Benzonatate, sold under the brand name Tessalon.

A medication used for the symptoms of cough and hiccups.

It is taken by mouth.

Effects generally begin within 20 minutes and last up to eight hours.

Elimination half-life 3-8 hours.

Side effects: sleepiness, dizziness, headache, upset stomach, skin rash, hallucinations, allergic reactions, constipation,, fatigue, stuffy nose, nausea, and headache.

Sedation, a feeling of numbness in the chest, sensation of burning in the eyes, a vague chilly sensation, itchiness, and rashes are also possible.

Excessive doses may cause seizures, irregular heartbeat, and death.

Chewing or sucking on the capsule can lead to laryngospasm, bronchospasm, and circulatory collapse.

Life-threatening adverse effects when the medication is absorbed by the oral mucosa, including choking, hypersensitivity reactions, and circulatory collapse.

It is unclear if use in pregnancy or breastfeeding is safe.

Mechanism of action: numbs stretch receptors in the lungs and suppresses the cough reflex in the brain.

100mg generic Benzonatate capsules

Benzonatate is a prescription non-opioid alternative for the symptomatic relief of cough.

It improves cough associated with a variety of respiratory conditions including asthma, bronchitis, pneumonia, tuberculosis, pneumothorax, opiate-resistant cough in lung cancer, and emphysema.

It also reduces the consistency and volume of sputum production associated with cough in those with chronic obstructive pulmonary disorder.

Compared to codeine, it is more effective in reducing the frequency of induced cough in experiments.

Benzonatate does not treat the underlying cause of the cough.

Has use in the suppression of hiccups.

It can act as a local anesthetic and the liquid inside the capsule can be applied in the mouth to numb the oropharynx for awake intubation.

Generally well-tolerated if the liquid-capsule is swallowed intact.

Ingestion of a small handful of capsules has caused seizures, cardiac arrhythmia, and death in adults.

It is structurally related to anesthetic medications of the para-aminobenzoic acid (PABA) class which includes procaine and tetracaine.

Capsule should be swallowed whole, as crushing or sucking on the liquid-filled capsule, will cause release of benzonatate from the capsule and can produce a temporary local anesthesia of the oral mucosa, with

development of numbness of the tongue and choking can occur.

In severe cases, excessive absorption can lead to laryngospasm, bronchospasm, seizures, and circulatory collapse.

There is a potential for these adverse effects to occur after dose, that is, a single capsule, if chewed or sucked on in the mouth.

Bizarre behavior, mental confusion, and visual hallucinations have been reported during concurrent use with other prescribed medications.

Safety and efficacy in children below the age of 10 have not been established, and accidental ingestion resulting in death has been reported in children below the age of 10, and chewing or sucking of a single capsule can cause death of a small child.

Within 15–20 minutes of ingestion restlessness, tremors, convulsions, coma, and cardiac arrest may occur.

Death has been reported within one hour of ingestion.

Benzonatate is classified by the U.S. Food and Drug Administration (FDA) as pregnancy category C: not known if benzonatate can cause fetal harm to a pregnant woman or if it can affect reproduction capacity.

It is not known whether benzonatate is excreted in  breast milk.

Benzonatate is chemically similar to other local anesthetics such as tetracaine and procaine, sharing their pharmacology and toxicology.

Overdose is characterized by symptoms of restlessness, tremors, seizures, cardiac arrhythmia, cerebral edema, apnea, tachycardia, and in severe cases, coma and death.

Treatment: removal of gastric contents and on managing symptoms of sedation, convulsions, apnea, and cardiac arrhythmia.

The safety margin of benzonatate is narrow.

Toxicity above the therapeutic dose is relatively low.

 The ingestion of a few pills can cause symptoms of overdose.

Children are at an increased risk for toxicity, which have occurred with administration of only one or two capsules.

Similar to other local anesthetics, benzonatate is a potent voltage-gated sodium channel inhibitor.

Benzonatate acts as a local anesthetic, decreasing the sensitivity of vagal afferent fibers and stretch receptors in the bronchi, alveoli, and pleura in the lower airway and lung: dampening their activity and reduces the cough reflex.

Benzonatate also has central antitussive activity on the cough center in central nervous system at the level of the medulla: It has is minimal inhibition of the respiratory center at a therapeutic dosage.

The antitussive effect of benzonatate begins within 15 to 20 minutes after oral administration and typically lasts between 3 and 8 hours.

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