What is benzonatate used for and is it safe with other drugs?

Benzonatate is a non-narcotic cough suppressant prescribed to relieve coughs caused by the common cold, bronchitis, pneumonia, or other respiratory conditions. Unlike opioid antitussives (such as codeine), benzonatate works by numbing the stretch receptors in the lungs and airways, reducing the cough reflex at its source (Dicpinigaitis, 2010).

Key Uses of Benzonatate
• Relief of cough severity and frequency in adults and children over 10 years old
• Symptomatic management in acute respiratory infections (bronchitis, pneumonia)
• Adjunctive therapy when non-drug measures (humidification, hydration) are insufficient

How It Works
• Benzonatate’s shell contains beaded capsules. After swallowing, it dissolves in the gastrointestinal tract.
• The active drug circulates in the bloodstream and anesthetizes (numbs) the nerve endings in the lungs and airways.
• By reducing the sensitivity of these nerves to mechanical and chemical stimuli, benzonatate diminishes the urge to cough.

Dosage and Administration
• Typical adult dose: 100 mg to 200 mg taken three times daily as needed, up to a maximum of 600 mg per day.
• Capsules must be swallowed whole—do NOT chew, crush, or dissolve in the mouth. Chewing can release too much drug at once, causing serious side effects.
• If a dose is missed, take it as soon as you remember, unless it’s almost time for your next dose. Do not double up.

Safety and Potential Side Effects
Most people tolerate benzonatate well when used as directed. Common side effects include:
• Drowsiness or dizziness
• Constipation
• Nasal congestion
• Nausea

Rare but serious reactions (seek immediate medical attention if they occur):
• Allergic reactions: rash, itching, swelling of face or throat, difficulty breathing
• Severe drowsiness, confusion, hallucinations
• Numbness of mouth, chest, or throat

Accidental Exposures in Children
Capsules look like candy, posing a poisoning risk if a child chews or swallows them accidentally. Between 2004 and 2009, 31 cases of benzonatate exposure in young children were reported, some requiring hospitalization and resulting in severe neurological symptoms (Shah, Spiller & Ackerman, 2010). To prevent accidental ingestion:
• Store capsules out of reach and sight of children.
• Keep the medicine in its original child-resistant container.
• Educate caregivers about proper handling.

Drug Interactions and Safety with Other Medications
Benzonatate has relatively few known drug interactions, but caution is advised when combining it with other central nervous system (CNS) depressants or local anesthetics:
• CNS Depressants (e.g., benzodiazepines, sedating antihistamines): May increase drowsiness or dizziness. Use caution when driving or operating machinery.
• Local Anesthetics (e.g., tetracaine, lidocaine): In theory, combining other anesthetics with benzonatate could amplify numbness or lead to toxicity. Monitor for unusual numbness beyond the respiratory tract.
• Monoamine Oxidase Inhibitors (MAOIs) and Tricyclic Antidepressants: No direct interaction has been firmly established, but both classes can affect metabolism of other drugs. Inform your doctor about all prescription and over-the-counter medications.

Use in Liver and Kidney Impairment
Although benzonatate is metabolized by the liver, there is limited data on dose adjustments in liver cirrhosis (Tsochatzis, Bosch & Burroughs, 2014). If you have liver or kidney disease:
• Discuss your condition with your physician before starting benzonatate.
• Monitor for increased side effects, as reduced clearance could lead to higher blood levels.
• Your doctor may choose a lower starting dose or an alternative cough suppressant.

Special Populations
• Pregnancy and Breastfeeding: Animal studies have shown no clear risk, but human data are lacking. Use only if benefits outweigh potential risks.
• Elderly Patients: May be more sensitive to side effects such as sedation or confusion. Start at the lower end of the dosing range.
• Children Under 10 Years: Safety and effectiveness have not been established. Do not prescribe to this age group.

Safe Use Tips
• Never share your prescription—dosages and tolerances vary.
• Swallow capsules whole with water; do not chew to avoid rapid release of the drug.
• Report any unusual sensations—numbness of the mouth, chest pain, or signs of an allergic reaction—immediately.

When to Seek Help
If you experience any of the following, seek medical attention without delay:
• Severe allergic reaction (swelling of face/throat, difficulty breathing)
• Confusion, hallucinations, or extreme drowsiness
• Persistent chest pain or numbness
• Signs of overdose: tremors, seizures, rapid heartbeat

If you’re unsure whether benzonatate is right for your cough—or if you’re experiencing new or worsening symptoms—you might consider doing a free, online "symptom check for " to get more information and guidance.

In Summary
Benzonatate is a useful, non-opioid antitussive that numbs lung and airway receptors to suppress cough. When taken exactly as prescribed, it is generally safe and well tolerated. Be mindful of potential interactions with other CNS depressants or local anesthetics, and store capsules securely to prevent accidental ingestion by children. Always inform your healthcare provider about all medications and health conditions—including liver or kidney issues—before starting benzonatate.

Speak to a doctor about anything that could be life threatening or serious. If you have questions about benzonatate’s safety, interactions, or suitability for your condition, consult your healthcare provider.