Benzonatate

Benzonatate Brand Names- Tessalon Perles | Zonatuss

What is Benzonatate

Benzonatate is an oral nonnarcotic antitussive agent that is chemically related to tetracaine and other ester-type local anesthetics.

Historically, benzonatate has been used to suppress cough associated with acute respiratory conditions like colds and other respiratory tract infections.

While benzonatate has been in use as an antitussive for decades, controlled trials are not available to support the efficacy of the drug when compared to placebo or other antitussive medications; guidelines designate benzonatate as an agent of limited utility.

Case reports suggest that benzonatate might be helpful to palliate chronic cough not responding to opiate agonists, particularly in patients with advanced cancer, but supportive data are limited.

Although not FDA-approved for this purpose, benzonatate has been applied topically to the oropharynx to obliterate the gag reflex prior to intubation or endoscopy.

Tessalon® Perles have also been applied externally to areas of the body prior to magnetic resonance imaging (MRI). This unusual use is unrelated to the pharmacology of the medication.

The three-dimensional capsules are good sources of multiple protons and show up well as ‘markers’ on the MRI image for more accurate mapping and measurement of defined lesions or abnormalities.

Benzonatate was approved by the FDA in 1958.

Indications

  1. cough
  2. endotracheal intubation
  3. singultus (hiccups)
  4. topical anesthesia

Side Effects

  1. anaphylactoid reactions
  2. bronchospasm
  3. chills
  4. confusion
  5. constipation
  6. dizziness
  7. drowsiness
  8. dysphagia
  9. hallucinations
  10. headache
  11. hypotension
  12. laryngospasm
  13. nasal congestion
  14. nausea
  15. ocular irritation
  16. pruritus
  17. rash

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • breast-feeding
  • children
  • driving or operating machinery
  • dysphagia
  • ester local anesthetic hypersensitivity
  • geriatric
  • infants
  • labor
  • neonates
  • obstetric delivery
  • para-aminobenzoic acid, PABA hypersensitivity
  • paraben hypersensitivity
  • potential for overdose or poisoning
  • pregnancy

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Amide local anesthetics
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Articaine; Epinephrine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Belladonna; Opium
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Calcium-channel blockers
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorthalidone; Clonidine
  • Cisatracurium
  • Clevidipine
  • Clonidine
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Doxacurium
  • Enalapril; Felodipine
  • Felodipine
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Isradipine
  • Levobupivacaine
  • Levorphanol
  • Lidocaine
  • Magnesium Salts
  • Meperidine
  • Meperidine; Promethazine
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Mivacurium
  • Monoamine oxidase inhibitors
  • Neuromuscular blockers
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Oxycodone
  • Oxymorphone
  • Pancuronium
  • Perindopril; Amlodipine
  • Prilocaine
  • Prilocaine; Epinephrine
  • Procaine
  • Procarbazine
  • Propofol
  • Propoxyphene
  • Rapacuronium
  • Remifentanil
  • Rocuronium
  • Ropivacaine
  • Saquinavir
  • Succinylcholine
  • Sufentanil
  • Tetracaine
  • Trandolapril; Verapamil
  • Tubocurarine
  • Vancomycin
  • Vecuronium
  • Verapamil
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