Benzonatate

Pronunciation: ben-ZOH-na-tate.

Generic name: benzonatate
Drug class: Non-narcotic oral antitussive (cough suppressant), chemically related to local anesthetics (tetracaine-like structure)
Form: Liquid-filled capsule ("perle"), 100 mg, 150 mg, or 200 mg
Route: Oral
Legal status: Prescription-only (United States); regulatory status unable to be verified in the other 5 standard markets reviewed

Availability and supply rules vary by country

Trade names by country: United States

Boxed warning: Serious risk from chewing/sucking the capsule, and fatal accidental poisoning in children

Severe hypersensitivity reactions (including bronchospasm, laryngospasm, and cardiovascular collapse) have been reported, possibly related to local anesthesia from sucking or chewing the capsule instead of swallowing it whole; some reactions have required treatment with vasopressor medicines and other supportive care. Isolated instances of bizarre behaviour, including mental confusion and visual hallucinations, have been reported in patients taking benzonatate together with other prescribed drugs. Accidental ingestion of benzonatate has resulted in death in children younger than 10 years old. Signs and symptoms of overdose have been reported within 15 to 20 minutes of ingestion, and death has been reported within 1 hour. Benzonatate must be kept out of the reach of children, and capsules must always be swallowed whole -- never chewed, broken, dissolved, cut, or crushed. (1)

What benzonatate is and how it works

Benzonatate is a prescription-only, non-narcotic medicine used to relieve cough. Unlike opioid cough suppressants, it works locally by numbing stretch receptors in the airways and lungs rather than acting mainly through the brain's cough center, though it does have some central effect too. (1)

Take benzonatate exactly as your prescriber directs, and always swallow the capsule whole -- never chew, suck, break, dissolve, cut, or crush it. This medicine carries a genuine, serious safety warning: even a small amount released in the mouth, or accidentally swallowed by a child, can cause rapid and potentially fatal poisoning. Store it safely out of the reach of children at all times.

Mechanism of action: how benzonatate works

Benzonatate is structurally related to tetracaine-type local anesthetics. It anesthetizes stretch ("J") receptors in the respiratory passages, lungs, and pleura, dampening vagal afferent activity and thereby reducing the cough reflex at its peripheral source, with additional central antitussive activity. Onset is within about 15-20 minutes and effects last roughly 3-8 hours. (1)

What benzonatate is used for

Symptomatic relief of cough

Used for short-term relief of cough from any cause. It is prescribed for adults and children over the age of 10. (1)

Before taking benzonatate

Do not take / not appropriate for

Do not take benzonatate if you have had a hypersensitivity (allergic) reaction to benzonatate or to related local-anesthetic-type compounds. (all countries) (1)
Never chew, suck, break, dissolve, cut, or crush the capsule -- always swallow it whole. Releasing the contents in the mouth can cause numbness, choking, and severe allergic-type reactions. (all countries) (1)

Tell your clinician about

Any allergy or unusual reaction to benzonatate or local-anesthetic-type medicines in the past.
All other medicines you take, especially anything that causes drowsiness (opioids, benzodiazepines, sleep medicines, muscle relaxants, or alcohol), since combining these with benzonatate can increase sedation and confusion.
Whether there are young children in the household, given the serious risk of fatal poisoning from accidental ingestion.
Pregnancy, plans for pregnancy, or breastfeeding.

(1)

How to take benzonatate

Swallow the capsule whole with water. Never chew, suck, break, dissolve, cut, or crush it.
Take as needed for cough, following your prescriber's instructions, typically up to three times a day.
Store the medicine well out of the reach and sight of children at all times -- accidental ingestion by a young child can be fatal within about an hour.

(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4)

Missed dose

Benzonatate is usually taken as needed for cough rather than on a strict fixed schedule. If your prescriber gave you a specific dosing schedule and you miss a dose, contact your prescriber or pharmacist for guidance rather than doubling a later dose.

