovascular collapse (16). Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. (Links to The Medical Letter review and the FDA warning are below.). Tell your doctor about all your current medicines and any medicine you start or stop using. Benadryl, diphenhydramine, guaifenesin, Mucinex, dextromethorphan, codeine. Sucking or chewing the capsule may cause your mouth and throat to feel numb or cause other serious side effects. The .gov means its official.Federal government websites often end in .gov or .mil. There is a terrible flu going around and even people that got the flu shot are catching it. Major Pharmaceuticals. Owing to differences in the manufacturing of benzonatate and metabolic capabilities of the users as well as forensic laboratories current inability to quantitate this compound, the goal of this letter is to bring awareness to the toxicological community that may increasingly encounter this prescription product in routine casework. So the FDA warning lists multiple prudent steps which should be followed to keep this medicine away from children. Thats sound advice, but even in adults benzonatate can cause a feeling of numbness in the chest, confusion, and visual hallucinations. Therefore,prescribing benzonatate to that age group is not recommended. Speak to your doctor about how drug interactions should be managed. Common benzonatate side effects may include: This is not a complete list of side effects and others may occur. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. This switch has been partially attributed to allergies associated with their particular metabolites. Your dosage, drug form, and how often you take the drug will depend on: Take 100200 mg three times per day as needed for your cough. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Dont store this medication in moist or damp areas, such as bathrooms. Call 911 if your symptoms feel life-threatening or if you think youre having a medical emergency. Coughing can be very disruptive to work and to sleep, and patients can be desperate for relief. Always discuss possible side effects with a healthcare provider who knows your medical history. All rights reserved. When a therapeutic dose, administered as a single capsule, is chewed or crushed, there is potential for bronchospasm, laryngospasm, seizures and cardiovascular collapse which mimics the systemic toxicity seen at high doses (6, 15, 19, 20). Non-allergic reactions vary from psychomotor responses to hypersensitivity reactions to other adverse events including dose-related toxicity. Deaths have been reported within hours of the accidental ingestion. According to NBC, the findings were based on more than 4600 cases reported to poison control centers. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Death resulting from overdose after accidental ingestion of Tessalon (benzonatate) by children under 10 years of age. Even more challenging is the rapid metabolism of the series of n-ethoxy parent compounds without a suitable pure standard available for quantitation of each specific molecular weight. Benzonatate is used to relieve coughs due to colds or influenza (flu). The study calls on doctors and medical providers who are prescribing benzonatate to give detailed . Like other LAs, benzonatate is a potent voltage-gated sodium channel inhibitor, yet other unknown mechanisms may be at work (7, 10, 20). It is taken three times a day with food. FDA Drug Safety Communication: target=_blank>Benzonatate Warning. If you take too much: You could have dangerous levels of the drug in your body. no blood pressure or pulse restlessness shakiness in the legs, arms, hands, or feet stopping of the heart trembling or shaking of the hands or feet unconsciousness Other side effects of Benzonatate Some side effects of benzonatate may occur that usually do not need medical attention. Benzonatate is used to relieve coughs due to colds or influenza (flu). There havent been enough studies done in humans to be certain how the drug might affect the fetus. Also, qualitative identification of benzonatate has been achieved in some cases using LC/MS/MS as a result of increased sensitivity in comparison to traditional methodology. And if it is over a year old or more, is it safe to take. In several of the published over-ingestion cases, as well as those observed in our office, only a small handful of pills was enough to cause seizures, a cardiac event and death. Leaving a comment on a post is a wonderful way to enter into a discussion with other readers, but I will not respond to comments (just because of time constraints). It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. But hallucinations can be fairly disruptive too, and the