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Benzonatate: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on May 18, 2021.

1. How it works

  • Benzonatate may be used to relieve the symptoms of a dry cough.
  • Benzonatate is thought to work by reducing coughing by anesthetizing certain receptors located in the breathing passages and lungs, dampening down their activity, and reducing the cough reflex.
  • Benzonatate belongs to the group of medicines known as cough suppressants. Benzonatate may also be called an anti-tussive.

2. Upsides

  • Used to relieve a dry, irritating cough. Numbs the throat to make the cough less active.
  • Fast-acting. Can be taken up to three times daily. The maximum dosage is 600 mg/day.
  • Not a narcotic.
  • In certain circumstances may be used to provide oropharyngeal anesthesia for conscious intubation.
  • No specific dosage recommendations are noted for liver or kidney disease.
  • Available as a generic.

3. Downsides

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:

  • Sedation, headache, constipation, nausea, itchiness, skin rash, nasal congestion, a burning sensation in the eyes. Generally well tolerated if the capsules are swallowed whole.
  • Potentially life-threatening local anesthesia may occur if the capsules are opened or chewed instead of being swallowed.
  • Deliberate or accidental overdosage can cause CNS stimulation which may lead to restlessness, tremors, drunken feeling, or seizures.
  • Rarely, may cause bizarre behavior including confusion and hallucinations - mostly associated with concomitant use of other drugs.
  • Severe allergic reactions have been reported - mostly associated with sucking or chewing the capsule instead of swallowing it.
  • Overdosage can be fatal, especially in children. Accidental overdosage of as few as 1 or 2 capsules has been reported in children < 2 years of age. Deaths have been reported within hours of the accidental ingestion.
  • Not recommended during pregnancy; only use if benefits outweigh risks. It is not known if benzonatate is distributed into breastmilk.

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. View complete list of side effects

4. Bottom Line

Benzonatate relieves a dry cough; however, the capsules must be swallowed whole because the risk of a fatal overdosage is increased if the capsules are opened in any way.

5. Tips

  • Swallow the capsule whole. Do not suck, chew, crush, cut, or break open as this can cause overdosage.
  • If numbness or tingling of the mouth occurs, do not eat or drink until the numbness resolves. Seek medical attention if it does not resolve. Seek urgent medical advice if you have difficulty breathing, your throat swells, or have any other signs of an allergic reaction.
  • Only take as directed. Do not exceed a single dose of 200mg or a total daily dose of 600mg. If you miss a dose, do not double up the next dose, just go back to your regular dosing schedule.
  • Keep out of reach of children. If children accidentally take benzonatate seek medical attention immediately. Signs and symptoms of overdosage include tremors, convulsions, coma, and heart attack.
  • Do not give to children aged less than 10.
  • Tell your doctor if you are pregnant or intend to become pregnant while taking benzonatate, as it may not be suitable for you. It is not known if it is safe to breastfeed while taking benzonatate.

6. Response and effectiveness

  • Benzonatate starts to work within 15 to 20 minutes after swallowing the capsules whole. The effects last for 3 to 8 hours.
  • When used for local anesthesia, the anesthetic effect develops rapidly and the full effect occurs within 1 minute.

7. Interactions

Medicines that interact with benzonatate may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with benzonatate. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

There are no known significant interactions with benzonatate. However, because it causes side effects such as constipation, sedation, and nausea, interactions may be likely with:

  • 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)
  • other medications that may also upset the gastrointestinal tract, such as prednisone or NSAIDs (such as ibuprofen or naproxen).

Avoid drinking alcohol or taking illegal or recreational drugs while taking benzonatate.

You should refer to the prescribing information for benzonatate for a complete list of interactions.

References

Benzonatate. Revised 05/2021. AHFS DI Essentials. https://www.drugs.com/monograph/benzonatate.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use benzonatate only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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