Overdose

Benzonatate overdose is a genuine medical emergency, especially in children, and can progress extremely quickly -- symptoms have been reported within 15 to 20 minutes of ingestion and death within about an hour. Call emergency services or a poison control centre immediately if you suspect an overdose or accidental ingestion, especially by a child, even if the person seems fine at first. Do not wait for symptoms to appear before seeking help. Do not attempt to make the person vomit unless specifically instructed to do so by emergency medical personnel or poison control. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Sedation and drowsiness.

What to notice: Sedation and drowsiness.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Headache and dizziness.

What to notice: Headache and dizziness.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Constipation, nausea, or upset stomach.

What to notice: Constipation, nausea, or upset stomach.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Itching (pruritus) and nasal congestion.

What to notice: Itching (pruritus) and nasal congestion.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Severe hypersensitivity/local anesthetic-type reaction from chewing or sucking the capsule — boxed_warning

Symptoms: Numbness or tingling in the mouth and throat, difficulty breathing, wheezing, throat tightness, or sudden collapse.

Action: Seek emergency medical help immediately. This reaction has been linked to chewing, sucking, or breaking the capsule instead of swallowing it whole, and some cases have needed emergency treatment with vasopressor medicines. (1)

Accidental ingestion or overdose, especially in children — boxed_warning

Symptoms: Restlessness, tremors, confusion, seizures, or collapse, appearing within 15 to 20 minutes of ingestion.

Action: Call emergency services or poison control immediately -- this can become fatal within about an hour. Keep this medicine out of the reach of children at all times. (1)

Confusion or hallucinations, particularly when combined with other medicines — emergency

Symptoms: Unusual mental confusion, visual hallucinations, or bizarre behaviour.

Action: Seek prompt medical attention. This has been reported in patients taking benzonatate together with other prescribed drugs; tell any treating clinician about all medicines you take. (1)

Interactions

Opioids, benzodiazepines, sedative-hypnotics, muscle relaxants, barbiturates, and alcohol: combining these with benzonatate may increase sedation, dizziness, confusion, and (with some combinations) breathing difficulty. Tell your prescriber about all other medicines and about alcohol use. (3) (1)
Any other prescribed medicine: the boxed warning specifically notes isolated reports of confusion and hallucinations when benzonatate was combined with other prescribed drugs, so tell your prescriber and pharmacist about everything you take. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Benzonatate is classified under the older FDA Pregnancy Category C: animal studies have shown adverse effects on the fetus, and there are no adequate, well-controlled studies in humans. Use only if a prescriber judges the potential benefit justifies the potential risk. (1) (2) (3) (4)

Breastfeeding

There is no published data on whether benzonatate passes into breast milk or its effects on a breastfed infant. If a prescriber decides benzonatate is needed while breastfeeding, an infant should be watched closely for unusual drowsiness, feeding difficulties, or changes in breathing; an alternative cough medicine with more established breastfeeding safety data may be preferred, especially for a newborn or premature infant. (1) (2) (3) (4)

Children

Not recommended for children 10 years of age or younger. The boxed warning specifically describes fatal accidental poisonings in children under 10, so this medicine must be stored securely out of children's reach even in households where an older child or adult is prescribed it. (1) (2) (3) (4)

Elderly

No specific dose adjustment based on age alone is described in the source reviewed, but older adults may be more sensitive to sedation and CNS side effects. (1) (2) (3) (4)

Hepatic_impairment

Not specifically addressed in the source reviewed for this dossier. (1) (2) (3) (4)

Renal_impairment

Not specifically addressed in the source reviewed for this dossier. (1) (2) (3) (4)

Source_ids

US-DAILYMED-BENZONATATE-2026,US-LACTMED-BENZONATATE-NBK615242 (1) (2) (3) (4)

Monitoring

Before starting

Confirm the patient (or caregiver, for a household with young children) understands the capsule must always be swallowed whole
Review of all other medicines, especially anything sedating
Confirm safe, child-proof storage arrangements

During treatment

Watch for any sign of numbness, tingling, or difficulty breathing shortly after taking a dose.
Watch for excess sedation, confusion, or unusual behaviour, especially if other medicines are also being taken.
Keep the medicine locked away or otherwise inaccessible to children throughout the course of treatment.