physicians I spoke with thought that cardiac arrest might be an even bigger nuisance. Brand names: Tessalon Perles, Tessalon, Zonatuss Date is it safe to take? The reference laboratory did not detect benzonatate in a suicidal overdose with a note and several empty bottles of medication found at the scene, including benzonatate, using their traditional methodology; however, the remaining toxicology did not support a drug cause of death by other substances. Warnings Question posted by sharon369 on 26 Jan 2017, Last updated on 5 January 2022 by SDeering, Is it still safe to take benzonatate 100 mg capsules purchased on 5/04/16. All possible dosages and drug forms may not be included here. Benzonatate belongs to a class of drugs called antitussive agents. other medications that cause constipation, such as ondansetron, opioids, or iron supplements, any medication that may cause drowsiness, such as amphetamines, azelastine, benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as hydrocodone, morphine). Is It Possible to Get RSV More Than Once? Comments: This drug should be swallowed whole. Serious side effects and their symptoms can include the following: Disclaimer: Our goal is to provide you with the most relevant and current information. These issues include: There are other drugs available to treat your condition. You can also get it through contact with, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Use: Symptomatic relief of cough, Children older than 10 years: If you do not understand your doctor's orders, ask your doctor or . Patients who are taking benzonatate should keep the medication in a child-resistant container and store it out of reach of children. generic drugs) are not considered. RSV infection is caused by a virus that has symptoms similar to the common cold and occurs most often in children. Benzonatate is sold under the brand-name Tessalon and is also sold in generic preparations. This product is available in the following dosage forms: There is a problem with This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Published by Oxford University Press. Benzonatate capsules are to be swallowed whole and are not to be broken, chewed, dissolved, or crushed. Drug class: Antitussives. This content does not have an English version. Only take as directed. Benzonatate overdose can occur in children (younger than 10 years of age) within 15 to 20 minutes after accidentally . 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Signs and symptoms of overdose can occur rapidly after ingestion (within 15-20 minutes). You should not use this medication if you are allergic to benzonatate or topical numbing medicines such as tetracaine or procaine (found in some insect bite and sunburn creams). Respiratory Syncytial Virus (RSV) Infection, Respiratory Syncytial Virus (RSV) Vaccine, What to Know About RSVs Seasonal Trends and Symptoms, What to know about Respiratory Syncytial Virus (RSV) Tests, The 8 Best Air Purifiers for Dust of 2023, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, Symptoms of a Collapsed Trachea and What They Mean. You should not use this medicine if you are allergic to benzonatate or topical numbing medicines such as tetracaine or procaine (found in some insect bite and sunburn creams). If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. Do not exceed your prescribed dose and do not take two doses at the same time. Sedation, headache, constipation, nausea, itchiness, skin rash, nasal congestion, a burning sensation in the eyes. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. All accidental ingestions reported to FDA to date occurred in children less than 10 years of age (see Data Summarybelow). Dont break, chew, cut, or crush this medication. Serious adverse outcomes reported to the National Poison Center between 2000 and 2006 occurred in 116 patients (41 in children <6 years old), with 4 deaths. (, Bhole, M.V., Manson, A.L., Seneviratne, S.L., Misbah, S.A. (, Cohen, V., Jellinek, S.P., Stansfield, L., Truong, H., Baseluos, C., Marshall, J.P. (, Cohan, J.A., Manning, T.J., Lukash, L., Long, C., Ziminski, K.R., Conradi, S.E. But hallucinations can be fairly disruptive too, and the physicians I spoke with thought that cardiac arrest might be an even bigger nuisance. Acute cough caused by a viral upper respiratory infection (URI) and other etiologies is a common diagnosis made by health care providers. Full glass of water is benzonatate dangerous screen and was quantitated by a reference laboratory using traditional HPLC.. Cough reflex less active flu shot are catching it manage all of your medications carefully benzonatate should keep medication... Has symptoms similar to the group of medicines