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the danger of tessalon perles



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This seemingly benign medication can have a deadly result.  Cardiac collapse, seizures and bronchospasm are serious side effects of Benzoatate overdose.  I have listed several references from different sites for your reference.  If you know of someone who takes Tessalon Perles, please make sure they do not chew or bite them.  I cannot say that this is what happened to Lisa, but I cannot think of anything short of an asthma attack that would have killed  her.  Stay informed about your medications!  If you take prescription medications, always carry a list with you that includes the medication, the dose in mg and the frequency.

Benzonatate <genindx>Benzonatate (Tessalon Perles)
Pregnancy Category: C Tessalon Perles (Rx)

Classification: Antitussive, nonnarcotic

Action/Kinetics: Acts peripherally by anesthetizing stretch receptors in the respiratory passages, lungs, and pleura, thus depressing the cough reflex at its source. No effect on the respiratory center in the doses recommended. Onset: 15-20 min. Duration: 3-8 hr.

Uses: Symptomatic relief of cough.

Contraindications: Sensitivity to benzonatate or related drugs such as procaine and tetracaine.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been determined in children less than 10 years of age.

Side Effects: Hypersensitivity reactions: Bronchospasm, laryngospasm, CV collapse. GI: Nausea, GI upset, constipation. CNS: Sedation, headache, dizziness, mental confusion, visual hallucinations. Dermatologic: Pruritus, skin eruptions. Miscellaneous: Nasal congestion, sensation of burning in the eyes, "chilly" sensation, numbness of the chest.

Overdose Mangement: Symptoms: Oropharyngeal anesthesia if capsules are chewed or dissolved in the mouth. CNS stimulation, including restlessness, tremors, and clonic convulsions followed by profound CNS depression. Treatment: Evacuate gastric contents followed by copious amounts of activated charcoal slurry. Due to depressed cough and gag reflexes, efforts may be needed to protect against aspiration of gastric contents and orally administered substances. Treat convulsions with a short-acting IV barbiturate. Do not use CNS stimulants. Support of respiration and CV-renal function.

How Supplied: Perles: 100 mg.

Capsules (Perles) Antitussive.
Adults and children over 10 years of age: 100 mg t.i.d., up to a maximum of 600 mg/day.

Copyright 2000 Delmar, A division of Thomson Learning - All Rights Reserved


  Generic Name: benzonatate (oral) (ben ZOE na tate)
Brand Names: Tessalon

What is the most important information I should know about benzonatate?

   Do not suck or chew the capsules. Swallow them whole. Sucking or chewing the capsules may cause the mouth and throat to feel numb or frozen, and choking may occur. 

What is benzonatate?

   Benzonatate is a local anesthetic. It numbs or reduces feeling in the throat and lungs. 
   Benzonatate is used to relieve coughing. 
   Benzonatate may also be used for purposes other than those listed in this medication guide. 


What should I discuss with my healthcare provider before taking benzonatate?

   Do not take benzonatate without first talking to your doctor if you have ever had an allergic reaction to it or to other topical anesthetic agents such as tetracaine or procaine (found in some insect bite and sunburn creams). 
   Benzonatate is in the FDA pregnancy category C. This means that it is not known whether benzonatate will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. 
   It is also not known whether benzonatate passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. 
   The safety and effectiveness of benzonatate have not been established for children younger than 10 years of age. 

How should I take benzonatate?

   Take benzonatate exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. 
   Take each dose with a full glass of water. 
   Do not suck or chew the capsules. Swallow them whole. Sucking or chewing the capsules may cause the mouth and throat to feel numb or frozen, and choking may occur. 
   Store benzonatate at room temperature away from moisture and heat. 


What happens if I miss a dose?

   Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. 


What happens if I overdose?

   Seek emergency medical attention. 
   Symptoms of an overdose of benzonatate include numbness in the mouth or throat, restlessness, tremor or shaking, seizures, and death. 


What should I avoid while taking benzonatate?

   Do not suck or chew the capsules. Swallow them whole. Sucking or chewing the capsules may cause the mouth and throat to feel numb or frozen, and choking may occur. 


What are the possible side effects of benzonatate?

