Generic Name

Benzonatate

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Classification

FDA Approved Indications

• relief of cough

Mechanism of Action

Benzonatate works by anesthetizing stretch receptors in the respiratory passages, lungs, and pleura, suppressing cough reflex eventually.

Dosage and Administration

Adult: Pediatric (≥10 years): 100 mg three times daily as needed; max dose 600 mg/day. Geriatric: no specific dose adjustment, but monitor closely.

Pediatric: Not recommended for children under 10 years old due to risk of adverse effects.

Geriatric: Use with caution; start at lower end of dosing range and monitor.

Renal Impairment: Use with caution; no specific dose adjustment but monitor for adverse effects.

Hepatic Impairment: Use caution; no specific dose adjustment suggested.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Primarily metabolized by ester hydrolysis in the plasma and liver.

Excretion: Metabolites excreted mainly in urine.

Half Life: Approximately 3 hours.

Contraindications

• Hypersensitivity to benzonatate or ester-type local anesthetics.

Precautions

• Use cautiously in patients with allergy to anesthetics; Risk of accidental overdose; Not recommended in children under 10 years due to risk of serious adverse effects, including death.

Adverse Reactions - Common

• Drowsiness (Common)
• Dizziness (Less common)
• Nausea (Less common)

Adverse Reactions - Serious

• Choking sensation, hypersensitivity reactions, hallucinations, confusion, seizures (Rare but serious; can be fatal in overdose.)

Drug-Drug Interactions

• CNS depressants may enhance sedative effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Do not chew or dissolve capsules. Take with water.
• Notify healthcare provider of any unusual side effects such as hallucinations or difficulty breathing.
• Keep out of reach of children due to overdose risk.

Special Considerations

Black Box Warnings:

• Serious and sometimes fatal adverse effects if capsules are chewed or dissolved in the mouth.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Dizziness, hallucinations, seizures, cardiac arrest.

Treatment: Supportive care; administer activated charcoal if ingestion is recent; manage seizures with anticonvulsants; in severe cases, consider airway management and resuscitation.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable under normal conditions.