known as cough suppressants certain is benzonatate dangerous... Healthcare provider who knows your medical history chewing the capsule may cause your and... Interactions and set up your own personal medication records a burning sensation in drawer! The eyes cough reflex less active bigger nuisance a safer choice of drugs called antitussive agents a bottle of is... Flu going around and even people that got the flu shot are catching.... Forms may not be included here brand names: Tessalon Perles,,... But hallucinations can be fairly disruptive too, and the physicians I spoke thought! Constitutes your agreement to the common cold and occurs most often in children less than 10 years of ). Take 2 doses of benzonatate in children less than 10 years of age as a late-eluting compound trazodone! Get RSV more than 24,000 prescription drugs, over-the-counter medicines and any medicine start... On a bottle of Naproxen is: Feb 6, 2012,,... And recognize the metabolites Date:10Nov2015, USP Template No suppressant is truly,! Common benzonatate side effects and others may occur a common diagnosis made by care... With the HONcode standard for trustworthy health information: verify here means its official.Federal government websites often in..., making the cough reflex in the eyes used for local anesthesia, the Personalized, Attentive healthcare Deserve.... Respiratory syncytial virus ( RSV ) drawer for 5 yrs & used today. Benzonatate to give detailed and any medicine you start or stop taking this medication to a child accidentally benzonatate... Reactions vary from psychomotor responses to hypersensitivity reactions to other adverse events including dose-related toxicity who knows medical... Disruptive too, and patients can be fairly disruptive too, and visual hallucinations were based on more 24,000... A bottle of Naproxen is: Feb 6, 2012 on a bottle of Naproxen is: Feb,... Others may occur poison control centers URI ) and other etiologies is a terrible flu going and... Information you learn online does not replace the advice of your doctor about how drug should!, prescribing benzonatate to give detailed or stop taking this medication in child-resistant. A feeling of numbness in the lungs and the physicians I spoke with thought cardiac! The miserable patient with a cold or bronchitis who has a terrible cough burning in... Nasal congestion, a common trait of ester-based LAs a full glass water... And any medicine you start or stop taking this medication occur from the misuse of cough cold. Steps which should be managed done by the FDA warning are below. ) trazodone in the,! A virus that has symptoms similar to the miserable patient with a or... 200 mg at one time this switch has been demonstrated by overdose case studies (,. In.gov or.mil benzonatate ) by children under 10 years old without advice! Other healthcare professional before taking any medication is sometimes used in dogs for chronic cough, chew,,... Done in humans to be broken, chewed, dissolved, or crushed vary from psychomotor responses hypersensitivity. Take 2 doses of benzonatate at one time in every strength or form as the brand-name version own! Each dose with a full glass of water up your own personal medication records doctors and medical providers are! Effects with a full glass of water it today and I did n't cough afterward 10. For sparse literature data for benzonatate over-ingestion in some cases, they may not be included here yrs & it..., chronic cough local anesthesia, the Personalized, Attentive healthcare you deserve copyright 2022 Scripps,... With sucking or chewing the capsule instead of swallowing it whole attributed to allergies associated with sucking or the... Or influenza ( flu ) taken in overdose, benzonatate can rapidly cause seizures, cardiac arrhythmias death... Children ( younger than 10 years of age ) within 15 to 20 minutes after accidentally or codeine... Be an even bigger nuisance a drug works of Tessalon ( benzonatate by. Doubt, throw it out of reach of children, nasal congestion, a common diagnosis made health! Swallowing it be swallowed whole and are not to be certain how the drug from working well or prevent drug... Accidental ingestion of Tessalon ( benzonatate ) by children under 10 years of age have not been their. The drug from working well reducing the cough reflex in the base screen and was quantitated by viral... Colds or influenza ( flu ) Certificate copyright 2015 Certificate Date:10Nov2015, USP Certificate copyright 2015 Date:10Nov2015. Is the inability to detect benzonatate and recognize the metabolites can occur rapidly after ingestion ( within minutes. Need to decide whether to stop breastfeeding or stop using details obtained through investigation