   Stop taking benzonatate and seek emergency medical attention or contact your doctor immediately if you experience 
       an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); 
       choking from chewing or sucking on the capsules; or 
       confusion or hallucinations. 
   Other, less serious side effects may be more likely to occur. Continue to take benzonatate and talk to your doctor if you experience 
       nausea, stomach upset, constipation; or 
   Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. 


What other drugs will affect benzonatate?

   Talk to your doctor or pharmacist before taking any other prescription or over-the-counter medicines, including herbal products during treatment with benzonatate. 


Where can I get more information?

   Your pharmacist has more information about benzonatate written for health professionals that you may read. 
   Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed 
   The information in this leaflet is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist. 

1996-2001 Multum Information Services Inc. Version: 5.03. Revision date: 7/23/02.


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Brand name:


Pronounced: TESS-ah-lon
Generic name: Benzonatate

Why is this drug prescribed?

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Tessalon is taken for relief of a cough.

Most important fact about this drug

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Tessalon should be swallowed whole, not chewed.

How should you take this medication?

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Tessalon perles (soft capsule form) should be swallowed whole. If chewed, they can produce a temporary numbness of the mouth and throat that could cause choking or a severe allergic reaction.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never double the dose.

--Storage instructions...

Store Tessalon at room temperature.

What side effects may occur?

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Side effects cannot be anticipated. If any occur or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe to continue taking Tessalon.

  • Side effects may include:
    Allergic reactions, burning sensation in the eyes, constipation, dizziness, extreme calm (sedation), headache, itching, mental confusion, nausea, numbness in chest, skin eruptions, stuffy nose, upset stomach, vague "chilly" feeling, visual hallucinations

Why should this drug not be prescribed?

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Tessalon should not be used if you are sensitive to or have ever had an allergic reaction to benzonatate or similar drugs (such as local anesthetics).

Special warnings about this medication

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Remember to swallow Tessalon perles whole.

Possible food and drug interactions when taking this medication

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There have been rare occurrences of bizarre behavior, including confusion and visual hallucinations, when Tessalon is taken with other prescribed drugs. Check with your doctor before taking Tessalon with other medications.

Special information if you are pregnant or breastfeeding

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The effects of Tessalon during pregnancy have not been studied adequately. Tessalon should be used during pregnancy only if clearly needed. If you are pregnant or plan to become pregnant, notify your doctor immediately. It is unknown if Tessalon appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to stop breastfeeding until your treatment with Tessalon ends.

Recommended dosage

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The usual dose is a 100-milligram perle 3 times per day, as needed. The maximum dose is 600 milligrams, or 6 perles, a day.


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If capsules are chewed or allowed to dissolve in the mouth, numbness of the mouth and throat will develop rapidly. Symptoms of restlessness and tremors may be followed by convulsions.

If you suspect a Tessalon overdose, seek medical attention immediately.



(ben zoe' na tate)

Brand name(s): Tessalon Perles

Contents of this page:

Why is this medication prescribed?

Benzonatate is used to treat cough due to the common cold, bronchitis, pneumonia, or other lung infections. It also is used for cough from chronic conditions, such as asthma.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Benzonatate comes as a liquid-filled capsule (perle) to take by mouth. It usually is taken three times a day, but your doctor may tell you to take this drug up to six times per day. The capsule should not be chewed, crushed, or allowed to dissolve in your mouth. The liquid inside may make your mouth numb, which can lead to choking and/or an allergic reaction. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take benzonatate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

What special precautions should I follow?

Before taking benzonatate,

  • tell your doctor and pharmacist if you are allergic to benzonatate, tetracaine, or any other drugs.
  • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including vitamins.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking benzonatate, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking benzonatate.
  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.

What special dietary instructions should I follow?

Benzonatate may cause an upset stomach. Take benzonatate with food or milk.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Although side effects from benzonatate are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

  • upset stomach
  • vomiting
  • drowsiness
  • nasal congestion
  • headache
  • dizziness
  • confusion
  • constipation

If you experience any of the following symptoms, call your doctor immediately:

  • rash or hives
  • itching
  • difficulty breathing or swallowing
  • hallucinations
  • burning sensation in the eyes

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

  • restlessness
  • tremors
  • seizures
  • unconsciousness

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Last Revised - 01/01/2003