(1)

Storage

Store at room temperature, away from excess heat and moisture. Keep the container tightly closed and always out of the reach and sight of children -- accidental ingestion by a child has caused death within about an hour in reported cases.

Professional information

Clinician-facing context only, sourced from the current US FDA prescribing information; verify against the current full label before prescribing.

United States

Indication: Symptomatic relief of cough

Dose summary: Adults and children over 10 years: 100 mg orally three times daily as needed; some products available as 150 mg or 200 mg capsules. Maximum 600 mg/day. Capsules must be swallowed whole and never chewed, broken, dissolved, cut, or crushed.

Renal context: Not established in the source reviewed for this dossier. (1)

Mechanism of action

Hepatic guidance

Not established in the source reviewed for this dossier.

Overdose note

Overdose can progress rapidly to restlessness, tremor, seizures, and cardiac arrest. Gastric decontamination is generally not advised given rapid absorption unless polysubstance ingestion is suspected; inducing vomiting is generally avoided because of seizure and aspiration risk. Seizures are managed with a short-acting barbiturate or benzodiazepine, carefully titrated to the smallest effective dose, along with supportive/symptomatic care and cardiorespiratory monitoring. (1)

Frequently asked questions

Why is it so important to swallow the benzonatate capsule whole?

Benzonatate is structurally related to local anesthetics. If the capsule is chewed, sucked, broken, dissolved, cut, or crushed, its contents released in the mouth can cause numbness, choking, and severe allergic-type reactions including difficulty breathing and collapse. It must always be swallowed whole. (1)

Is benzonatate dangerous for children?

Yes -- this is a genuine, serious safety concern. Accidental ingestion of benzonatate has resulted in death in children younger than 10 years old, with symptoms appearing within 15 to 20 minutes and death reported within about an hour. It must always be stored out of the reach and sight of children. (1)

Is benzonatate available outside the United States?

Direct searches of the UK, EU, Canadian, Australian, and New Zealand medicines regulators did not find a confirmed marketing authorisation for benzonatate, and this is honestly reported as 'unable to verify' rather than assumed. It is an established, FDA-approved prescription medicine in the United States. (1) (4)

Can I take benzonatate with sleep medicine, opioids, or alcohol?

Use caution and tell your prescriber. Combining benzonatate with other sedating medicines (opioids, benzodiazepines, sleep aids, muscle relaxants) or alcohol may increase drowsiness, confusion, and dizziness. (3) (1)

What is the mechanism of action of benzonatate?

What is the generic name of Benzonatate?

The generic name is benzonatate. (1)

What class of drug is benzonatate?

Benzonatate is classed as: Non-narcotic oral antitussive (cough suppressant), chemically related to local anesthetics (tetracaine-like structure). (1)

References

BENZONATATE capsule -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-29 · source 1
Benzonatate -- Drugs and Lactation Database (LactMed)LactMed, National Library of Medicine (NIH), hosted on NCBI Bookshelf · United States · accessed 2026-07-29 · source 2
Benzonatate CNS depressant interaction summaryAggregated secondary clinical-reference summaries (drug-interaction checkers/clinical education sources), cross-checked against the boxed-warning mechanism in the US label · Not country-specific · accessed 2026-07-29 · source 3
Benzonatate -- geographic marketing scopeSecondary tertiary reference, cross-checked against absence of results in UK/EU/Canada/Australia/New Zealand official regulator searches performed for this dossier · Not country-specific · accessed 2026-07-29 · source 4

Brand names by country

Single-ingredient benzonatate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

Tessalon / Tessalon Perles (1)FDA approved currently labeled · 100 mg, 150 mg, 200 mg · Various US manufacturers under approved ANDAs; originator brand Tessalon

View brands in additional countries.