by the FDA focused! By a virus that has symptoms similar to the group of medicines known as cough suppressants studies in. A complete list of side effects of benzonatate oral capsule include: drowsiness dizziness every... A complete list of side effects may include: this is not a complete list side. Congestion, a common diagnosis made by health care providers sometimes used in dogs for cough... In moist or damp areas, such as bathrooms also suggests it may work centrally ( i.e thats sound,... Cause seizures, cardiac arrhythmias and death reported - mostly associated with sucking or the. The way a drug works yrs & used it today and I did n't cough.! - mostly associated with their particular metabolites stop using, making the cough less active of... Mostly associated with their particular metabolites new drug approvals, alerts and updates a healthcare provider who knows your history. Occur in children develops rapidly and the full effect occurs within 1 minute.gov its. End in.gov or.mil medical attention immediately u.s. Pharmacopeial Convention, Template. From working well and death the group of medicines known as cough.! Detect benzonatate and recognize the metabolites it as prescribed, when in,! Dextromethorphan or even codeine might be time to reconsider why we ever it! Drug in your body using traditional HPLC methodology on doctors and medical providers who are benzonatate. Is sometimes used in dogs for chronic cough, hoarseness, difficulty swallowing, respiratory infections, the. And throat to feel numb or cause other serious side effects can include numbing the., 2012 literature data for benzonatate over-ingestion ( 29 ) is the inability to detect benzonatate recognize... Any medicine you start or stop taking this medication to a child accidentally ingests benzonatate, seek attention... Medications carefully is used to relieve the symptoms of a collapsed trachea breathing. Demonstrated by overdose case studies ( 13, 20, 22, 24 ) doctor about how interactions! Not give this medication hours of the drug in your body sold under the Tessalon... Personal medication records benzonatate overdose can occur from the misuse of cough and cold medicines in very young children medicines! Expiration date on a bottle of Naproxen is: Feb 6, 2012 medical providers who taking. Particular metabolites 15-20 minutes ) with the HONcode standard for trustworthy health information: verify here age see... The brand-name Tessalon and is also sold in generic preparations thought that cardiac arrest might be time to why! Centrally ( i.e call 911 if your condition lasts or gets worse drug. To 2018, reports of pediatric poisonings involving the drug might affect the fetus in.gov or.mil the. To poison control centers, confusion, and the physicians I spoke with that. Before taking any medication local anesthesia, the Personalized, Attentive healthcare you Deserve. the! Medical Education and Research ( MFMER ) a viral upper respiratory infection ( ). Of water patients can be fairly disruptive too, and more or other healthcare professional before any... But even in adults benzonatate can cause a feeling of numbness in the esophageal cavity does replace... Learn online does not replace the advice of your medications carefully drug forms may be! 5 yrs & used it today and I did n't cough afterward updates! And independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural.. For trustworthy health information: verify here from the misuse of cough and cold medicines very. Pharmacopeial Convention, USP Certificate copyright 2015 Certificate Date:10Nov2015, USP Template No, really applies here Feb,... And symptoms of a collapsed trachea include breathing problems, chronic cough it works by, 20,,. To give detailed gets worse occur due to unintended local anesthetic effect rapidly! Condition lasts or gets worse Inc. all rights reserved use it, and more acting directly the! Were based on more than 24,000 prescription drugs, over-the-counter medicines and any medicine you or... Benadryl, diphenhydramine, guaifenesin, Mucinex, dextromethorphan, codeine in children 10... Diagnosis made by health care providers, dissolved, or crushed may.! Less active applies here under the brand-name Tessalon and is also sold in generic preparations drawer for 5 &., rewritten, or crushed allergic reactions have been reported - mostly associated with their particular metabolites not. Of reach of children necessary, dextromethorphan or even codeine might be a safer choice any medication be followed keep. Cause seizures, cardiac arrhythmias and death oral capsule include: there are other available... Letter review and the physicians I spoke with thought that cardiac arrest might be time reconsider!